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Archive for March, 2010

Needlesticks During Business Hours

Just to be clear, needle stick patients who are hospital employees should be sent to employee health from 9-5 Monday thru Friday. They sometimes show up in the ED.
Adam Vella, MD

Just to be clear, needle stick patients who are hospital employees should be sent to employee health from 9-5 Monday thru Friday. They sometimes show up in the ED.

Adam Vella, MD

Written by reuben

March 25th, 2010 at 8:39 pm

Posted in Needlestick

Analgesia Policy

From Dr. Hill:

Below is the most important clip from this policy. Starting doses of opiate pain meds are LIMITED BY POLICY. If you give more than the recommended you have to document a rationale. Please adhere to the policy. Analgesia will be tailored for the patient’s pain, see Appendix 2 and 3 of policy below.

  • The recommended initial dose of intravenous morphine in adults is 4 mg (0.05-0.1 mg/kg/dose in pediatrics); up to 10 mg can be given in patients who have chronic pain
  • The recommended initial dose of intravenous hydromorphone is 0.5 mg (0.015mg/kg/dose in pediatrics) up to 1.4 mg in patients who have chronic pain
  • Patients receiving greater than an initial dose of 10 mg of morphine or 1.4 mg of hydromorphone should have a “clinical decision” note entered on the chart and consideration given to contacting the pain service
  • Repeat dosing of morphine or hydromorphone should not be more frequent than every 30 minutes; when given more frequently a “clinical decision” note should be entered on the chart
  • Patients requiring more than three doses of intravenous pain medications in a 3 hour period should be considered for a Pain Service consult

pain-management policy

Written by phil

March 24th, 2010 at 3:47 pm

Code 11 Paperwork

Please note that the provider managing a sexual assault case, should
Request that the survivor sign an insurance waiver form (attached and
extras available in the evidence collection kit and the colpo closet) so
that the hospital gets reimbursed for the service. Form goes with the
chart. Thanks so much.

Barbara Richardson, MD
Medical Director, SAFE
20100312125928092.tif

Written by reuben

March 15th, 2010 at 7:43 pm

Posted in Sexual Assault

Please log your ultrasound scans, and LOG OUT when done

Just wanted to clear up some confusion.

When you perform an ultrasound on a patient in the ED, you must save an image of the exam.

Press the YELLOW-labelled  “Start & End” button on any of the machines in the Mount Sinai ED. This allows you to enter the patient medical record number (under ID) as well as your IBEX initials (Under patient Last Name).

As you scan, images you save will then be saved properly with the proper identifying information.

When you are finished, press the YELLOW-labelled  “Start & End” button AGAIN, that ends the exam. Hence the name, “Start & End.” Just one button to remember, does two jobs.

Please follow the link below for an ILLUSTRATED tutorial on this:

http://sinaiem.us/tutorials/using-the-m-turbo

Why is this so important?

1. As soon as you end the exam, the images are wirelessly transmitted for electronic image archival to our department image database. If you don’t end the exam, the images will sit there, with no backup, prone to deletion or other data corruption.

2. If you don’t log out (end exam), the next person to use the machine will likely save THEIR images onto your login. The images will then show up as part of YOUR patient’s exam. We don’t need images of ascites., pregnancy, cardiac standstill, and AAA all logged in under the SAME PATIENT.

3. Do NOT leave the exam “Open” because you want to show the attending or someone else the study. ANY study on the machine can be viewed by pressing “Review” on the right side of the keyboard. All stored images currently on the machine can then be viewed. So if you want someone else to look at the images, you should still press “Start & End” after you scan.

Thanks again for your continued support. Stay tuned to SinaiEM.us and your email inbox for more exciting updates, including an upcoming cardiac resuscitation protocol!

Bret

Written by reuben

March 13th, 2010 at 4:34 pm

Posted in Ultrasound

MSSM Central Venous Catheterization Safety Policy

Ultrasonic guidance is now required per Medical Board policy for placement of all non-emergency central venous catheters in the internal jugular vein.  Attendings must be present at all critical events during central venous catheterization.  Chest radiography is insufficient to determine if a central venous catheter is in the venous circulation.  We must also measure pressure through the catheter (by manometry or pressure transducer), perform a blood gas analysis, or certain other methods.  Please read the policy in detail.  It is in effect immediately, and failure to comply is a serious matter.  Thank you for your efforts to increase patient safety.

