Harbor:Transferring a patient - Revision history

Kwilhelm: /* Transferring patients out for HLOC - Time Sensitive Life/Limb/Permanent Disability Threatening Conditions */

2025-05-21T21:13:16Z

Transferring patients out for HLOC - Time Sensitive Life/Limb/Permanent Disability Threatening Conditions

← Older revision		Revision as of 21:13, 21 May 2025
Line 9:		Line 9:
	**Sending facility (YOU) MUST ACCEPT PATIENT BACK ONCE STABILIZED by receiving facility at their request (per agreement with LAC+USC CMO).		**Sending facility (YOU) MUST ACCEPT PATIENT BACK ONCE STABILIZED by receiving facility at their request (per agreement with LAC+USC CMO).
	****If LAC+USC specialty service states no further care needed there, accept back at Harbor ED to complete care.		****If LAC+USC specialty service states no further care needed there, accept back at Harbor ED to complete care.
			****If you are dealing with a complex case, please elevate such calls to our EMS AOD, or UM MOD (Peter Balingit) so they can provide direction to MAC and Transfer Center UM regarding management.

	*Once accepted, '''ask MAC for estimated transport time'''		*Once accepted, '''ask MAC for estimated transport time'''
	**If the time frame for getting transport is inappropriately long for the patient's emergency, ask to speak to the MAC MOD to discuss, or contact your Harbor DEM AOD to request their involvement.		**If the time frame for getting transport is inappropriately long for the patient's emergency, ask to speak to the MAC MOD to discuss, or contact your Harbor DEM AOD to request their involvement.
	**If MAC has no ambulances, MAC may decide to use 911 Emergency Trauma Re-Triage as last resort. Avoid if possible as it takes the local unit of paramedics out of their response area for an extensive period of time. But you can suggest this to MAC if you feel it truly indicated		**If MAC has no ambulances, MAC may decide to use 911 Emergency Trauma Re-Triage as last resort. Avoid if possible as it takes the local unit of paramedics out of their response area for an extensive period of time. But you can suggest this to MAC if you feel it truly indicated
	* Advanced Transport Options - MAC can arrange ALS or Critical Care Ground or Air Transport		* Advanced Transport Options - MAC can arrange ALS or Critical Care Ground or Air Transport if transferring to a DHS facility
	**May require 45 min or longer to activate		**May require 45 min or longer to activate
			**If transferring to a non DHS facility, ask the accepting facility if they can send air transport if you feel it is needed.
	*Consider sending RN, MD or RT staff with LA County fire when CCT level of air ambulance transport is required and private CCT is unavailable or the ETA is too long.		*Consider sending RN, MD or RT staff with LA County fire when CCT level of air ambulance transport is required and private CCT is unavailable or the ETA is too long.

Bchap23: /* Transferring patients out for HLOC - Time Sensitive Life/Limb/Permanent Disability Threatening Conditions */

2023-01-23T22:35:47Z

Transferring patients out for HLOC - Time Sensitive Life/Limb/Permanent Disability Threatening Conditions

← Older revision		Revision as of 22:35, 23 January 2023
Line 28:		Line 28:
	**'''Stroke patient to Comprehensive Stroke Center''' - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]		**'''Stroke patient to Comprehensive Stroke Center''' - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]
	**Patient needing '''emergent radiation therapy''' - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]		**Patient needing '''emergent radiation therapy''' - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]
	** [[Carbon monoxide toxicity\|Hyperbaric Treatment for Carbon Monoxide Toxicity]]		** [[Carbon monoxide toxicity\|'''Hyperbaric Treatment for Carbon Monoxide Toxicity''']]
	*** Options - UCLA Westwood, Long Beach Memorial, UCSD, '''NOT MAC to Catalina''' (only for dive injuries)		*** Options - UCLA Westwood, Long Beach Memorial, UCSD, '''NOT MAC to Catalina''' (only for dive injuries)
	*** UR coordinates the acceptance		*** UR coordinates the acceptance

Bchap23: /* Transferring patients out for HLOC - Time Sensitive Life/Limb/Permanent Disability Threatening Conditions */

2023-01-23T22:34:15Z

Transferring patients out for HLOC - Time Sensitive Life/Limb/Permanent Disability Threatening Conditions

