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Archive for January, 2010

PB 840 Ventilator

Written by reuben

January 29th, 2010 at 4:29 pm

Posted in Airway

TCC Patients should have a call-in

Please note that a new policy with tcc will be starting this weekend.  Please email me if you have tcc pts arrive without a call in.
Thanks

Kevin M. Baumlin

—–Original Message—–
From: Lechich, Anthony
Sent: Friday, January 15, 2010 4:41 PM
To: TCC MEDICAL ADMINISTRATION; TCC NURSE MANAGERS-ANCC; TCC NURSE MANAGERS-DISCRETE; TCC NURSE MANAGERS-SNF
Cc: Frenkel, Cheryl; Carey, Kathy; Sussingham, Robert; Baumlin, Kevin; Dunn, Andrew; Southwick, Robert
Subject: FLOW SHEET TO BE FOLLOWED UPON TRANSFER OF TCC RESIDENTS
Importance: High

Please note the attached flow sheet. For all patients transferred to Mount Sinai Hospital for possible admission the steps indicated on the FLOW SHEET must be followed. The physician or Nurse Practitioner must inform the concierge operator in accordance with the proceedure outlines below. When the MD is off site the nurse relaying the information on the patient must do so thoroughly so that the MD can convey a proper clinical picture to the Emergency Room Staff.

FLOW SHEET TO BE FOLLOWED UPON TRANSFER OF TCC RESIDENTS

EFFECTIVE DATE: January 15, 2010

Step 1
MD/NP directing transfer calls the concierge number: 212 241 3611.
States ( to the concierge operator)  own name and that this is regarding a patient of Terence Cardinal Cooke Health Care Center.
Cell number (best) or beeper # that will work to reach him/her for the next 12 hours or, if going off duty, the next covering MD/NP.
States: name of the patient; brief summary of the patient’s baseline; statement of the reason for transfer and suggested workup, issues, other info such as family contacts,issues; advance directives;
States (to the best extent possible) service to which the patient, if admitted, should go to.

Options are: >65 geriatric= Dr. Winik (Cell 917 837 0147)
<65  geriatric= Hospitalist service (Beeper # 7217(Mon-Fri 8AM-6PM); 3989 (Nights weekends)
HIV cases=Hospitalist for ID  reachable at www.amion.com login mssm and click infectious diseases to find the two HIV  attendings.
Pure ESRD issues: MSH  Renal team must be notified. (All patients from TCC on dialysis need MSH renal notified even when admitted for non-renal issues so that dialysis may be arranged during their stay.

TCC MD/NP must remind nursing in charge of the transfer to include all of the items in the INTERACT II envelop and clearly mark on the transfer form that the patient is from TCC and instructions are included in the dictated information on the concierge record.
If the patient is over 65 geriatric the TCC MD/NP should call Dr. Winik and inform him of the admission. (We will need to confirm with Dr. Winik how to handle this when he might be away, w/e etc.

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Written by reuben

January 15th, 2010 at 10:00 pm

Posted in Admitting

Disposition of patients undergoing Therapeutic Hypothermia

Please note that there has been a change in mechanism for disposition of patients treated with therapeutic hypothermia.  In the past, the CCU had been taking all patients, but we have come to the agreement that disposition will be based on etiology not therapy.

Obviously, it may be difficult to determine the most likely etiology of arrest in some patients.  To expedite the ICU triage process for the patients who do not have a clear etiology of their arrest, the units have agreed to have the neurology hypothermia consultant (Frontera or Gordon) in consultation with the ED, decide which unit will take the patient.  The pulmonary and cardiology fellows should be aware of this change.

If there are any difficulties with this process, please notify phil.

Written by phil

January 11th, 2010 at 12:47 pm