CENTRAL VENOUS CATHETERIZATION SAFETY POLICY
This policy pertains to all elective central venous catheterizations. The policy does not apply during emergency circumstances.  Ultrasonic guidance of central venous catheterization reduces the incidence of inadvertent arterial cannulation. Ultrasonic vessel finder usage is required in all non-emergency internal jugular central venous catheterizations performed without fluoroscopy.
All elective central line insertions on patient floors will be performed by dedicated central line placement teams, such as the Surgical and Medical Intensive Care Unit Line Placement Services.
Appropriately privileged physicians who practice anesthesia, emergency medicine, critical care, and interventional procedures (interventional cardiologists, interventional radiologists, and nephrologists) may insert elective central lines in their procedural areas.  The Chief Medical Officer may identify other physicians that may receive privileges to insert elective central lines in specific procedural areas.
The attending physician must be present and visually supervise critical portions of the procedure, especially the confirmation of catheter placement within the central venous circulation.
A surgeon who has privileges to insert surgical central lines (e.g., Broviac catheters) in the operating rooms shall not place elective central lines outside of the operating room setting unless he/she is a member of a dedicated central line placement team or otherwise qualified as defined by the Chief of Service and the Chief Medical Officer.
Non-contrast radiographic examination will NOT be used to confirm the venous position of central venous catheters.  Radiologic examination is useful for determining the depth of insertion and the presence or absence of complications related to the central line placement, such as pneumothorax or hemothorax.
For all central venous lines, the techniques to be used for confirmation of venous placement include:
Observation of the intravascular pressure waveform using an electronic transducer and pressure tubing;
Determination of the of the intravascular pressure using sterile tubing as a venous manometer;
Analysis of the PO2 of a blood specimen drawn from the needle/catheter;
Using real-time fluoroscopic or echocardiographic confirmation of venous catheterization (e.g., visualizing the guide wire or catheter within the superior vena cava); or
Using a contrast study to opacify the venous structures.
For Insertion of Large-Bore Catheters and Introducers
To prevent inadvertent arterial cannulation with large-bore catheters (>5 French diameter or equivalent pediatric sizes), venous localization of the introducing needle or (angio) catheter must be confirmed by one or more of several techniques noted above prior to vessel dilation.  If technically unfeasible to conduct a confirmatory test with a short catheter or introducer needle prior to dilation, the recommendation is that a temporary catheter (<5 French) be placed to conduct one of the confirmatory methods.
In the event that no confirmatory test is conclusive, then the catheter must be removed.
The medical and nursing personnel present at the central line insertion must complete all applicable checklists, follow strict asepsis, and use all precautions currently required by the Central Line Associated Bloodstream Infection (CLABs) protocols of The Mount Sinai Hospital.  Nursing personnel will retain the authority to supervise and intervene to ensure that CLABs protocols are followed by the physicians and teams that are placing the central lines.  The current checklist for central line insertion is attached to this policy.
Ideally, central lines shall be removed no more than 7-10 days following insertion unless there are extenuating circumstances, which should be documented in the medical record.  Peripherally-inserted central catheter (PICC) lines are exempt from this requirement.  The primary service responsible for patient care shall monitor central lines for duration of insertion and signs of CLABs.  If the patient has a positive blood culture (as defined by CDC guidelines), the primary service will complete and forward a Root Cause Analysis (RCA) form to the Director of Epidemiology.  The current RCA form is attached to this policy.
The Materials Management service shall only distribute central line insertion materials and catheters to dedicated central line placement teams, and the procedural areas and patient care units where the physicians have privileges to insert central lines (see #2 above).  Sterile tubing to facilitate venous manometry shall be distributed with central line insertion materials  Central line insertion supplies shall be restricted to resuscitation carts and other emergency supply locations on patient floors.
NOTES ON LIMITATIONS OF THE TECHNIQUES TO PREVENT INADVERTENT ARTERIAL CANNULATION:
No one technique is guaranteed to be completely accurate in confirming venous location of a needle or catheter.
The following issues must be considered in interpreting these tests:
The “arterial-like” blood spurt and “arterial-looking” blood color are unreliable markers of the exact arterial location of a catheter and should not be used as confirmation of position, except in dire emergencies, such as CPR.
Manometric observation of a liquid column in the tubing connected to the catheter will provide a rough estimate of the venous or arterial nature of the intravascular pressure. However, manometric observation can be misleading in circumstances where the arterial pressure is low and the venous pressure is high.
Blood gas analysis is most effective when the sample from the central line is compared with a known arterial sample, or is <50 mm Hg in the presence of a high arterial saturation (>90%) as assessed using pulse oximetry.
Radiologic interpretation of a single planar image is not conclusive evidence of central venous catheterization due to the proximity of arterial and venous structures in the thorax.

