Harbor:ED policy manual - Revision history

Bchap23: /* #12 Consent for Blood Alcohol Tests Requested by Law Enforcement */

2024-02-20T05:26:41Z

#12 Consent for Blood Alcohol Tests Requested by Law Enforcement

← Older revision		Revision as of 05:26, 20 February 2024
Line 267:		Line 267:

	'''Protocol''':		'''Protocol''':
	#Patients in police custody presenting to DEM for blood alcohol test ~~'''must be registered'''~~ and have appropriate documentation made in the electronic medical record.		#Patients in police custody presenting to DEM for blood alcohol test MUST BE REGISTERED and have appropriate documentation made in the electronic medical record.
	#If the blood sample is drawn by Harbor staff member, a ~~'''physician signature on the medical record is required~~ (eg, ~~need~~ MSE ~~note~~, ~~ok to book form~~'''; no need for communication order).		#If the blood sample is drawn by Harbor staff member, a PHYSICIAN SIGNATURE ON THE MEDICAL RECORD IS REQUIRED (eg, NEED MSE NOTE, OK TO BOOK FORM'''; no need for communication order).
	#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.		#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.
	#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.		#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.

Bchap23: /* #12 Consent for Blood Alcohol Tests Requested by Law Enforcement */

2024-02-20T05:23:34Z

#12 Consent for Blood Alcohol Tests Requested by Law Enforcement

← Older revision		Revision as of 05:23, 20 February 2024
Line 267:		Line 267:

	'''Protocol''':		'''Protocol''':
	#Patients in police custody presenting to DEM for blood alcohol test must be registered and have appropriate documentation made in the electronic medical record.		#Patients in police custody presenting to DEM for blood alcohol test '''must be registered''' and have appropriate documentation made in the electronic medical record.
	#If the blood sample is drawn by Harbor staff member, a physician signature on the medical record is required (eg, need MSE note, ok to book form; no need for communication order).		#If the blood sample is drawn by Harbor staff member, a '''physician signature on the medical record is required (eg, need MSE note, ok to book form'''; no need for communication order).
	#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.		#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.
	#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.		#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.

Bchap23: /* #5 Evaluation By Consulting Services */

2023-05-02T17:15:06Z

#5 Evaluation By Consulting Services

← Older revision		Revision as of 17:15, 2 May 2023
Line 345:		Line 345:
	**The Consulting Resident then discusses the case with an ED provider who will also independently evaluate the patient and write their own note in the ED chart.		**The Consulting Resident then discusses the case with an ED provider who will also independently evaluate the patient and write their own note in the ED chart.

			*DHS Policy 360a
			** Emergent within 2 hours
			** must document recommendations, attending co-sign within 24 hours
			*DHS Policy 605 - 72 hours for attending signature

	==Psych==		==Psych==

Bchap23: /* #12 Consent for Blood Alcohol Tests Requested by Law Enforcement */

2023-05-01T07:27:24Z

#12 Consent for Blood Alcohol Tests Requested by Law Enforcement

← Older revision		Revision as of 07:27, 1 May 2023
Line 272:		Line 272:
	#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.		#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.
	#'''ED staff will not attempt to obtain a blood alcohol test if physical force is required (on the part of staff or law enforcement personnel) to obtain the test'''		#'''ED staff will not attempt to obtain a blood alcohol test if physical force is required (on the part of staff or law enforcement personnel) to obtain the test'''
	#Police must supply the evidence collection tube for the lab draw and then follow chain of ~~command~~.		#Police must supply the evidence collection tube for the lab draw and then follow chain of custody.
	# For patient that do NOT have capacity and are getting a blood draw for their medical care, staff can draw for police if they have the appropriate written requests and the evidence tube per the implied consent in California.		# For patient that do NOT have capacity and are getting a blood draw for their medical care, staff can draw for police if they have the appropriate written requests and the evidence tube per the implied consent in California.

Bchap23: /* #12 Consent for Blood Alcohol Tests Requested by Law Enforcement */

2023-04-24T21:48:46Z

#12 Consent for Blood Alcohol Tests Requested by Law Enforcement

← Older revision		Revision as of 21:48, 24 April 2023
Line 268:		Line 268:
	'''Protocol''':		'''Protocol''':
	#Patients in police custody presenting to DEM for blood alcohol test must be registered and have appropriate documentation made in the electronic medical record.		#Patients in police custody presenting to DEM for blood alcohol test must be registered and have appropriate documentation made in the electronic medical record.
	#If the blood sample is drawn by Harbor staff member, a physician signature on the medical record is required.		#If the blood sample is drawn by Harbor staff member, a physician signature on the medical record is required (eg, need MSE note, ok to book form; no need for communication order).
	#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.		#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.
	#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.		#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.

