Template:Harbor Admission Guidelines - Revision history

Bchap23: /* Breast abscess/mastitis */

2026-04-16T19:45:46Z

Breast abscess/mastitis

← Older revision		Revision as of 19:45, 16 April 2026
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	**** If you need a formal US after hours to confirm abscess, order "US Chest (R or L)" STAT [radiology only reads "Chest US", BDC only reads "Breast US"]		**** If you need a formal US after hours to confirm abscess, order "US Chest (R or L)" STAT [radiology only reads "Chest US", BDC only reads "Breast US"]
	**** Needle aspiration, send wound culture		**** Needle aspiration, send wound culture
	***** Standard care is needle ~~drainage~~ 2x prior to I&D		***** Standard care is needle aspiration 2x prior to I&D
	**** Discharge with PO antibiotics		**** Discharge with PO antibiotics
	***** Keflex, dicloxacillin if lactating, bactrim or doxycycline if concern for MRSA		***** Keflex, dicloxacillin if lactating, bactrim or doxycycline if concern for MRSA

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T21:03:22Z

Pulmonary Embolus

← Older revision		Revision as of 21:03, 16 March 2026
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	* For all Confirmed PE or DVT with findings suggestive of PE (Clot in transit or right heart thrombi on TTE/TEE) but unable to obtain CTPA, risk stratify patient for PE Response Team Activation using [https://s3.ap-southeast-2.amazonaws.com/wikem.cf.bucket/images/ED_PERT_Activation_Algorithm_%282026%29.pdf ED PERT Activation Algorithm 2026].		* For all Confirmed PE or DVT with findings suggestive of PE (Clot in transit or right heart thrombi on TTE/TEE) but unable to obtain CTPA, risk stratify patient for PE Response Team Activation using [https://s3.ap-southeast-2.amazonaws.com/wikem.cf.bucket/images/ED_PERT_Activation_Algorithm_%282026%29.pdf ED PERT Activation Algorithm 2026].
	* '''Risk Stratification'''		* '''Risk Stratification'''
	** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:		** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care: [[File:ESC 2019 PE Risk Stratification Table.jpg\|center]]
	[[File:ESC 2019 PE Risk Stratification Table.jpg\|center]]
	** Definition of hemodynamic instability for risk stratification		** Definition of hemodynamic instability for risk stratification
	*** Cardiac arrest and need for cardiopulmonary resuscitation.		*** Cardiac arrest and need for cardiopulmonary resuscitation.
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	** Unfractionated Heparin (UFH)		** Unfractionated Heparin (UFH)
	*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|center]]		*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|center]]
	*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|center]]		*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|center]]
	** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)		** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)
	** DOACs (Low Risk Only):		** DOACs (Low Risk Only):

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T21:02:19Z

Pulmonary Embolus

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T21:00:01Z

Pulmonary Embolus

← Older revision		Revision as of 21:00, 16 March 2026
Line 391:		Line 391:
	* '''Risk Stratification'''		* '''Risk Stratification'''
	** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:		** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:
	[[File:ESC 2019 PE Risk Stratification Table.jpg\|frame]]		[[File:ESC 2019 PE Risk Stratification Table.jpg\|frame\|center]]
	** Definition of hemodynamic instability for risk stratification		** Definition of hemodynamic instability for risk stratification
	*** Cardiac arrest and need for cardiopulmonary resuscitation.		*** Cardiac arrest and need for cardiopulmonary resuscitation.
Line 409:		Line 409:
	* '''Anticoagulation Guidelines'''		* '''Anticoagulation Guidelines'''
	** Unfractionated Heparin (UFH)		** Unfractionated Heparin (UFH)
	*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|frame]]		*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|frame\|center]]
	*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|frame]]		*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|frame\|center]]
	** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)		** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)
	** DOACs (Low Risk Only):		** DOACs (Low Risk Only):

