Epic Messaging: POCUS, HASS, OTF, Avian Flu, and more

Hey all, some quick hits this school vacation week!

We have now embedded Impression sections into our POCUS procdocs. Even better, some are cascading based on technique, meaning had you clicked cardiac as opposed to abdominal at the arrow sign, you would see different impressions.

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On signing of the unineb order, a reminder to obtain a HASS score one hour later will fire to nursing. This should help our HASS documentation and improve care for the asthma patients

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Follow-Up Fast and Off The Floor –

When we discharge a patient, they go an ‘Off The Floor’ status until the PER completes their tasks. Until that happens, the patient will not hit the Follow Up Fast tab (which is when the PER clicks the ‘discharged’ status within EPIC.

This is particularly important to remember for Extension and Fegan where the patient needs to get back to the main ED to have that process completed.

The deficiencies do go to your InBasket so continue to peruse both places for things to do. Or, you can go to the ED Manager and look for your patients there.

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Avian flu –

The hospital is changing infection prevention control measures for the Avian Flu. Our nurses will now see this in their triage for,

An answer of YES for any of the following single or combination symptoms:

· Red eye

· Fever AND cough

· Fever AND sore throat

· Fever AND muscle pain

· Fever AND vomiting

· Fever AND diarrhea

Will prompt a new question:

And the answer is yes, this patient is at considered at risk of avian influenza (H5N1 or other strains) and recommendation below are advised.

1. Ask the patient and family members to put on a mask

2. Immediately place them in a single room (ideally a negative pressure airborne isolation room, if available)

3. Use airborne and contact precautions (N95 respirator, eye protection, gown, and gloves required to enter the room)

4. Page Infection Prevention and Control on call (pager 2058). IPC will report the case to public health and can provide guidance on requested specimens.

5. If conjunctivitis is present, notify the patient’s clinical team that conjunctival swabs will be required.

6. Strongly consider consulting Infectious Diseases for testing and treatment guidance.

7. Guidance is available on the BCH internal H5N1 website

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Is direct contact with sick birds considered ‘fowl play’?

Always forward!

Your ASAP team,

AJC, JKC, and MBH