ED Muskoka Physicians - Living the Dream

Form One intake

Please be aware that you do not have to wait for a CMH assessment to send the package for admission consideration for a form one patient to OSMH!! Attached is OSMH intake form!! Of coarse if you feel that a CMH assessment may help create a safety plan or that CMH may very well come up with a plan to care for the patient out of hospital then I would certainly indicate this on sending the intake package or wait for CMH….

Airway boxes

Please look at the example of the airway boxes in both ER’s and provide me any feedback you have within the next week. These are going to be on each crash cart,one in each ICU , and one for transfers and looked after by RT’s. They aren’t meant to take the place of our full carts but provide a basic set of standard things that are at hand/available throughout the hospital. AND THAT ARE THE SAME EACH SITE AND PLACE! Thanks!

Tylenol Overdose

Hi all,

Attached is the NEW updated and simplified NAC protocol for Tylenol overdoses. Take a little read. I have asked our Nurse leaders at both ER’s to update our protocols too!!

John

SMMH Ultrasound

Please make an effort to use ( to test it!!) the Zonaire ultrasound in SMMH. It is supposed to be fully repaired and functional. The Sonosite has currently been removed as it is only a loaner . Let me know please by email or text when you have used in the next couple of weeks and that it is functioning ok or not ok!! Thanks John

Transfer of Care OPP to ER

Please take a moment to read this algorithm for transfer of care of patients brought in by OPP under the mental health act or with concerns of a mental health issue. You will see that if we are going to detain a patient under these circumstances we need to have the patient’s MD assessment and form one completed or at minimum an order for a FORM one on the chart.

dialysis patients admitted

If you are admitting any dialysis patient followed at OSMH nephrology want to be called with goal of admitting them at OSMH! Even peritoneal!

SMMH CT

Ct tech is now onsite ( most weekday evenings) till 11:30pm!!

THIS IS GOOD! I see Kersti already posted a post in the SMMH sleep room with this! haha!! I just edited to say weekdays!

If they are onsite on the weekday you don’t need to call radiology to protocol CT’S or approve them until after 9 pm!!

Still fill out a req for contrast studies and follow same weekend policy at present.

recovery room for consults

If a patient is waiting a surgical consult and you need the space in the ER then consider sending the patient to wait ( and/or be monitored) in the recovery room during our reno’s!! Nursing Manager has agreed to this and COS confirmed this today with me!! Another way to alleviate congestion maybe!!

Orders outside directives

Anyone else have recent examples of tests being ordered outside of any directive? I had extended lytes preordered by nursing this am and a d -dimer pre-ordered by nursing on sunday. I didn’t want either of these things done! waste of money and I and I didn’t want results.

I spoke to both nurses in SMMH about these issues and spoke to the nursing manager too. Is this only happening to me? as Manager wants to know if nurses are repeatedly working outside their scope.

Please email me or text me, within the next week, if you have examples or a concern about this and I will take either no concerns or concerns back to the manager.

PIA time

Reminder to write PIA times on all charts along with your name as attending. Our misses on this are rising again and health records requires this information!