CENTRAL VENOUS CATHETERIZATION SAFETY POLICY

This policy pertains to all elective central venous catheterizations. The policy does not apply during emergency circumstances.  Ultrasonic guidance of central venous catheterization reduces the incidence of inadvertent arterial cannulation. Ultrasonic vessel finder usage is required in all non-emergency internal jugular central venous catheterizations performed without fluoroscopy.

All elective central line insertions on patient floors will be performed by dedicated central line placement teams, such as the Surgical and Medical Intensive Care Unit Line Placement Services.

Appropriately privileged physicians who practice anesthesia, emergency medicine, critical care, and interventional procedures (interventional cardiologists, interventional radiologists, and nephrologists) may insert elective central lines in their procedural areas.  The Chief Medical Officer may identify other physicians that may receive privileges to insert elective central lines in specific procedural areas.

The attending physician must be present and visually supervise critical portions of the procedure, especially the confirmation of catheter placement within the central venous circulation.

A surgeon who has privileges to insert surgical central lines (e.g., Broviac catheters) in the operating rooms shall not place elective central lines outside of the operating room setting unless he/she is a member of a dedicated central line placement team or otherwise qualified as defined by the Chief of Service and the Chief Medical Officer.

Non-contrast radiographic examination will NOT be used to confirm the venous position of central venous catheters.  Radiologic examination is useful for determining the depth of insertion and the presence or absence of complications related to the central line placement, such as pneumothorax or hemothorax.

For all central venous lines, the techniques to be used for confirmation of venous placement include:

Observation of the intravascular pressure waveform using an electronic transducer and pressure tubing;

Determination of the of the intravascular pressure using sterile tubing as a venous manometer;

Analysis of the PO2 of a blood specimen drawn from the needle/catheter;

Using real-time fluoroscopic or echocardiographic confirmation of venous catheterization (e.g., visualizing the guide wire or catheter within the superior vena cava); or

Using a contrast study to opacify the venous structures.

For Insertion of Large-Bore Catheters and Introducers

To prevent inadvertent arterial cannulation with large-bore catheters (>5 French diameter or equivalent pediatric sizes), venous localization of the introducing needle or (angio) catheter must be confirmed by one or more of several techniques noted above prior to vessel dilation.  If technically unfeasible to conduct a confirmatory test with a short catheter or introducer needle prior to dilation, the recommendation is that a temporary catheter (<5 French) be placed to conduct one of the confirmatory methods.

In the event that no confirmatory test is conclusive, then the catheter must be removed.

The medical and nursing personnel present at the central line insertion must complete all applicable checklists, follow strict asepsis, and use all precautions currently required by the Central Line Associated Bloodstream Infection (CLABs) protocols of The Mount Sinai Hospital.  Nursing personnel will retain the authority to supervise and intervene to ensure that CLABs protocols are followed by the physicians and teams that are placing the central lines.  The current checklist for central line insertion is attached to this policy.

Ideally, central lines shall be removed no more than 7-10 days following insertion unless there are extenuating circumstances, which should be documented in the medical record.  Peripherally-inserted central catheter (PICC) lines are exempt from this requirement.  The primary service responsible for patient care shall monitor central lines for duration of insertion and signs of CLABs.  If the patient has a positive blood culture (as defined by CDC guidelines), the primary service will complete and forward a Root Cause Analysis (RCA) form to the Director of Epidemiology.  The current RCA form is attached to this policy.

The Materials Management service shall only distribute central line insertion materials and catheters to dedicated central line placement teams, and the procedural areas and patient care units where the physicians have privileges to insert central lines (see #2 above).  Sterile tubing to facilitate venous manometry shall be distributed with central line insertion materials  Central line insertion supplies shall be restricted to resuscitation carts and other emergency supply locations on patient floors.

NOTES ON LIMITATIONS OF THE TECHNIQUES TO PREVENT INADVERTENT ARTERIAL CANNULATION:

No one technique is guaranteed to be completely accurate in confirming venous location of a needle or catheter.

The following issues must be considered in interpreting these tests:

The “arterial-like” blood spurt and “arterial-looking” blood color are unreliable markers of the exact arterial location of a catheter and should not be used as confirmation of position, except in dire emergencies, such as CPR.

