Revised massive transfusion protocol and emergency release blood product delivery forms

The revised massive transfusion and emergency release forms for uncrossmatched product are now stocked in the trauma room and available for download from the GUIDELINES page.

With the revised MTP form, the delivery schedule has now been replaced by a fixed ratio of 5U PRBCs, 4U FFP, and 1U single donor platelets.  2 Pooled cryoprecipitate (equivalent to 10U of cryo) will be added to every 3rd delivery of product.  You may also request FEIBA, Kcentra, or other blood product as needed.

In addition, in situations in which a patient is not rapidly exsanguinating and you don’t expect you will need multiple deliveries, you can also obtain smaller quantities of uncrossmatched blood product just as quickly with the emergency release form.   As a reminder, 1U of single donor/apheresis platelets is equivalent to ~5U of pooled platelets.

In both cases, call 4-2028 and send a runner with the signed forms affixed with a patient label to the blood bank to pick up the product.

MASSIVE TRANSFUSION FORM - 7.19.17
EMERGENCY BLOOD PRODUCT RELEASE - 7.19.17

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.