Harbor:Pediatric ED (main): Difference between revisions

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*[[Harbor:Paging|Paging consultants]]
*[[Harbor:Paging|Paging consultants]]
*[[Harbor:Pediatric admission guidelines|Admission guidelines]]
*[[Harbor:Pediatric admission guidelines|Admission guidelines]]
**Patient age
***Pediatric ward and PICU admit patients up to age 21 years and 364 days old
****If another service is asking to admit an adult patient aged 18-21 years, state that the patient should be admitted to pediatrics with the other service consulting
***Patients < 1 month old with no respiratory symptoms or diarrhea may potentially be admitted to NICU or nursery
****Discuss with admitting nursery (x2311) or NICU (x2340) resident
**ED attendings have admitting privileges
***Admissions will be accepted by pediatric residents regardless
****Pediatric residents, in conjunction with their attending, may evaluate the patient and perform an immediate discharge if they so desire
**ED attendings determine, with admitting resident input, the appropriate location: ward, step-down, PICU
**ED should have done all of the following prior to contacting the admitting resident
***Complete necessary work-up and treatment for stabilization that should occur acutely in the ED
***Make sure with Utilization Review that the patient can be admitted to Harbor
****If the attending says patient is not stable for transfer, then the patient will be admitted
****The Interqual icon does NOT have to be green prior to contacting admitting resident IF ED staff are sure the patient will be admitted to Harbor
**Peds does not have isolation areas, so if patient needs isolation (eg active TB, meningococcemia, measles, varicella), discuss with admitting resident
***Patient may need to be admitted to an adult area and followed by peds, or transferred
**Contacting admitting resident
***Harbor MedHub call schedule (linked from PEMsource.org Harbor only page)
***Protected time
****Weekdays 6:45am-7:30am
****Weekends 7:45am-8:30am
****All evenings 7pm-7:30pm
***For ward and step-down
****Mon-Fri 7a-7p: Pediatrics Ward Senior Admit resident (will be Gold or Blue, depending on which team is admitting)
****Mon-Fri 7p-7a: Pediatrics PM Ward Senior
****Sat-Sun 24 hours: Pediatrics Ward Senior Admit resident
****If unsure, can call Peds ward at x2333 to ask for admitting resident
***For PICU
****Mon-Fri 7a-7p: Pediatrics PICU
****Mon-Fri 7p-7a: Pediatrics PM PICU
****Sat-Sun 24 hours: Pediatrics PM PICU
****If unsure, can call PICU at x2480 to ask for admitting resident
***If you forget to ask, the Attending name for Ward Blue or Gold team, or PICU will be listed on MedHub
**After admission
***Once the ED staff puts in a "Request for Admit" order, the pediatrics team is managing the patient
****ED staff should have all ED orders in and completed prior to putting in Request for Admit
*****Make sure nursing has had a chance to complete ED orders prior to putting in Request for Admit
***As part of their admission orders, pediatric residents may order additional labs, imaging, etc.
****These do NOT need to be done in the ED prior to the patient going upstairs
****Ultrasounds can be difficult to obtain from inpatient, so attempt to get any ultrasounds done prior to leaving ED
***For any delays in patient going upstairs, have nursing contact Patient Flow


===Other===
===Other===

Revision as of 21:05, 13 August 2016

See Adult ED for the main adult Harbor page.

Background

This is the main page for Harbor-UCLA Pediatric ED.

General Administrative

Managing your Patient

Ordering

Documenting

Procedures

Finding Things

  • Paging consults
  • Consultation of subspecialists
    • For pediatric patients (< 21 years old), pediatric medical subspecialists are consulted
      • MedHub Harbor call schedule (link from PEMsource.org Harbor only page), choose Pediatrics
      • Peds Department Pagers also posted in PED docbox and linked on PEMsource.org Harbor only page
    • For surgical subspecialties (eg Ortho, ENT, Ophtho, Neurosurg, Plastics, Derm, Urology, OMFS), use the on-call schedule as for adult patients except:
      • General surgery, consult resident on Pediatric surgery pager 6105 Mon-Fri 8am-5pm
        • Otherwise, consult Trauma surgery
    • For Psychiatry
      • Mon-Fri 8am-4pm call the Child and Adolescent Psychiatry fellow
        • MedHub Harbor call schedule (link from PEMsource.org Harbor only page), choose Psychiatry -> Child and Adolescent Psychiatry
      • After hours and on weekends and holidays, call Psych ED for Psychiatry resident on call x3144

Special patient types

Patient Disposition

Discharging a Patient

Admitting a patient

Other

Disaster

See Also

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