Bchap23: /* #12 Consent for Blood Alcohol Tests Requested by Law Enforcement */

2023-04-24T21:46:13Z

#12 Consent for Blood Alcohol Tests Requested by Law Enforcement

← Older revision		Revision as of 21:46, 24 April 2023
Line 271:		Line 271:
	#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.		#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.
	#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.		#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.
	#'''ED staff will not attempt to obtain a blood alcohol test if physical force is required (on the part of staff or law enforcement personnel) to obtain the test.'''		#'''ED staff will not attempt to obtain a blood alcohol test if physical force is required (on the part of staff or law enforcement personnel) to obtain the test'''
	#Police must supply the evidence collection tube for the lab draw and then follow chain of command.		#Police must supply the evidence collection tube for the lab draw and then follow chain of command.
	# For patient that do NOT have capacity and are getting a blood draw for their medical care, staff can draw for police if they have the appropriate written requests and the evidence tube per the implied consent in California.		# For patient that do NOT have capacity and are getting a blood draw for their medical care, staff can draw for police if they have the appropriate written requests and the evidence tube per the implied consent in California.

Bchap23: /* #12 Consent for Blood Alcohol Tests Requested by Law Enforcement */

2023-04-24T21:45:13Z

#12 Consent for Blood Alcohol Tests Requested by Law Enforcement

← Older revision		Revision as of 21:45, 24 April 2023
Line 271:		Line 271:
	#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.		#A police officer must sign a written request form, with witnessed signature. This will go into the medical record.
	#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.		#If the patient has capacity, is conscious and coherent, reasonable effort should be made to obtain consent. If the patient does not have capacity, then implied consent per the state of California, allows the blood draw to occur.
	#ED staff will not attempt to obtain a blood alcohol test if physical force is required (on the part of staff or law enforcement personnel) to obtain the test.		#'''ED staff will not attempt to obtain a blood alcohol test if physical force is required (on the part of staff or law enforcement personnel) to obtain the test.'''
	#Police must supply the evidence collection tube for the lab draw and then follow chain of command.		#Police must supply the evidence collection tube for the lab draw and then follow chain of command.
	# For patient that do NOT have capacity and are getting a blood draw for their medical care, staff can draw for police if they have the appropriate written requests and the evidence tube per the implied consent in California.		# For patient that do NOT have capacity and are getting a blood draw for their medical care, staff can draw for police if they have the appropriate written requests and the evidence tube per the implied consent in California.

Bchap23: /* Family and Next-of-Kin (#17 NOTIFICATIONS & REPORTING, Policy 17.1) */

2021-12-02T20:01:09Z

Family and Next-of-Kin (#17 NOTIFICATIONS & REPORTING, Policy 17.1)

@@ Line 197: / Line 197: @@
-==Family and Next-of-Kin (#17 NOTIFICATIONS & REPORTING, Policy 17.1)==
+===Family and Next-of-Kin (#17 NOTIFICATIONS & REPORTING, Policy 17.1)===
 *All attempts will be made to notify family or legal guardians whenever possible and as soon as possible when a minor presents or is brought to the emergency room.  However, these attempts will not delay emergent care when an emergency medical condition exists. Additionally, the family or next-of-kin of adult patients will be notified at the patient’s request.
 *In the event of a critical patient or patient death Social Services will be contacted to assist with family notification.
 *All attempts to notify family and next of kin should be documented on the patient’s health record.
 ==Triage==

Bchap23 at 20:00, 2 December 2021

2021-12-02T20:00:03Z

Show changes

Bchap23: /* #7 Scope of Assessment */

2021-12-02T19:50:54Z

#7 Scope of Assessment

← Older revision		Revision as of 19:50, 2 December 2021
Line 200:		Line 200:


	==#7 Scope of Assessment==		===#7 Scope of Assessment===
	'''Policy'''		'''Policy'''
	*Patients are initially assessed in triage for the severity of their complaint, where they will also be seen by a provider to initiate the Medical Screening Exam (MSE). ESI Triage guidelines are utilized to ensure standardization of care. Patients are seen in the patient care areas in the order of their triage acuity and ED capacity. Patients in the waiting area are reassessed on a regular basis and treated as their current condition requires.		*Patients are initially assessed in triage for the severity of their complaint, where they will also be seen by a provider to initiate the Medical Screening Exam (MSE). ESI Triage guidelines are utilized to ensure standardization of care. Patients are seen in the patient care areas in the order of their triage acuity and ED capacity. Patients in the waiting area are reassessed on a regular basis and treated as their current condition requires.
Line 220:		Line 220:
	**In general, patients with respiratory symptoms should remain in droplet precautions.		**In general, patients with respiratory symptoms should remain in droplet precautions.
	**When a patient is placed in droplet precautions, the door to the room may remain open, and health care workers and visitors need to wear masks within 3 feet of the patient. Patients moving about the hospital or in crowded areas of the hospital away from a private room should wear a mask.		**When a patient is placed in droplet precautions, the door to the room may remain open, and health care workers and visitors need to wear masks within 3 feet of the patient. Patients moving about the hospital or in crowded areas of the hospital away from a private room should wear a mask.









	==Legal Issues==		==Legal Issues==