All posts by Dan Lakoff

Hand & Extremity Cellulitis

The observation unit will accept patients with hand cellulitis after they’ve been seen by the covering consult service in the AED. They’ll also accept cellulitis cases that crosses joints where there is a concern about septic arthritis – as long as orthopedics sees the patients in the AED and documents their impressions.

 

Pediatric Trauma – Adult ED versus PAC

Reminder:

  • ALL pediatric trauma patients must be first evaluated in the adult trauma room
    • If they are determined to be a ayellow or red trauma team, the patient needs to stay in the adult trauma room for their evaluation/treatment ( if there is some reason this cannot happen then a senior ED provider, preferably an attending, should accompany the peds patient to the peds ED).
  • Only send rock stable patients with trivial injury mechanisms to the PAC
  • Err on the side of caution when deciding whether to send EMS/patient to PAC

Provider-In

To all providers –

We need a concerted effort to push the “PROVIDER-IN” button.

This should be clicked as soon as you see the patient and can be back-timed to the time of contact. 

This will help us reduce the “Time to Provider”  which is a nationally reported metric.

 

If you see another provider who hasn’t done this, please educate them.

 

 

Thank you.

 

 

 

 

Radiology technical issues

Please see contact numbers for any Radiology  tech/report/image issues.

Tour I    –   Radiology Front Desk   – Extension 42778

Tour II   –   Radiology PACS Office – Extension 42082

Mobile     64698

Tour III  –   Radiology PACS Office –  Extension 42082

Mobile      64698

 

If you have any questions, please call me at extension 41429.

 

Nia

 

Humipak

What is the Humipak? 

  • It is a plastic bag to be used when returning reusable instrument trays for cleaning.

What kits do you need to use them for?

  • All reusable kits, all of which should have the Humipaks included on top of the blue sheets.

How to use them:

Use the kit and complete your procedure successfully

  • Place all tools back on the tray
  • Wrap the tray in the blue sheet
  • Place in the Humipak
  • Add 1 cup of water
  • Seal the bag

 

Subject: ATTENDING INTAKE UNIT

From Department of Internal Medicine:

Starting tomorrow, Tuesday May 30th at 7-8PM an attending intake unit will start to expedite ED admissions (or further assessments) to medicine. This will consist of attendings who will evaluate and admit patients without house staff. They will work from 7PM to 7am on nights. In the am they will sign out admitted patients to the MTAR who will give them teams. We will show everyone the flow on Tuesday. However, in order for this to work, it is imperative that all admitted patients to medicine (except MICU, CCU or A4 ) go through the MTAR. The MTARs will than assign teams starting at about 8 PM when the shift  starts. The MTAR will assign cases to the attending intake  as well. This will decrease the number of admissions that the MTAR and night floats will be admitting. Therefore, having the MTAR assign all admissions after 8 PM (irrespective of whether the teams have capped or NOT) is mandatory. A4 admissions will be called directly to the resident on A4 or TR once the team has capped or after 2 PM. MICU and CCU will continue to function as at present.

 

Addendum from ED Admin:
There is no change to the current admission process on the part of the ED provider.  The change is related to the way medicine will assign admitted patients to their service.

TB and ED discharges and disposition

Good morning

Patients may be referred to the TSTU (Tuberculosis Surveillance and Treatment Unit) following an ED visit for the next available non-holiday weekday.

Procedure

1.  Ask the patient to go to J1-05 Immunology Clinic from 8 AM to 3:30 PM. (the earlier the better).  After they enter the Immunology Clinic, the first door to their immediate left is the TSTU (door is marked IPaC TSTU Clinic).
2.  Provide the patient with a mask and ask him/her to wear it to the TSTU.
3.  The patient should state that he/she was seen in the ED and was asked to come to the TSTU.
4.  The referring ED need NOT write orders for sputum nor write a referral.
5.  IF, the patient is strongly suspected of having active PULMONARY tuberculous disease but is clinically stable following an evaluation in the ED during off-hours, weekends or holidays, the same process may be followed however, the medical provider should call 43077 and leave a voice message indicating that the patient is strongly suspected of having disease.
6.  The TSTU extension is 46058

Please understand that patients presenting with strongly suspected active PULMONARY tuberculosis should be carefully evaluated to reasonably assess that they will return for follow up.  Clinically unstable patients or patients that will likely not follow up with the TSTU following evaluation in the ED on a weekend or holiday should be considered for admission (e.g., homeless person).

During weekdays, cases with a low level of suspicion may be referred to the TSTU in the manner described above.

During weekdays, cases with a high level of suspicion should be called into IPaC at 43077.  The patients can be evaluated in the ED and referred to the TSTU prior to admission.  Admitted patients are evaluated in the same manner and offered the workup in the TSTU with the consent of the medical-surgical admitting team.

regards,

George Alonso, M.D.
Director, Infection Prevention and Control (IPaC)
Elmhurst Hospital Center