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T20:59:17Z

Pulmonary Embolus

← Older revision		Revision as of 20:59, 16 March 2026
Line 391:		Line 391:
	* '''Risk Stratification'''		* '''Risk Stratification'''
	** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:		** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:
	[[File:ESC 2019 PE Risk Stratification Table.jpg\|frame~~\|left~~]]		[[File:ESC 2019 PE Risk Stratification Table.jpg\|frame]]
	** Definition of hemodynamic instability for risk stratification		** Definition of hemodynamic instability for risk stratification
	*** Cardiac arrest and need for cardiopulmonary resuscitation.		*** Cardiac arrest and need for cardiopulmonary resuscitation.
Line 409:		Line 409:
	* '''Anticoagulation Guidelines'''		* '''Anticoagulation Guidelines'''
	** Unfractionated Heparin (UFH)		** Unfractionated Heparin (UFH)
	*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|frame~~\|left~~]]		*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|frame]]
	*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|frame~~\|left~~]]		*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|frame]]
	** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)		** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)
	** DOACs (Low Risk Only):		** DOACs (Low Risk Only):

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T20:58:38Z

Pulmonary Embolus

← Older revision		Revision as of 20:58, 16 March 2026
Line 391:		Line 391:
	* '''Risk Stratification'''		* '''Risk Stratification'''
	** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:		** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:
	[[File:ESC 2019 PE Risk Stratification Table.jpg\|frame\|~~center~~]]		[[File:ESC 2019 PE Risk Stratification Table.jpg\|frame\|left]]
	** Definition of hemodynamic instability for risk stratification		** Definition of hemodynamic instability for risk stratification
	*** Cardiac arrest and need for cardiopulmonary resuscitation.		*** Cardiac arrest and need for cardiopulmonary resuscitation.
Line 409:		Line 409:
	* '''Anticoagulation Guidelines'''		* '''Anticoagulation Guidelines'''
	** Unfractionated Heparin (UFH)		** Unfractionated Heparin (UFH)
	*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set		*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|frame\|left]]
	[[File:Heparin Order 1.jpg\|frame\|~~center~~]]		*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|frame\|left]]
	*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box
	[[File:Heparin bolus order.jpg\|frame\|~~center~~]]
	** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)		** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)
	** DOACs (Low Risk Only):		** DOACs (Low Risk Only):

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T20:56:54Z

Pulmonary Embolus

← Older revision		Revision as of 20:56, 16 March 2026
Line 390:		Line 390:
	* For all Confirmed PE or DVT with findings suggestive of PE (Clot in transit or right heart thrombi on TTE/TEE) but unable to obtain CTPA, risk stratify patient for PE Response Team Activation using [https://s3.ap-southeast-2.amazonaws.com/wikem.cf.bucket/images/ED_PERT_Activation_Algorithm_%282026%29.pdf ED PERT Activation Algorithm 2026].		* For all Confirmed PE or DVT with findings suggestive of PE (Clot in transit or right heart thrombi on TTE/TEE) but unable to obtain CTPA, risk stratify patient for PE Response Team Activation using [https://s3.ap-southeast-2.amazonaws.com/wikem.cf.bucket/images/ED_PERT_Activation_Algorithm_%282026%29.pdf ED PERT Activation Algorithm 2026].
	* '''Risk Stratification'''		* '''Risk Stratification'''
	** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care: [[File:ESC 2019 PE Risk Stratification Table.jpg\|frame\|center]]		** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:
			[[File:ESC 2019 PE Risk Stratification Table.jpg\|frame\|center]]
	** Definition of hemodynamic instability for risk stratification		** Definition of hemodynamic instability for risk stratification
	*** Cardiac arrest and need for cardiopulmonary resuscitation.		*** Cardiac arrest and need for cardiopulmonary resuscitation.
Line 408:		Line 409:
	* '''Anticoagulation Guidelines'''		* '''Anticoagulation Guidelines'''
	** Unfractionated Heparin (UFH)		** Unfractionated Heparin (UFH)
	*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|frame\|center]]		*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set
	*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|frame\|center]]		[[File:Heparin Order 1.jpg\|frame\|center]]
			*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box
			[[File:Heparin bolus order.jpg\|frame\|center]]
	** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)		** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)
	** DOACs (Low Risk Only):		** DOACs (Low Risk Only):

