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Archive for November, 2012

UTI resistance at Elmhurst

There has been increasing resistance to Cipro for urine cultures sent from Elmhurst ED. Cephalexin and Macrobid currently have lower resistance rate. Bactrim continues to have high resistance for treatment of UTI.

Sheree Givre, MD, FACEP
Associate Director
Department of Emergency Medicine
Queens SART, Medical Director

Written by phil

November 29th, 2012 at 7:53 pm

Posted in Antibiotics,Elmhurst

Central Line Policy

Written by phil

November 29th, 2012 at 7:50 pm

Healthix

Data on all NYU patients is available through Healthix by going to the “More Services” button in the lower left hand corner of Epic. Available data includes: hospital d/c summaries, cardiology reports, radiology reports, pathology reports. NO LABORATORY RESULTS ARE AVAILABLE for at least several more weeks. Similar data is also available from BI, SLR, and many other hospitals in Long Island and Queens.

Please let me know if you have any questions or problems.

Thanks,
Jason

Written by phil

November 14th, 2012 at 8:10 pm

Pediatric Procedures

So we now have Sweet Ease for calming our cranky babies or babies before procedures and Pain Ease spray for use over intact skin to help with procedures, access, etc ! Both these items are stored in our Pediatric med / store room in our ED: the Sweet ease on the shelf near diapers and the Pain Ease immediately to the R, on the lower metal shelf. We are waiting for our baby pacifiers to arrive. Sweet ease and the pacifiers are great to help our little patients deal with painful procedures ( LP, etc.; can also be helpful when obtaining a BP on infants, hint, hint); please use them.

Also, please take time to review the location of items in the resuscitation room and on our isolette (located in room 3T) so you are also prepared to find things if an emergency occurs. There are 2 neonatal resuscitation boxes, one located on the code cart in the resuscitation room and one on the isolette cart, top shelf.

We also have shorter needles for use in accessing our younger infants.
If there are any concerns or questions about any operations related issues,please let me know.
Thanks
Sylvia
Sylvia E Garcia, MD
Assistant Professor, Pediatric Emergency Medicine
Operations Director, Pediatric Emergency Medicine
PALS Director, Emergency Medicine Residency

Written by phil

November 14th, 2012 at 4:19 pm

Posted in Peds

Hurricane Sandy Map

google sandy crisis map has various layers of information including reported availability of gas

http://www.google.org/crisismap/2012-sandy-nyc

Written by phil

November 9th, 2012 at 4:34 pm

Posted in Hurricane Sandy

Emergency Dialysis Patients

Patients are having a tremendous problem accessing their usual hemodialysis.
Here is a summary of how to get these folks the services they need. This is neither a ‘policy’ nor a ‘protocol.’ It is a summary of conversations yesterday with ED and Renal folks.

For HD patients:

* NYU Dialysis patients who have temporary, pre-arranged HD arranged here will be flagged by BAs at greet and sent to outpatient HD. If that fails, we should call Yvette Cummings at 646-285-8273, then the patient should be d/c from ED and go to outpatient HD.

* For other patients who cannot access their home dialysis centers we should draw a GEM for K+ and get hep B surface Ag and Ab quant. If the pt has HYPERkalemia or volume overload call renal for emergency dialysis.
* If a patient does NOT need emergent dialysis follow the steps below:

1. call the ED social worker who will assess where the patient was supposed to go based on their home HD site.
2. If the patient has such a secondary HD they are supposed to be using during this time, they should be discharged to follow up there for dialysis.
3. if such a secondary site cannot be identified, call renal, they will arrange a dialysis time here. Whether that is now or tomorrow, the patient can be discharged from the ED to go to that appointment. (There I some technical thing the BAs do that isn’t quite discharging then, so just be sure the BA at discharge knows the patient is leaving the ED and going to outpatient HD)

(Brian Radbill added “if you have any concerns, please call the on call Renal Fellow, especially if pt is going to be discharged and does not have a very solid plan for HD the next day at their own unit. We discussed having these pts come back to the B1 HD unit at 9am so. We can work it out from there.)

Written by phil

November 1st, 2012 at 9:31 pm

Posted in Hurricane Sandy

EMERGENCY ACCESS TO PRESCRIPTION MEDICATIONS

Written by phil

November 1st, 2012 at 9:30 pm