EAST CAMPUS HOSPITAL APPROPRIATE?
Conditions that should not be admitted for acute and intermediate care:
- Unstable for Transport
- Conditions Requiring:
· Emergent Procedural Interventions
· Emergent Cardiac Cath Lab Needs
· Chemotherapy Needs
Patients from LLUMC Emergency Department
The following criteria are intended to serve as guidelines to identify clinical scenarios deemed inappropriate for patients transferred from LLUMC ED to East Campus. Whereas the criteria indicate the appropriate placement in most cases, there may be exceptions, based on the patient’s complete clinical picture. ED-LLUMC will designate patients deemed appropriate for East Campus placement (in consultation with the designated Service Attending on call), when bed capacity exists (plus one staffed bed for “internal emergency”).
Intensive Care Unit Service
The East Campus Level 2 ICU (unit 1400) is capable of caring for a variety of critically ill Medical and Surgical (perioperative) patients, with several important limitations based on the immediate availability of certain (on-site) consultants and inpatient specialty services, diagnostic imaging & procedural equipment/facilities, and (on call) Operating Room.
Patients with the following diagnoses should NOT be admitted to the East Campus ICU Service:
· Acute MI/ Cardiogenic Shock/Malignant Arrhythmia- needing PCI, invasive pacing, therapeutic hypothermia s/p cardiac or rest of potentially requiring urgent CT surgery
· Acute Stroke/ICH- needing CT Angiography, Interventional Radiology (IR), +/- Craniotomy/Neurosurgical Intervention or invasive monitoring
· Acute Major-Multiple Trauma/Burns or Surgical/Vascular Emergencies- needing urgent IR-angiography or surgical intervention
· Acute/Active GI bleeder- needing urgent endoscopic, IR &/or surgical intervention
· Massive Hemoptysis/Central Upper Airway Obstruction (foreign body/stricture vs malignancy) needing urgent airway intervention (eg. Rigid/flex bronchoscopy, OR/GA) by interventional pulmonology, ENT/Thoracic Surgery, +/- IR-Angio-Embolotherapy
· Severe ARDS/Pulmonary HTN- may require HFO/NO/IV Epoprostenol
· Cerebral Arterial Gas Embolisim/CO Poisoning/Decompression Sickness needing emergent/ongoing hyperbaric oxygen therapy
· Rattle Snake Envenomation- needing urgent anti-venom administration
· Obstetrical Emergencies/Issues (any/all), pregnant patients beyond first trimester
· Pediatric patients
Medicine-Intermediate/Acute Service
East Campus Units 1200 and 1300 admit adult patients requiring acute and intermediate care; these units are subject to the same limitations of immediate availability of certain on-site consultants and inpatient services as described above.
Therefore, the below list of patient conditions that should not be admitted for acute and intermediate care encompasses and is in addition to the diagnoses listed above:
· Unstable for transport
· Conditions requiring:
o Urgent procedural intervention
o Urgent cardiac laboratory needs
o Urgent chemotherapy needs
o Urgent MRI imaging needs without prior radiology approval
o Anticipated IV Biotherapy administration
Patients already at East Campus
The East Campus ICU (ECICU) will admit patients following Rapid Response/Code Blue or demonstrating worsening medical status, requiring higher level of care (deemed suitable for ECICU), from ECH-Medicine-Surgical Floors, ECH-Rehab Unit, OR-PACU or Urgent Care.
Patients transferred from Beaver Medical Group
The East Campus ICU will directly admit patients transferred from outside hospitals (per above criteria), referred only by physicians belonging to the Beaver Medical Group.