Harbor:Screening EMS Patients

EMS Directive #4 Jan 2022

• EMS Directive #4
• Kelsey

ALS & BLS Direct to triage (2/5/18)

• ALS or BLS patients with the following:
  • Stable Vital Signs
    • T 36-38C
    • HR 60-100
    • SBP 100-210, DBP 60-120
    • RR 12-20
  • Ambulatory
  • Cleared by Charge RN
  • If your patient meets all 3 criteria, take them directly to the physician in triage (or NP if physician is unavailable)
• Charge RN must:
  • Quick-register the patient AND
  • Use the Pre-Hospital template to enter:
    • VS
    • EMS unit
    • Brief statement about patient being stable and ambulatory to triage

Patients not meeting "Direct to Triage" criteria

AED Charge

• Quick-register patient
  • If clearly needs to stay AED
    • Room Available
      • Place in room
      • Assign purple/green based on room
    • No room available - Assign by alternating purple/green
      • Notify Senior Resident via Spectra - "EMS is waiting"
      • Hold EMS until physician arrives (30 min max)
      • If no room, after MSE by senior resident:
        • If assigned "AED" by screening MD, place in next available room (senior to remove team assignment unless they want to keep the patient on their team; if no team assignment, goes to team based on room placement/geography)
        • If assigned "Triage" by screening MD, to triage for physician/NP in triage to perform MSE

Senior Resident

• If you notice EMS patient has been waiting > 30 min for team assignment - call Charge RN
• Respond to screen ASAP to get EMS report
• Release ALS personnel (BLS may have to stay until patient in room)
• If on wall and appears stable for triage/WR, discuss with attending
  • If attending agrees use .edambutriage note but do NOT click the "MSE"
  • Write "Triage" in the RN Comments column
  • These patients will then go to team triage
• If the patient needs to stay in the ED, do a brief MSE note

MICN

• ALS Arrivals ONLY
  • Download and print 2 copies of ePCR (aka EMS Report Form)
  • Place stickers on them
  • Leave 1st copy with patient’s RN
• Give 2nd copy to clerk

ED ATTENDING

• If you notice EMS patient has been waiting > 30 min for team assignment - call Charge RN

See Also

• Harbor:Main

References

Chappell 1/31/18 rev Peterson 1/2019