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Archive for February, 2009

Multiple Updates from Kevin Baumlin

Multum update–  the end result of this means that your med service and rx quick lists may be a bit different… of note toradol and lasix have changed… sorry, these updates .. we are required to take…

bed request– “none” is no longer autopopulated in the isolation question…. UGGGH.. i know… but hopefully this will decrease the re-listing for isolation pts that seems to happen daily.

bedboard overview– now has an additionally column for mrsa/vre– this is pulled through from cerner– (meaning the pt has had a mrsa/vre positive cx in the past.  this should help decrease confusion as to who is and who isn’t iso, and for what reason.

current medications  please put this on your tool bar and check pts med lists!

Obs– for pts 8+ hours and overnight obs pts– fill out the new “hpi” template

Peds ROS– working on it

Studer– AIDET— bottom line is, its not enough to take great care of your pts.  you need to do it with a smile, introduce yourself, manage expectations and say thanks for coming….

-kb

Written by reuben

February 26th, 2009 at 9:50 pm

Policies

The formal, comprehensive repository of our ED policies is here.

For now, on this page, we’ve collected the most relevant policies as well as our frequently used “guidelines” which you may not find on the mssm.edu/emergmed/manual page.

Antibiotic Recommendations
Antibiogram
Capnometry
Central Line Confirmation
Fourth Year Responsibilities
Hemorrhagic Stroke Protocol
Hypothermia Protocol Worksheet Shivering Protocol
ICU Consult (MARS) Criteria
ICU Admission Criteria
Intubation Checklist
OB/GYN Consultation
Pain Policy
Propofol
Sepsis Flowsheet
Stroke Policy
Trauma

Written by phil

February 26th, 2009 at 4:29 pm

Posted in ED Guidelines

Dog Bite Form Online

So for all dogbites you can fill it out online.  I actually usually have the parent fill out the form at one of the computers on the desk.

The link is:  http://www.nyc.gov/html/doh/html/vet/vetegp.shtml

No need to work on paper anymore…

Adam

Keyword: Dogbite

Written by reuben

February 25th, 2009 at 11:09 pm

Posted in Toxicology

Respiratory / Droplet Isolation

From Dr. Hill,

If someone is on respiratory/ droplet isolation and they leave the department, they MUST leave with a mask on.

This issue arose regarding r/o meningitis patients who go for CT HEAD.

Written by phil

February 24th, 2009 at 5:32 pm

Posted in ID

NYCLIX Go Live Mon 2/23

As mentioned in Faculty meeting on 2/11, NYCLIX patient consent is going
live the morning of 2/23, you will therefore have access to login and look
up patient information starting tomorrow morning.

Your login is:Rstray01

password is: [assigned password]

The URL is: http://146.203.137.92/portal-prod/login

NYCLIX can only be accessed from the hospital or through msonsitehealth.org

Once in, you can change your password by clicking on “Personal Settings” in
the upper right hand corner, and then under “User Administration”, typing in
a new password and clicking “Save” at the top.  This is only temporary since
your NYCLIX login will soon be automatically linked to your Sinai network
login.

I am working on getting a link from the IBEX toolbar implemented so that you
can just follow that and then login.  Eventually, we should have a
pass-through link like the one from IBEX to EDR so that your login
credentials allow you to go directly to the IBEX patient’s chart in NYCLIX
with one click.

A few important points:

-DO NOT GET FRUSTRATED IF THE DATA YOU ARE LOOKING FOR IS NOT ACCESSIBLE.
This is a pilot implementation, mainly to get your feedback as pilot users.
There are many patients with data on the system that you may not be able to
access because the patient has not consented at the other site (consent is
required at each site before data from that site will be shared).

-Many patients have consented at VNS and NYU, if you have a patient to have
been at either of those sites, you are more likely to find information.

-The likelihood of finding information will increase over time as more
patients have the opportunity to consent.

-If you do use NYCLIX for any reason, and you find useful information (or a
problem), please let me know.  What we really need right now are stories
from end users about how it helped, and feedback to help us make it better.

-NYCLIX Helpdesk support is not up and running yet at Sinai.  If you
experience difficulty, need a password reset, or have any questions, please
contact me by email and/or cell phone (917-334-6233).

Thanks,

-Jason

Written by reuben

February 23rd, 2009 at 10:59 pm

SonoSite S-Cath

I am pleased to announce we are going “live” with our new ultrasound machine, the SonoSite S-Cath. It is the grey flatscreen monitor machine with a vascular probe attached to it.

The machine should be used to place difficult peripheral IV lines, and ALL central lines should be placed under ultrasound guidance.

There is a very brief tutorial on using the machine at:
http://sinaiem.us/?page_id=170

Basically, the ON button is on the top left of the machine. There are two knobs: they control Depth and Gain. There are no other controls to worry about.

A few more things to keep in mind:

1. Clean the probe
This is a medical device and according to OSHA regulations and common courtesy, it cannot be left bloodied or gooped up. The probe goes in the probe holder to the right of the machine.

2. Return the machine to the Resus area
The glidescope and ultrasound machine get plugged in behind the MD workstation, next to the secure document receptacle.

3. Plug the machine in as much as possible
When the battery is low, it will shut down while you are trying to place a central line.

4. Use extra-long IV catheters for deeper veins
They are located in the Resus area storage bins (alcove under blanket warmer) and in the ED storeroom (on your left just behind the door).

Please email me with any questions, and thank you in advance for taking good care of the machine.

Bret

Written by phil

February 18th, 2009 at 1:15 pm

Posted in Ultrasound

PSL Phones

Felix 29352
Rosario 29351
Leydiana 29357
Zoraya 29353
Rose 29358

Written by phil

February 15th, 2009 at 5:45 pm

Posted in Phones

IRS and Mount Sinai Tax Information

From Jill — Several faculty members have come to me with questions on how to handle receiving 1099s for payments that have been deposited in our Emergency Medicine Faculty practice and not to you as an individual.  A copy of the 1099s should be faxed to Angus Ramadeen, Associate Director of Finance. He can be contacted at the following telephone or fax number and in Outlook via email:

Angus Ramadeen
fax: (212) 731-3420
Tel:  (212) 731-3384
email: angus.ramadeen@mountsinai.org

Or

Treneon Ng
Financial Analyst
Fax: 212-731-3420

If you receive notice of an IRS audit, in relation to “medical payments” deposited at Mount Sinai from our physician billing program in the ED, you need to send Angus or Treneon a copy of that  part of the IRS letter with the payments in question (total letters are generally 15-16 pages long – and talking to Mr. Ramadeen 2/9/2009 he recommends scanning entire document and sending to him angus.ramadeen@mountsinai.org).  Angus will then prepare an individual letter for you, indicating what the payments are for to respond to the IRS.  Please note that about 30% of all physicians at Mount Sinai get audited  by the IRS each year as physician salaries are in the higher income levels. If you have any questions at all, please call me or feel free to call Angus directly. Thanks.  Jill

Written by phil

February 10th, 2009 at 8:57 pm

Posted in Finance