ED Muskoka Physicians - Living the Dream

RVH peds psychiatry beds

RVH beds open today!
The email with criteria/labs/etc for intake is coming via Sara and Nancy!!

More beds.


CT Reqs! Light it up!

Please remember to do CT reqs for all CT scans requiring IV contrast!!

Both sites.
All the time.

Nurses will stop laughing at you in Bracebridge when you do them now…but they have been told to look for them!

ROB SANSOM told me he only reads the posts with a better title so hence “Light it up!”
Tis the season!


Please code any overdose as much as possible on your diagnosis line!
We need this for our coders who are struggling…

“Overdose – suspect fentanyl”
or “Overdose – mixed without opiod” are two examples

cleary chart if you gave narcan as they are looking for this and if there is a response to narcan.

Add a progress note to put your d/c diagnosis if you don’t have room.

Also – don’t just write “MVC” or “pain” as a discharge diagnosis but rather more useful is” 1) MVC 2) Whiplash – neck 3) contussion left arm, left chest” as an example.
and instead of “pain” write “pain – acute on chronic left shoulder” as an example.

Our coders are struggling and the more we can take a moment to specify what we can helps them and actually helps our hospital funding!!

Thanks team

plastics – RVH

Just to be aware..
RVH is having the same issues with plastics access as we are. Eventhough they have in house plastics they are not taking any calls except days they are on call.
Our whole LHIN is!!
Hopefully a solution coming soon…
many irons in the fire…

Just thought knowing this would help us explain to patients the whole LHIN is suffering.

Kidney care!

Hi all,
Please always call nephrology if a patient is sent from the dialysis site in huntsville to the ED and has any medical related issue that could alter resumption of dialysis or their next dialysis.
Or if you see a dialysis patient in Bracebridge ER who is attending huntsville dialysis site and has a medical issue ( even if you are just starting antibiotics for a chest issue) then please just call nephrology and document you have talked to them.

We have had a couple instances recently when this hasn’t been done and the satellite dialysis team has expressed concern around this and it is has been super challenging for the patient then to have their dialysis /care.


$25 per test!

FLU rapid tests are $25 per test out of hospital budget. Sensitivity – maybe 80 percent, specificity – maybe 90…maybe, maybe…depending what data you look at…
Public health is not doing confirmatory testing routine this year (like they have for years)so you gotta live with a relatively poor rapid test is you wanna test…

Flu is predicted to be 2.5 times worse this year than last in terms of numbers.


new deb trials

As you may know we are in the process of trialing equipment to determine a new hospital standard for Defibrillation Equipment. Some of our current equipment with Philips is at end of life and Philips no longer has replacement equipment that is Health Canada approved at this time. As such we will be evaluating two alternate vendors for this equipment, Zoll and Physio Controls.

I was asked to share this one re new defibs that are coming to trial….

“Next steps in this process is to have a demonstration day set up at each site for each of these vendors to demonstrate their equipment and allow staff an opportunity to try this out and ask any questions they may have. Each vendor will be on site for one day and will visit all areas at various times throughout the day to try and catch as many staff as possible. I will distribute an evaluation form prior to these demos which staff can use to record their thoughts. If further days are required we can arrange this at a later time.

Also during these days they will be holding a 90 minute formal presentation type session at each site where they can discuss some of the more advanced features of these units and run through a mock code blue scenario for the group. These presentations will be open to all , I will send a meeting invite with times and room locations out shortly. Please share this with any interested staff or Physicians.

Demonstration Dates:

Vendor #1 – Zoll

Dec 5, 2017 – SMMH Site – 0800 to 2000

Dec 6, 2017 – HDMH Site – 0800 to 2000

Vendor #2 – Physio Controls

Dec 12, 2017 – HDMH Site – 0800 to 2000

Dec 13, 2017 – SMMH Site – 0800 to 2000

Please share this info with your staff and physician group. Let me know if you have any questions around this process.

Thank You

Assigned doc!

Hi all,

You should have all received an email from either Sara or Nancy yesterday regarding a process change that has gone live today.

The attending doc section is now gonna be blank on ED charts!

Please write your name on each patient chart you see so charts are properly assigned to you.

This will cut down results going tot he wrong docs and negate the need to change MDS assigned to patients charts at shift change. It should help all so please remember to write your name!!

ED directives and orders done by Bob will still have to be entered under a doc so this will be done with the “most likely doc to see” but won’t be perfect around shift change or if more than one doc in the department (back-up etc)…

However..this is one way to improve patient info flow and maintain confidentiality!!

any issues please email, text or call me

harvest festival

can anyone who saw a patient from the “harvest festival” at the screaming heads location last weekend please message me…

How many you saw?
Severity of medical issue?

Adam and I shared care for one patient with a significant mixed overdaose , Pierre and I had a patient with a significant mixed overdose and GCS 3 on presentation, and Pierre had a lady with new onset seizures relating to mixed substance use ( most likely).

I plan to meet with Public health and OPP to offer feedback about this event.
EMS is doing the same.


psychiatry peds

FYI: Urgent PEDS mental health clinic functioning at RVH and available to all in our LHIN !!
Use as need.

RVH approved for acute peds mental health beds (inpatient) should be open near start of 2018. Construction underway and staffing gearing up now. Just FYI