Esophageal Foreign Bodies
ENT is to be consulted for non-meat foreign bodies believed to be in the cervical esophagus (above the cricopharyngeus). As a reminder, they are on in-hospital call every third night
GI is to be consulted for all meat-related foreign bodies, as well as those believed to be in the lower esophagus
The ED staff should not accept direct admissions from the clinics – even when there are no “available beds” on the floors. She assures us that the bed coordinator (4-6505) is always able to make arrangements for these patients. These patients shouldn’t have to board in the ED or come to the ED “just for blood draws”. Please advise those providers to refer the patients to the TR and to the bed coordinator.
I was hoping Joe would be the bad guy on this one, but I guess it falls to me.
There has been a relatively consistent lack of care for the video intubation equipment. I have walked into 5 shifts in the past 2 months with a dirty blade sitting on top of the intubation cart (if you think I am talking about you, I am, but not just you so don’t feel that bad).
Each of these blades cost a few thousand dollars. Joe & Stu worked to get us this new equipment. Convincing the hospital to replace broken items is going to be pretty tough.
So the image above should never exist: Either the blade should be sitting in a drawer or it should be in your hand. NOWHERE ELSE. Getting ready for an intubation–keep it in the drawer. Things fall off flat tops, they do not fall out of drawers.
This should happen immediately after intubation as in IMMEDIATELY after intubation.
The residents should be taking care of this, but it is the responsibility of the ED attending to make sure it happens and happens properly. We will be blaming the attending not the resident if blades are not handled properly because we are consistent while residents come and go as outside rotators or while switching between institutions.
Please write Joe or me with any questions.