Diferencia entre revisiones de «Harbor: Hyperbaric Transfers»

Revisión del 22:09 28 feb 2023

Hyperbaric Transfer Options
- LBMMC (56x) 933-6960
  - Consult hyperbarics physician to confirm appropriateness; HBO physicians are consultants and not admitting physicians.
  - Speak to ED physician for ED to ED transfer; LBMMC Transfer Center only handles inpatient-to-inpatient transfers
  - Specify anticipated level of inpatient care (ICU), your treatment time goal (<6 hrs)
- UCLA-Westwood
  - Details TBD (Dr. Cheng working on it)
- Transport Options
  - UR involved ONLY if the patient has private (non-DHS) insurance
  - RoundTrip request for ALS (via AED clerk - for the desired transport level of care; all CO poisonings need ALS at minimum)
    - Immediately call the CDO (866-941-4401) to request that the RoundTrip be expedited as a time-critical illness; the patient should leave Harbor’s ED within 2 hours.
    - ALTERNATE: request BLS and assemble an internal critical care transport team (RN, RT, physician, etc) with instructions to call Harbor base for base physician orders if the patient's condition changes en route or for a physician-led team, take the HERT meds box from the Trauma Pyxis and additional medications as necessary and downtime order forms with instruction to call Harbor base for physician orders if necessary
  - 911 re-triage - if no ambulances and/or staff are available; discuss with Harbor AOD and LACoFD/LAFD Medical Director(s) as appropriate

Authors:

@@ Línea 1: / Línea 1: @@
 * Hyperbaric Transfer Options
-** LBMMC (56x) 933-6960
+** '''LBMMC''' (56x) 933-6960
 *** Consult hyperbarics physician to confirm appropriateness;  HBO physicians are consultants and not admitting physicians.
 *** Speak to ED physician for ED to ED transfer;  LBMMC Transfer Center only handles inpatient-to-inpatient transfers
 *** Specify anticipated level of inpatient care (ICU), your treatment time goal (<6 hrs)
-** UCLA-Westwood
+** '''UCLA-Westwood'''
 *** Details TBD (Dr. Cheng working on it)
 ** Transport Options
 *** UR involved ONLY if the patient has private (non-DHS) insurance
+*** '''RoundTrip request for ALS''' (via AED clerk - for the desired transport level of care; all CO poisonings need ALS at minimum)
-*** RoundTrip request for ALS, contact CDO to request expedited assignment of this request
+**** Immediately call the CDO (866-941-4401) to request that the RoundTrip be expedited as a time-critical illness;  the patient should leave Harbor’s ED within 2 hours.
-)	Put through the RoundTrip request (through the AED clerk) for the desired transport level of care (all CO poisonings will need ALS at minimum). Ask the AED clerk to notify the Attending once the RoundTrip request has been completed.
+**** ALTERNATE:  request BLS and assemble an internal critical care transport team (RN, RT, physician, etc) with instructions to call Harbor base for base physician orders if the patient's condition changes en route or for a physician-led team, take the HERT meds box from the Trauma Pyxis and additional medications as necessary and downtime order forms with instruction to call Harbor base for physician orders if necessary
-)	Immediately call the CDO (at (866) 941-4401) to request that the RoundTrip be expedited as a time-critical illness. Explain that we want the patient to leave Harbor’s ED within 2 hours. If CDO anticipates that they will not be able to attain the requested transport level within that timeframe, discuss options for alternate transport. The primary option for alternate ALS is to request BLS and for Harbor to provide the transport monitor and staff (RN, MD) for the transport. For CritCare alternative, Harbor would request an ALS or BLS ambulance and provide (for ALS) an RN/MD and/or RT (depending on patient needs) with instruction to call Harbor base for Base physician orders if patient condition changes en route, or (for BLS) and RN/MD and/or RT with anticipated medications (advise taking the HERT meds box from the Trauma Pyxis and additional medications as necessary) and downtime order forms with instruction to call Harbor base for physician orders if necessary.
+*** '''911 re-triage''' - if no ambulances and/or staff are available; discuss with Harbor AOD and LACoFD/LAFD Medical Director(s) as appropriate
-*** BLS and assemble internal critical care transport team (RN, RT, physician, etc)
-*** 911 re-triage
-)	If no ambulances and/or staff are available to effect the transfer as per #4 above, consider 9-1-1-retriage request. Discuss with Harbor AOD and LACoFD/LAFD Medical Director(s) as appropriate.