Tag: HITH

Hospital in the home (HITH)

Thanks to HITH registrar Dr Pamela Anjara and ID physician Dr Cristina Mateevici for providing their presentation about HITH services at the end of last year.

HITH ED presentation

 

Key points:

  1. HITH registrar is on extension 56309 – 24 hrs a day
  2. Admission conditions include
    1. IV antibiotics – cellulitis, multi-drug resistant TB, osteomyelitis
    2. anticoagulation – bridging clexane to warfarin
    3. complex wound management eg VAC dressing
    4. post operative care – drain tubes
    5. cardiogeriatric – IV frusemide
  3. Exclusion criteria
    1. unstable
    2. complex infection eg. hand / head / neck / necrosis / bites
    3. unable to manage at home
    4. no consent

Winter’s Wrap – 21/12/2016 – Trauma call, Brugada, HITH

TRAUMA CALL AUDIT 

Thanks to Steve Lee. Review his talk here.

Audit showed that there is a delay to review by the Surgical Registrar – in 68% of cases > 10 minutes, in 32% >30 minutes. ED team should maintain their role as team leader and coordinate the Trauma assessment – retain your skills and be confident in your role.

Please remember the trauma call criteria – and SPEED is no longer one of them! If you think the presentation warrants a Trauma Call, please initiate it.

In the future we would be keen to audit the outcomes of Trauma Calls – a project in cooperation with the Surgical Units so watch this space!

See below for the trauma call criteria:

 

Trauma 2

 

BRUGADA SYNDROME   

Thankyou Michael Gibbons for reminding us of this rare entity.

Important messages included:

  • look for the R-on-T in ectopics
  • consider cardioversion for arrhythmias
  • treat pyrexia aggressively as this may precipitate an arrhythmia

Review his talk

Hospital-In-The-Home 

Available 24/7 – including public holidays

Contact registrar on x56309 (BH) and via switchboard (AH)

Procedure:

  1. referral to registrar
  2. complete drug chart and prescription
  3. discharge patient if safe – leave IV in-situ
  4. if not reviewed in ED – patient should return to 2South (Footscray) following morning for clinic review
  5. If admitting to HITH for DVT/PE – fax “HAEMATOLOGY CLINIC” referral

Things to tell patient:

  • May need long-term antibioitics
  • HITH team may insert long-term IV cannula in clinic
  • Anticoagulation – discuss medication (Clexane/warfarin), risks, duration (1st below knee DVT – 3 months, PE or above knee DVT – 6 months, recurrent – life-long)