Manometric observation of a liquid column in the tubing connected to the catheter will provide a rough estimate of the venous or arterial nature of the intravascular pressure. However, manometric observation can be misleading in circumstances where the arterial pressure is low and the venous pressure is high.

Blood gas analysis is most effective when the sample from the central line is compared with a known arterial sample, or is <50 mm Hg in the presence of a high arterial saturation (>90%) as assessed using pulse oximetry.

Radiologic interpretation of a single planar image is not conclusive evidence of central venous catheterization due to the proximity of arterial and venous structures in the thorax.

Written by reuben

March 12th, 2010 at 5:00 pm

CDC Advisory: Notice to Providers Concerning Potential Cases of Mumps During a Multi-State Outbreak

We have just received a CDC Advisory concerning mumps outbreak. It is available on the HAN home page, is appended to this email, and is also attached as a pdf file. To read the attachment, you will need the Adobe reader. If you do not have that software, it can be downloaded at no cost at http://www.adobe.com/products/acrobat/readstep2.html.
To log into the HAN, for this alert and many related documents, go to www.nyc.gov/health/nycmed
If you have any questions or problems, call 1-888-NYCMED9 or write to nycmed@health.nyc.gov
If healthcare providers have any concerns regarding a suspected or confirmed case related to the CDC notification below, please call the NYC DOHMH Provider Access Line at 1-866-NYC DOH1.
This is an official
CDC Health Advisory
Distributed via Health Alert Network
March 11, 2010, 14:32 EST (2:32 PM EST)
CDCHAN-00310-10-03-11-ADV-N
MARCH, 2010, Notice to Providers Conce rning
Potential Cases of Mumps During a Multi-State Outbreak
CDC, in collaboration with public health officials in numerous states in the Northeast, continues to investigate a multi-state mumps outbreak.
Who is affected: The Hasidic (Jewish) populations from New York and New Jersey are primarily affected. This outbreak is also occurring among members of the same population in Israel.
Why mumps transmission is a concern at this time: The onset of Passover (March 30th through April 5th) may offer further opportunities for mumps transmission as people from the Hasidic community travel for this major religious observance.
Recommendations for Providers:
• Healthcare providers with patients in any Hasidic community should ensure that these patients, including both children and adults, are up to date with measles-mumps-rubella (MMR) vaccine. The second dose of MMR vaccine for children may be administered as early as 28 days followi ng the first dose.
• Healthcare providers may consider offering a second dose of MMR vaccine to adults who have received one dose.
• Healthcare providers who have contact within the Hasidic community should ensure that they themselves and ALL staff are immune to mumps in accordance with ACIP recommendations http://www.cdc.gov/vaccines/recs/provisional/downloads/mmr-evidence-immunity-Aug2009-508.pdf or receive two doses of MMR vaccine.
• Persons with suspected mumps should be isolated for 5 days after onset of parotitis and, if they visit a health-care setting, droplet precautions should be initiated immediately.
• Any suspected mumps case should be reported to the health department in the area where the case-patient resides.
Resources for Providers:
Vaccine Information Statement
Yiddish: http://www.nyc.gov/html/doh/downloads/pdf/imm/mumps_vis-yi.pdf
English: http://www.cdc.gov/vaccines/pubs/vis/default .htm#mmr
Resources (fact sheets on mumps and the outbreak) for Patients:http://www.cdc.gov/mumps/about/downloads/mumps-factsheet.pdf
http://www.cdc.gov/mumps/outbreaks/outbreak-patient-qa.html
Radio PSA (free for download): http://www2c.cdc.gov/podcasts/player.asp?f=805169
For Additional Information:
For more information on MMR vaccines, visit: http://www.cdc.gov/vaccines/vpd-vac/mumps
More information about mumps can be found at http://www.cdc.gov/mumps
For the latest information about this outbreak, go to http://www.cdc.gov/mumps/outbreaks.html
For background, please refer to the following articles:
• Update: Mumps Outbreak — New York and New Jersey, June 2009–January 2010
MMWR Vol 59, No 5;February 12, 2010
• Mumps Outbreak — New York, New Jersey, Quebec, 2009
MMWR Vol 57, No 58(Dispatch);1-4 November 12, 2009

We have just received a CDC Advisory concerning mumps outbreak. It is available on the HAN home page, is appended to this email, and is also attached as a pdf file. To read the attachment, you will need the Adobe reader. If you do not have that software, it can be downloaded at no cost at http://www.adobe.com/products/acrobat/readstep2.html.