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T20:56:05Z

Pulmonary Embolus

Show changes

Alexgrohmann: /* Pulmonary Embolus */

2026-03-16T19:12:38Z

Pulmonary Embolus

← Older revision		Revision as of 19:12, 16 March 2026
Line 388:		Line 388:
	===Pulmonary Embolus===		===Pulmonary Embolus===

	[~~[File~~:~~PERT flowchart~~ 2 ~~18 2025~~.pdf~~\|thumb]~~]		[https://s3.ap-southeast-2.amazonaws.com/wikem.cf.bucket/images/ED_PERT_Activation_Algorithm_%282026%29.pdf ED PERT Activation Algorithm 2026]

	* Confirmed PE or DVT with symptoms suggestive of PE but unable to obtain CTPA		* Confirmed PE or DVT with symptoms suggestive of PE but unable to obtain CTPA

Alexgrohmann: /* Pulmonary Embolus */

2025-11-19T21:54:35Z

Pulmonary Embolus

← Older revision		Revision as of 21:54, 19 November 2025
Line 387:		Line 387:

	===Pulmonary Embolus===		===Pulmonary Embolus===

			[[File:PERT flowchart 2 18 2025.pdf\|thumb]]

	* Confirmed PE or DVT with symptoms suggestive of PE but unable to obtain CTPA		* Confirmed PE or DVT with symptoms suggestive of PE but unable to obtain CTPA
	** Start anticoagulation and consider pulmonary consult if contraindications to anticoagulation or other clinical concerns		** Start anticoagulation and consider pulmonary consult if contraindications to anticoagulation or other clinical concerns

← Older revision		Revision as of 21:02, 16 March 2026
Line 391:		Line 391:
	* '''Risk Stratification'''		* '''Risk Stratification'''
	** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:		** Harbor UCLA's PERT Program currently uses the European Society of Cardiology (ESC) 2019 Guidelines for risk stratification to help determine treatment options and level of care:
	[[File:ESC 2019 PE Risk Stratification Table.jpg~~\|frame~~\|center]]		[[File:ESC 2019 PE Risk Stratification Table.jpg\|center]]
	** Definition of hemodynamic instability for risk stratification		** Definition of hemodynamic instability for risk stratification
	*** Cardiac arrest and need for cardiopulmonary resuscitation.		*** Cardiac arrest and need for cardiopulmonary resuscitation.
Line 409:		Line 409:
	* '''Anticoagulation Guidelines'''		* '''Anticoagulation Guidelines'''
	** Unfractionated Heparin (UFH)		** Unfractionated Heparin (UFH)
	*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg~~\|frame~~\|center]]		*** Utilize Heparin Drip DVT/PE per Pharmacy subphase order set [[File:Heparin Order 1.jpg\|center]]
	*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg~~\|frame~~\|center]]		*** Note, this order set automatically includes a bolus of heparin. If this is not desired such as in patients who are at increased risk of bleeding, please unclick the checked off box [[File:Heparin bolus order.jpg\|center]]
	** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)		** Low Molecular Weight Heparin (LMWH): Enoxaparin 1 mg/kg q12h (avoid if CrCl < 30mL/min)
	** DOACs (Low Risk Only):		** DOACs (Low Risk Only):
Line 417:		Line 417:
	*** Note when able, Apixaban is favored over Rivaroxaban given decreased bleeding risk		*** Note when able, Apixaban is favored over Rivaroxaban given decreased bleeding risk
	* '''Thrombolytic Contraindications'''		* '''Thrombolytic Contraindications'''
	[[File:Thrombolytic Contraindications.jpg~~\|frame~~\|center]]		[[File:Thrombolytic Contraindications.jpg\|center]]
	* '''Frequently Asked Questions'''		* '''Frequently Asked Questions'''
	** '''PERT is not responding. What should I do?'''		** '''PERT is not responding. What should I do?'''