The problem I see is with the subspecialists. Will these be adult or pediatric, some will not be comfortable taking care of these patient. Will pulmonary, surgery, anesthesia, etc. I’m sure nursing will give pushback as well. Now they would have to be ACLS certified since it would be an aging population. I would agree with the age max. Also, sometimes we are busy enough taking care of our own patients, our ICU seems like it is always full. This patient population may only get bigger so more resources would need to be addressed like social work and care coordinators. You would also have to remember if there are any MIPs or other re imbursement obstacles to take care of these patients that the adults might already be doing.
Thank you for your time
Daniel Thimann MD
Pediatric Emergency Medicine
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> On Mar 26, 2019, at 10:45 AM, Fernando G Mendoza, MD FAAP, FACEP <[log in to unmask]> wrote:
> Hi all-
> Would like to get the groups opinion and any official hospital policy and DOP information on taking care of those chronic, complex pedi patients that graduate into adulthood (over 21yo).
> Basically, genetic syndromes/chronic CP/technically dependent, etc.
> Our hospital is an children's hospital within and adult hospital. We're looking to officially take care of these patients in our Pedi ED and PICU.
> Patients would have to be under 50kg, (since all adult crash carts start at 50kg and greater). Not included would be the otherwise "normal" adult with chronic issues (like UC, cardiac, etc).
> We're putting official hospital policy in place, checking with our med-mal carrier....any other issues? Concerns? Current practice?
> Fernando G. Mendoza, MD
> Baptist Children's Hospital
> Miami, FL
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: