Kaiser WLA

N

to page: 2500 BBBB CCCC#

Info

Deaths

• Document whether or not "coroner's case", if yes you MUST contact the coroner.

• If non-member, document whether you contacted PMD and/or POMD to sign death certificate.

• If member, leave message on PMD voicemail, generally will sign death certificate.

Outpt

• Suture/abscess >13yo: follow up in UC, no appt needed.

• Suture <13yo: wound check and suture removal in peds clinic. Walk-in peds clinic 5-830. If parent calls before 7am they will get same day appt.

• Abscess <13yo: FU in ED

Fx

Nasal fractures: ENT
other Facial fractures (includ mandible): Plastics

Urology

Painless Hematuria
- CT urogram: In ED if active painless bleeding AND only if pt has gross hematuria, sig drop Hct, or anemic from bleeding.
- if not active bleeding -> outpatient CT urogram & outpt urology referral
- 20 F 3way cath for irrigation.

Kidney Stones
- CT KUB
- Uric acid stones cannot be seen on KUB, must use CT
- urine strainer for dc pt's, urology WANTS stone for analysis
- Tamulosin preferred agent, if already on hytrin then no just keep them on it

UTI
- Urine Culture all recurrent UTI. (Many times it is not a UTI and the culture helps them when seeing the patient in clinic)

General
1. Our standard foley catheters are 16 F coudet catheters. If the patient has a prior stricture, surgery, TURP then do not keep attempting to place a larger catheter. This will just cause trauma and bleeding. Call urology. In the case of BPH a LARGER catheter may pass more easily
2. If a patient is post op, please do NOT have the RN's automatically place a foley in triage. This may be contraindicated after certain surgeries
3. Please DO NOT tell patients to go to urology clinic without an appointment. Send a referral or direct book the patient. Later the same day or the next day may be too soon. For example, a kidney stone patient should be seen in 2-3 days to allow time for the stone to pass. They won't change management if seen later the same day or the next day.