TSICU:Admissions

Coming Soon: ER to TSICU Handoff

Every admission to the TSICU requires Trauma/SICU Attending approval

• A TSICU MD is required to be at the bedside to receive report from the admitting service upon patient arrival to the TSICU

• Input orders as soon as possible

• Verbal orders are discouraged unless absolutely necessary as a results patient acuity (i.e. Code Blue)

• Ensure completion of:
  • History documentation
  • Admission Medication Reconciliation

• Obtain iMedConsent for "Intensive Care Unit Interventions" as soon as possible
• Include "Blood Consent"

From the Emergency Room

media:ER_to_SICU_Workflow_v2.pdf

• Following approval by the Trauma/SICU Attending, the charge or relief RN will be notified and a unit bed assigned

• At minimum, the following patient information should be conveyed (Name, MRN, admission diagnosis, clinical condition)

• Bed assignment requires notification of bed control

• An ER RN to SICU RN handoff must take place PRIOR to the patient's arrival in the TSICU

• A formal handoff is to take place between a member of the on-call surgery team and a member of the TSICU team
  • media:IPASS.jpg

• Any clinical concerns or signs of deterioration requires IMMEDIATE notification of the Trauma or TSICU Attending
  • TSICU:Mandatory Call Criteria

From the OR

• Patients previously admitted to the TSICU
  • media:OR_to_TSICU_RN_Handoff_Tool_.pdf

• Elective or scheduled operations in which TSICU admission is anticipated
  • The surgical service should communicate potential need for a TSICU bed at least 1 day prior to the elective case

From the Ward (including Surgical RRTs)

• Ensure that the TSICU Attending and relief/charge RN are aware of pending admission
  • Patient flow RNs are present at RRTs and should also be made aware of TSICU transfer/need for higher level of care

• A formal handoff should be performed between the primary team MD or rapid response team MD and TSICU MDs using the iPASS handoff tool
  • media:IPASS.jpg

Interfacility Transfers

• Direct TSICU admissions are a rare occurrence

• Only the TSICU or on-call Trauma Attending is permitted to accept a direct admission to the TSICU

• As per all inpatient transfer requests, the media:Inpatient_Transfer_Accept_Form.pdf must be completed and submitted to bed control