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24/7 one of our APPs holds the ICU phone. This phone is who anyone will call with emergent questions, consults and urgent issues. Whenever this phone rings it must be answered no matter what. With the sound of that ringtone you should assume someone is actively dying. This means that if it starts ringing during a line, you answer it during your line. If you are in a code, you answer it during the code. Although sometimes people call for non-urgent issues, it’s extremely important to stay vigilant with answering it.
When you get a call for a consult, the APP/MD should introduce themselves and give a basic sign out on the patient. For any ER provider they should have ordered basic labs and imaging. In general you need to assess every patient before formally accepting the patient. Often in the ED they will place “bridge orders” to let bed control know a bed will likely be needed, but the patient will only move if you place the admission order.
Once you have accepted the patient and placed the orders to admit/transfer, they are yours. This means if the patient dies 30 seconds after you place the admit order you have to do the death note, not the previous care team.
(PAH specific) If the patient is being admitted to the acute care floor, you in general do not need to call anyone - you simply place the admit order to pulmonology and they will go.
If the patient is being admitted to the ICU, you will either need to call Nursing Supervisor (PAH) or your charge nurse (PHH, PNH, PFH) and let them know you need a bed. Often, they will let you know what bed they are going to, but not always.
Once you see a patient and have called your attending/the person who you call for a bed, you should try to complete the triad of communication:
Let patient know their disposition (floor/ICU/neither)
Let the patients nurse know their disposition (bonus: ask if they need any orders)
Let the provider who called you know their disposition