Harbor:Replantation Patients: Difference between revisions
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*** For Plastics, ensure that senior resident has evaluated patient | *** For Plastics, ensure that senior resident has evaluated patient | ||
* If patient is deemed a potential replantation candidate, then | * If patient is deemed a potential replantation candidate, then | ||
** Hand consultant (senior resident or attending) should speak directly to LAC+USC Attending | ** '''Hand consultant (senior resident or attending) should speak directly to LAC+USC Attending Replant Surgeon''' on the recorded MAC line to discuss replant candidate transfer acceptance | ||
** Once patient is accepted for transfer, ED provider coordinates further transfer logistics via MAC | ** Once patient is accepted for transfer, ED provider coordinates further transfer logistics via MAC | ||
** ED provider to say: "We are requesting a Higher Level of Care Urgent/Emergent transfer to USC per DHS Policy 373.3". This makes the request a priority and should get transfer approved within 60 minutes. Ask MAC for ETA of transport. | ** '''ED provider to say: "We are requesting a Higher Level of Care Urgent/Emergent transfer''' to LAC+USC per DHS Policy 373.3". | ||
** If MAC is unable to provide transport for Higher Level of Care Urgent/Emergent transfer within a reasonable amount of time this issue should be escalated to the MAC MOD, DEM Admin on Duty (AOD), and the Attending Trauma Surgeon | ** This makes the request a priority and should get transfer approved within 60 minutes. | ||
** '''Ask MAC for ETA of transport'''. | |||
** If MAC is unable to provide transport for Higher Level of Care Urgent/Emergent transfer within a reasonable amount of time this issue should be escalated to the MAC Medical Officer of the Day (MOD), DEM Admin on Duty (AOD), and the Attending Trauma Surgeon | |||
**TRANSFERS FOR POTENTIAL REPLANTATION WILL PROCEED REGARDLESS OF WHETHER LAC+USC HAS AVAILABLE BEDS. (Even if closed to transfers for that reason per CMO Dr. Spellberg at LAC+USC) | **TRANSFERS FOR POTENTIAL REPLANTATION WILL PROCEED REGARDLESS OF WHETHER LAC+USC HAS AVAILABLE BEDS. (Even if closed to transfers for that reason per CMO Dr. Spellberg at LAC+USC) | ||
Revision as of 19:12, 30 June 2022
For immediate clinical management see "Replantation"
Transfer Protocol
- Obtain STAT Hand Call Consult and page out as TTA2 if not done already
- Hand call consultant should come to ED for emergent evaluation
- Rotates between Ortho, Plastics, check doc box for who is on for the day
- For Plastics, ensure that senior resident has evaluated patient
- Hand call consultant should come to ED for emergent evaluation
- If patient is deemed a potential replantation candidate, then
- Hand consultant (senior resident or attending) should speak directly to LAC+USC Attending Replant Surgeon on the recorded MAC line to discuss replant candidate transfer acceptance
- Once patient is accepted for transfer, ED provider coordinates further transfer logistics via MAC
- ED provider to say: "We are requesting a Higher Level of Care Urgent/Emergent transfer to LAC+USC per DHS Policy 373.3".
- This makes the request a priority and should get transfer approved within 60 minutes.
- Ask MAC for ETA of transport.
- If MAC is unable to provide transport for Higher Level of Care Urgent/Emergent transfer within a reasonable amount of time this issue should be escalated to the MAC Medical Officer of the Day (MOD), DEM Admin on Duty (AOD), and the Attending Trauma Surgeon
- TRANSFERS FOR POTENTIAL REPLANTATION WILL PROCEED REGARDLESS OF WHETHER LAC+USC HAS AVAILABLE BEDS. (Even if closed to transfers for that reason per CMO Dr. Spellberg at LAC+USC)
Dealing with Disagreements Regarding Transfer
- If there is disagreement between HUCLA ED/Trauma/Hand Call Consultatant and Hand LAC+USC Replantation service about proceeding with replantation then HUCLA Hand Call Attending must talk to LAC+USC Replantation Attending on the recorded MAC line.
- If there continues to be disagreement - the patient WILL be accepted by LAC+USC for an in-person evaluation by the replantation service (per CMO's at LAC+USC and HUCLA) - please involve both Trauma Attending and DEM Admin on Duty (AOD)
Repatriation
- If the patient is transferred to LAC+USC and after evaluation it is decided that replantation is not indicated - HUCLA WILL accept the patient back in transfer.