To log into the HAN, for this alert and many related documents, go to www.nyc.gov/health/nycmed

If you have any questions or problems, call 1-888-NYCMED9 or write to nycmed@health.nyc.gov

If healthcare providers have any concerns regarding a suspected or confirmed case related to the CDC notification below, please call the NYC DOHMH Provider Access Line at 1-866-NYC DOH1.

This is an official

CDC Health Advisory

Distributed via Health Alert Network

March 11, 2010, 14:32 EST (2:32 PM EST)

CDCHAN-00310-10-03-11-ADV-N

MARCH, 2010, Notice to Providers Conce rning

Potential Cases of Mumps During a Multi-State Outbreak

CDC, in collaboration with public health officials in numerous states in the Northeast, continues to investigate a multi-state mumps outbreak.

Who is affected: The Hasidic (Jewish) populations from New York and New Jersey are primarily affected. This outbreak is also occurring among members of the same population in Israel.

Why mumps transmission is a concern at this time: The onset of Passover (March 30th through April 5th) may offer further opportunities for mumps transmission as people from the Hasidic community travel for this major religious observance.

Recommendations for Providers:

• Healthcare providers with patients in any Hasidic community should ensure that these patients, including both children and adults, are up to date with measles-mumps-rubella (MMR) vaccine. The second dose of MMR vaccine for children may be administered as early as 28 days followi ng the first dose.

• Healthcare providers may consider offering a second dose of MMR vaccine to adults who have received one dose.

• Healthcare providers who have contact within the Hasidic community should ensure that they themselves and ALL staff are immune to mumps in accordance with ACIP recommendations http://www.cdc.gov/vaccines/recs/provisional/downloads/mmr-evidence-immunity-Aug2009-508.pdf or receive two doses of MMR vaccine.

• Persons with suspected mumps should be isolated for 5 days after onset of parotitis and, if they visit a health-care setting, droplet precautions should be initiated immediately.

• Any suspected mumps case should be reported to the health department in the area where the case-patient resides.

Resources for Providers:

Vaccine Information Statement

Yiddish: http://www.nyc.gov/html/doh/downloads/pdf/imm/mumps_vis-yi.pdf

English: http://www.cdc.gov/vaccines/pubs/vis/default .htm#mmr

Resources (fact sheets on mumps and the outbreak) for Patients:http://www.cdc.gov/mumps/about/downloads/mumps-factsheet.pdf

http://www.cdc.gov/mumps/outbreaks/outbreak-patient-qa.html

Radio PSA (free for download): http://www2c.cdc.gov/podcasts/player.asp?f=805169

For Additional Information:

For more information on MMR vaccines, visit: http://www.cdc.gov/vaccines/vpd-vac/mumps

More information about mumps can be found at http://www.cdc.gov/mumps

For the latest information about this outbreak, go to http://www.cdc.gov/mumps/outbreaks.html

For background, please refer to the following articles:

• Update: Mumps Outbreak — New York and New Jersey, June 2009–January 2010

MMWR Vol 59, No 5;February 12, 2010

• Mumps Outbreak — New York, New Jersey, Quebec, 2009

MMWR Vol 57, No 58(Dispatch);1-4 November 12, 2009

Written by reuben

March 11th, 2010 at 10:07 pm

Posted in ID

M&M Tips March 2010

Tips from your diligent peer review committee.
1. When a patient has copious ongoing bleeding, and is hypotensive, consider giving blood. The blood bank can provide un-crossmatched blood very quickly if necessary.
2. When a patient who has a very low blood pressure requires intubation, consider improving the blood pressure prior to performing intubation, as the transition to positive pressure and pharmacologic sympatholysis that accompanies RSI often further depress blood pressure. Intravenous fluids and pressors are two strategies. Phenylephrine 10 mg/1 cc vials, are now available in both the adult and pediatric med rooms at Sinai.
3. In patients who require intubation but cannot be preoxygenated effectively, or in patients who require high minute ventilation to maintain physiologic pH, consider maneuvers to improve oxygenation/ventilation around RSI if an awake approach is not predicted to be successful. These maneuvers include BVM or NIV before, during, and after induction, perhaps using an LMA (after induction). Short laryngoscopy times and first pass success are more important in these patients – choose your approach and intubator accordingly.
Thanks to Dr. Holland Yang for her expertly-presented M&M yesterday.
Key points from the discussion:
* Aortic dissection is an uncommon but lethal, treatable disease associated with a steadily increasing mortality with every hour the diagnosis is delayed.
* Aortic dissection can be very hard to diagnose. 1 out of 3 cases do not have chest pain, and 1 out of 20 cases have no pain anywhere. 1 out 3 cases are first diagnosed on autopsy.
* Key risk factors include abnormalities of the aorta (connective tissue disorders, syphilitic aortitis, Takayasu arteritis) and aortic valve abnormalities (bicuspid aortic valve, valvuloplasty). The disease is also associated with hypertension (especially stimulant use and weightlifting) and pregnancy.
* The most important clinical presentations are pain in the chest and back, migratory chest/back/abdominal pain, and chest pain with a neurological deficit.
* Unusual combinations of symptoms, such as back or abdominal pain with a neurological deficit and symptoms on both sides of the diaphragm, should raise suspicion of the disease. Although not as well described, we have seen several cases at Sinai/Elmhurst where diarrhea (from bowel ischemia) was a prominent component of the presentation.
* In cases where the diagnosis is entertained but not ruled out with a definitive study (usually CT aortography), clinical decision-making to that effect should be documented. Charting a normal neuro exam and peripheral pulse exam implies thoroughness, though absence of findings with these maneuvers does not exclude the diagnosis.

Written by reuben

March 11th, 2010 at 3:12 pm

Posted in Pearls

Q Tips – March 2010

Tips from your diligent peer review committee.
1. When a patient has copious ongoing bleeding, and is hypotensive, consider giving blood. The blood bank can provide un-crossmatched blood very quickly if necessary.
2. When a patient who has a very low blood pressure requires intubation, consider improving the blood pressure prior to performing intubation, as the transition to positive pressure and pharmacologic sympatholysis that accompanies RSI often further depress blood pressure. Intravenous fluids and pressors are two strategies. Phenylephrine 10 mg/1 cc vials, are now available in both the adult and pediatric med rooms at Sinai.
3. In patients who require intubation but cannot be preoxygenated effectively, or in patients who require high minute ventilation to maintain physiologic pH, consider maneuvers to improve oxygenation/ventilation around RSI if an awake approach is not predicted to be successful. These maneuvers include BVM or NIV before, during, and after induction, perhaps using an LMA (after induction). Short laryngoscopy times and first pass success are more important in these patients – choose your approach and intubator accordingly.

Tips from your diligent peer review committee.

1. When a patient has copious ongoing bleeding, and is hypotensive, consider giving blood. The blood bank can provide un-crossmatched blood very quickly if necessary.

2. When a patient who has a very low blood pressure requires intubation, consider improving the blood pressure prior to performing intubation, as the transition to positive pressure and pharmacologic sympatholysis that accompanies RSI often further depress blood pressure. Intravenous fluids and pressors are two strategies. Phenylephrine 10 mg/1 cc vials, are now available in both the adult and pediatric med rooms at Sinai.

3. In patients who require intubation but cannot be preoxygenated effectively, or in patients who require high minute ventilation to maintain physiologic pH, consider maneuvers to improve oxygenation/ventilation around RSI if an awake approach is not predicted to be successful. These maneuvers include BVM or NIV before, during, and after induction, perhaps using an LMA (after induction). Short laryngoscopy times and first pass success are more important in these patients – choose your approach and intubator accordingly.

Written by reuben

March 11th, 2010 at 2:13 pm

Posted in Pearls

Chart Printing

Written by phil

March 11th, 2010 at 12:32 pm

Posted in IBEX

Office Based Surgery Complications

If you see a patient with a complication of Office Based Surgery, there is a provider obligation to report it in NYS. Please call Risk management for assistance in getting it reported as there is a one business day time frame. Below is a key excerpt from the FAQ.

Any physician, physician assistant or specialist assistant in a hospital setting who believes that a patient complaint, complication, condition, emergency room visit, hospital admission or death is related to an OBS procedure must report an OBS adverse event as soon as they suspect that there is some relationship to an OBS surgical procedure . In such a case, the reporter may not be able to complete the form in its entirety, but should submit as much information as possible.

From Dr. Hill

Written by phil

March 10th, 2010 at 6:13 pm

Posted in Admin

GE Monitors Support

Written by reuben

March 2nd, 2010 at 7:25 pm