← Older revision		Revision as of 22:34, 23 January 2023
Line 27:		Line 27:
	*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel		*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel
	**'''Stroke patient to Comprehensive Stroke Center''' - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]		**'''Stroke patient to Comprehensive Stroke Center''' - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]
	**Patient needing '''emergent radiation therapy''' - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]		**Patient needing '''emergent radiation therapy''' - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]
			** [[Carbon monoxide toxicity\|Hyperbaric Treatment for Carbon Monoxide Toxicity]]
			*** Options - UCLA Westwood, Long Beach Memorial, UCSD, '''NOT MAC to Catalina''' (only for dive injuries)
			*** UR coordinates the acceptance
			*** Transfers: UR should help coordinate the transfer - ELTC/HLOC - needs to occur <1-2 hrs
			**** Sending facility is supposed to arrange transfer
			**** If UR not able to get transfer in a timely manner --> MAC (CDO) - must be approved by house supervisor & Joy; BLS/ALS/CC transport
			***** Medics can call the radio for online base medical direction/orders

	==Transfers out to Out of Plan (OOP) patient's health network==		==Transfers out to Out of Plan (OOP) patient's health network==

Andreawu at 23:09, 27 June 2022

2022-06-27T23:09:54Z

← Older revision		Revision as of 23:09, 27 June 2022
Line 26:		Line 26:
	**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED		**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED
	*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel		*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel
	**'''Stroke patient to Comprehensive Stroke Center''' - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]		**'''Stroke patient to Comprehensive Stroke Center''' - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]
	**Patient needing e'''~~mergent~~ radiation therapy''' - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]		**Patient needing '''emergent radiation therapy''' - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]

	==Transfers out to Out of Plan (OOP) patient's health network==		==Transfers out to Out of Plan (OOP) patient's health network==

Andreawu at 22:57, 27 June 2022

2022-06-27T22:57:58Z

← Older revision		Revision as of 22:57, 27 June 2022
Line 19:		Line 19:
	*HLOC Transfer Sites		*HLOC Transfer Sites
	**'''[https://emedicine.medscape.com/article/1288203-overview#a2\| Replant Candidates]''' Candidates		**'''[https://emedicine.medscape.com/article/1288203-overview#a2\| Replant Candidates]''' Candidates
	***LAC+USC, see[[Harbor:Replantation_Patients]] for details on transfer process		***LAC+USC, see [[Harbor:Replantation_Patients]] for details on transfer process
	***UCLA Westwood		***UCLA Westwood
	**'''[https://wikem.org/wiki/Harbor:Burns\| Burns]'''		**'''[https://wikem.org/wiki/Harbor:Burns\| Burns]'''

Andreawu at 22:55, 27 June 2022

2022-06-27T22:55:18Z

← Older revision		Revision as of 22:55, 27 June 2022
Line 26:		Line 26:
	**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED		**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED
	*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel		*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel
	**Stroke patient to Comprehensive Stroke Center - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]		**'''Stroke patient to Comprehensive Stroke Center''' - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]
	**Patient needing ~~emergent~~ radiation therapy - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]		**Patient needing e'''mergent radiation therapy''' - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]

	==Transfers out to Out of Plan (OOP) patient's health network==		==Transfers out to Out of Plan (OOP) patient's health network==

Andreawu at 22:54, 27 June 2022

2022-06-27T22:54:17Z

← Older revision		Revision as of 22:54, 27 June 2022
Line 19:		Line 19:
	*HLOC Transfer Sites		*HLOC Transfer Sites
	**'''[https://emedicine.medscape.com/article/1288203-overview#a2\| Replant Candidates]''' Candidates		**'''[https://emedicine.medscape.com/article/1288203-overview#a2\| Replant Candidates]''' Candidates
	***LAC+USC		***LAC+USC, see[[Harbor:Replantation_Patients]] for details on transfer process
	***UCLA Westwood		***UCLA Westwood
	**'''[https://wikem.org/wiki/Harbor:Burns\| Burns]'''		**'''[https://wikem.org/wiki/Harbor:Burns\| Burns]'''

Andreawu at 19:55, 7 June 2022

2022-06-07T19:55:01Z

← Older revision		Revision as of 19:55, 7 June 2022
Line 26:		Line 26:
	**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED		**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED
	*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel		*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel
	**Stroke patient to Comprehensive Stroke Center - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center~~]] [[https://wikem.org/wiki/Harbor:Transfer_to_Comprehensive_Stroke_Center\|Transfer to Comprehensive Stroke Center~~]]		**Stroke patient to Comprehensive Stroke Center - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]]
	**Patient needing emergent radiation therapy - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT~~]] https://wikem.org/wiki/Harbor:XRT\|Transfer for Emergent Radiation Therapy~~]]		**Patient needing emergent radiation therapy - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]]

