Non -North American experience
We've always managed the adults, regardless of how ill or unstable, ourselves and then sent them to the adult ED (about 500 m away). Mostly due to lack of cooperation on their part but also reflecting the philosophy that as EM providers, we need to be able to manage everything. We have 2-3 of these a year. We have had a protocol in place for years to transfer sick adult to the adult ED but the adult EM docs were not really ready to help us manage adult patients here.
This year we finally formalized a protocol in which if there is a pediatric arrest in the adult hospital (on nights and evenings some of the surgical sub-specialities see kids over there) their rapid response team responds and their nurse coordinator calls our rapid response team nurse coordinator and we go over as well; if the child is stable, then the call to us is cancelled. The reverse will now occur as well. Equipment for adult care exists in all of our code carts; the adult hospital added it on in areas which see pediatric patients (but not visitors). This new protocol also included security to direct each team to the appropriate location.
Interestingly, this process was instituted by them. They are much more fearful of managing a seizing child then we are in managing an adult who's in VF...
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of trzim29
Sent: Thursday, November 7, 2019 11:26 PM
To: [log in to unmask]
Subject: Re: Adult MSE
Hi all,Question...ScenarioAdult shows up on your side of the hospital, to the Peds ER...do you conduct MSE and send over to Adult ER?...seems like an easy answer...do the Peds docs do the MSE, the PA/NP?What if the adult is really sick...do you stabilize, ACLS, call a code kid and adult ER doc comes over?Any and all thoughts, answers, experiences are welcome.Thanks,Todd ZSent from my Verizon, Samsung Galaxy smartphone
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