Harbor: Hyperbaric Transfers

• Hyperbaric Transfer Options for Carbon Monoxide (CO) - Long Beach or UCLA Westwood
  • UR coordinates the transfer - Higher Level of Care (HLOC) - needs to occur <1-2 hrs
    • Sending facility should arrange transfer
    • If UR not able to get transfer in a timely manner --> MAC (CDO) - must be approved by house supervisor & Joy; BLS/ALS/CC transport

• • LBMMC (56x) 933-6960
    • Consult hyperbarics physician to confirm appropriateness; HBO physicians are consultants and not admitting physicians.
    • Speak to ED physician for ED to ED transfer; LBMMC Transfer Center only handles inpatient-to-inpatient transfers
    • Specify anticipated level of inpatient care (ICU), your treatment time goal (<6 hrs)
  • UCLA-Westwood
    • Details TBD (Dr. Cheng working on it)
  • NOT Catalina (only for dive injuries)
  • Transport Options
    • UR involved ONLY if the patient has private (non-DHS) insurance; ELTC/HLOC - needs to occur <1-2 hrs
    • RoundTrip request for ALS (via AED clerk - for the desired transport level of care; all CO poisonings need ALS at minimum)
      • Immediately call the MAC CDO (866-941-4401) to request that the RoundTrip be expedited as a time-critical illness; the patient should leave Harbor’s ED within 2 hours.
      • ALTERNATE: request BLS and assemble an internal critical care transport team (RN, RT, physician, etc) with instructions to call Harbor base for base physician orders if the patient's condition changes; for a physician-led team, take the HERT medication box from the Trauma Pyxis, additional medications as necessary, and downtime order forms with instruction to call Harbor base for physician orders if necessary
    • 911 re-triage - if no ambulances and/or staff are available; discuss with Harbor AOD and LACoFD/LAFD Medical Director(s) as appropriate