	==Transfers out to Out of Plan (OOP) patient's health network==		==Transfers out to Out of Plan (OOP) patient's health network==
	*Any OOP patients who are deemed stable for transfer, should have Interqual request placed to see if Utilization Review (UR) staff can transfer the patient back to a hospital in the patient's insurance network.		*Any OOP patients who are deemed stable for transfer, should have Interqual request placed to see if Utilization Review (UR) staff can transfer the patient back to a hospital in the patient's insurance network.
	*Applies for patients who would otherwise be admitted~~, placed in observation or CORE.~~		*Applies for patients who would otherwise be admitted
	*If UR is unable to contact the health plan, or unable to find a bed in a timely fashion (up to attending discretion considering status of ED), then the patient can be admitted~~/obs/CORE'd~~ at HUMC.		*If UR is unable to contact the health plan, or unable to find a bed in a timely fashion (up to attending discretion considering status of ED), then the patient can be admitted at HUMC.

	==See Also==		==See Also==

Andreawu at 19:53, 7 June 2022

2022-06-07T19:53:59Z

← Older revision		Revision as of 19:53, 7 June 2022
Line 26:		Line 26:
	**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED		**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED
	*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel		*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel
	**Stroke patient to Comprehensive Stroke Center - not through MAC. [[https://wikem.org/wiki/Harbor:Transfer_to_Comprehensive_Stroke_Center\|Transfer to Comprehensive Stroke Center]]		**Stroke patient to Comprehensive Stroke Center - not through MAC. [[Harbor:Transfer_to_Comprehensive_Stroke_Center]] [[https://wikem.org/wiki/Harbor:Transfer_to_Comprehensive_Stroke_Center\|Transfer to Comprehensive Stroke Center]]
	**Patient needing emergent radiation therapy - through MAC, rare, but patient goes to LAC+USC [[https://wikem.org/wiki/Harbor:XRT\|Transfer for Emergent Radiation Therapy]]		**Patient needing emergent radiation therapy - through MAC, rare, but patient goes to LAC+USC [[Harbor:XRT]] https://wikem.org/wiki/Harbor:XRT\|Transfer for Emergent Radiation Therapy]]

	==Transfers out to Out of Plan (OOP) patient's health network==		==Transfers out to Out of Plan (OOP) patient's health network==

Andreawu at 19:52, 7 June 2022

2022-06-07T19:52:32Z

← Older revision		Revision as of 19:52, 7 June 2022
Line 21:		Line 21:
	***LAC+USC		***LAC+USC
	***UCLA Westwood		***UCLA Westwood
	***[[https://wikem.org/wiki/Harbor:MAC_Transfer_Burn_or_Replant\|Harbor:MAC_Transfer_Burn_or_Replant]]
	**'''[https://wikem.org/wiki/Harbor:Burns\| Burns]'''		**'''[https://wikem.org/wiki/Harbor:Burns\| Burns]'''
	***LAC+USC		***LAC+USC
Line 27:		Line 26:
	**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED		**'''STEMI''' if our cath lab is encumbered: 911 to closest STEMI Receiving Facility. MICN - has what SRCs are open, courtesy call to their ED
	*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel		*** '''[[STEMI 911 Inter-Facility Transfer (IFT)]]''' during cath lab remodel
	**[[https://wikem.org/wiki/Harbor:Transfer_to_Comprehensive_Stroke_Center\|~~Stroke patient~~ to Comprehensive Stroke Center]] - ~~not~~ through MAC.		**Stroke patient to Comprehensive Stroke Center - not through MAC. [[https://wikem.org/wiki/Harbor:Transfer_to_Comprehensive_Stroke_Center\|Transfer to Comprehensive Stroke Center]]
	**[[https://wikem.org/wiki/Harbor:XRT\|~~Harbor:XRT~~ Transfer]]		**Patient needing emergent radiation therapy - through MAC, rare, but patient goes to LAC+USC [[https://wikem.org/wiki/Harbor:XRT\|Transfer for Emergent Radiation Therapy]]

	==Transfers out to Out of Plan (OOP) patient's health network==		==Transfers out to Out of Plan (OOP) patient's health network==