Appropriate orders Code <65 yo: quadrivalent vaccine (multidose vial with preservative): IMM155 65 or older: high dose trivalent (‘Flu vaccine HD 65+): IMM31 -EPIC will block you from ordering the high dose vaccine in patients <65 years old (even if immunosuppressed, not approved yet for this indication) –Reference article Pregnant or infants: preservative […]
MICU Triage Rules update 9/14/14
In order to adhere to resident team caps of 18 and to distribute patients evenly when MICU is overflowing, please adhere to the following guidelines for MICU admits. Triage fellows please contact GAP staff for advice. GAP staff should be your resource for staff-to-staff discussions. CICU Triage: During MICU high-census periods (>60 beds), patients with […]
MICU Quality Rounds – Starting Tuesday September 2
In an effort to improve the quality of care across all of our ICU pods, we have been performing a trial of multi-disciplinary “Quality Rounds” across all of our ICUs over the last two months. The feedback has been uniformly positive. Among other things, foleys are being removed, central lines are being addressed, and a […]
GAP Staff – What’s that?
GAP staff is a daily clinical assignment for PCCM senior staff on weekday afternoons that was created for the following purposes: Provide clinical coverage for MICU staff who are in clinic or unavailable due to other clinical/administrative duty Provide MICU triage coverage on Fridays from Noon to 3PM to allow fellow to attend PCCM educational […]
DEM/MICU Interdepartmental Guidelines for Emergent GastroEsophageal Balloon Tamponade (GEBT)
Purpose: The goal of this guideline is to ensure the safety of patients and to provide the best care with the most expert staff available to perform emergent GEBT placement with a Minnesota or Sengstaken–Blakemore tube. MICU staff should be aware of the limited time the DEM staff have to assist with clinical services outside […]
MICU Intubation Guidelines for MICU Fellows – August 2014
The following guidelines apply if staff cannot be present at the bedside to supervise (nights, weekends) the intubation. If you have not completed your anesthesia rotation, anesthesia should be called for all intubations. If you have completed a minimum of 15 intubations (supervised in OR or in MICU) call the overnight intensivist with the information […]
Ambulatory Specialty Pharmacist for K17 (COPD)
K17 Pharmacy Services Summary: Process by which COPD patients can be referred to the clinical pharmacist
Comfort Measures Order Set and Policy
Currently, we do not have an EPIC order set for comfort measures for the ICUs, only hospice does. In order to provide some guidance in providing symptom management for our patients at the end of life, please review the attached order set and policy. 1. Comfort Measures Order Set You can use this to help guide […]
ICU Call Staff Coverage
As of July 15, 2014, we will have an Intensivist in-house at HFWB every night. All fellow calls to the ICU staff physician from 7 PM to 7 AM should be directed to the physician covering HFWB. They will be carrying the spectralink phone assigned to that number. There is also a physician assigned to […]
Bronchoscopy in the MICU: Documentation in EPIC
Fellows and Staff, Please document all MICU bronchoscopies as shown here. Make sure you are logged into EPIC as Critical Care Provider. 1. Use procedure tab 2. Document ASA/Mallampati – Must be done before the procedure starts! 3. Choose ICU bronchoscopy for correct template (this may not work if you are not logged in as […]