Urgent RMT - Revision history

JenniferH: /* Fever in Infants less than 90 days */

2020-12-02T11:54:56Z

Fever in Infants less than 90 days

← Older revision		Revision as of 11:54, 2 December 2020
Line 22:		Line 22:
	Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.		Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.

	If the patient gets worse in the village…[[Emergency RMT Scenarios and Responses\|see emergency RMT section]]		If the patient gets worse in the village…[[Emergency RMT Scenarios and Responses\|see emergency RMT section]] and contact Peds Wards on Duty through Tiger Connect.

	Need more examples of sick patients that need to come in here…		Need more examples of sick patients that need to come in here…

JenniferH: /* Fever in Infants less than 90 days */

2020-12-02T11:53:51Z

Fever in Infants less than 90 days

← Older revision		Revision as of 11:53, 2 December 2020
Line 18:		Line 18:

	===Fever in Infants less than 90 days===		===Fever in Infants less than 90 days===
	[[media:Fever_less_than_90_days.pdf\|Stable See YKHC Clinical Guideline]]		[[media:Fever_less_than_90_days.pdf\|If Stable, See YKHC Clinical Guideline]]

	Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.		Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.

JenniferH: /* Fever in Infants less than 90 days */

2020-12-02T11:53:29Z

Fever in Infants less than 90 days

← Older revision		Revision as of 11:53, 2 December 2020
Line 18:		Line 18:

	===Fever in Infants less than 90 days===		===Fever in Infants less than 90 days===
	[[media:Fever_less_than_90_days.pdf\|Stable See ~~guidelines~~]]		[[media:Fever_less_than_90_days.pdf\|Stable See YKHC Clinical Guideline]]

	Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.		Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.

JenniferH: /* Fever in Infants less than 90 days */

2020-12-02T11:52:49Z

Fever in Infants less than 90 days

← Older revision		Revision as of 11:52, 2 December 2020
Line 22:		Line 22:
	Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.		Infants under 3 months of age with a fever of 100.4° or greater must be evaluated in Bethel for a sepsis and/or meningitis work up and treatment if indicated. Infants with fevers 100.4° or greater with a normal exam, who are clinically stable, need to be evaluated within 12 hours in Bethel. These patients can come in by commercial flight, if there is one available in less than 8-10 hours. If it is after hours the patient can be monitored closely by the family at home and be rechecked by a CHA in the morning (or sooner if worse) to make sure the patient is still stable for commercial flight in. It is best not to pretreat these infants with Ceftriaxone unless there are weather delays or the patient is getting worse. Please consult the pediatrician on call if there is any question about what to do in these challenging RMT cases.

	If the patient gets worse in the village…[[#Emergency RMT\|see emergency RMT section]]		If the patient gets worse in the village…[[Emergency RMT Scenarios and Responses\|see emergency RMT section]]

	Need more examples of sick patients that need to come in here…		Need more examples of sick patients that need to come in here…

JenniferH at 11:51, 2 December 2020

2020-12-02T11:51:34Z

← Older revision		Revision as of 11:51, 2 December 2020
Line 26:		Line 26:
	Need more examples of sick patients that need to come in here…		Need more examples of sick patients that need to come in here…

	[[:Category: Radio Medical Traffic (RMT)]]
			[[:Category: Radio Medical Traffic (RMT)\|Radio Medical Traffic (RMT) Main Page]]

JenniferH: /* Abdominal Pain */

2020-12-02T11:50:59Z

Abdominal Pain

← Older revision		Revision as of 11:50, 2 December 2020
Line 15:		Line 15:
	These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.		These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.
	===Abdominal Pain===		===Abdominal Pain===
	That has a concerning exam (for example: RLQ tenderness with rebound pain) and not responding to GERD or constipation treatment. These patients can usually go in to Bethel ER commercially, sometimes requiring an escort after the pain is treated either with IM morphine or PO TC3 or Tylenol-Motrin.		That has a concerning exam (for example: RLQ tenderness with rebound pain) and/or not responding to GERD or constipation treatment. These patients can usually go in to Bethel ER commercially, sometimes requiring an escort after the pain is treated either with IM morphine or PO TC3 or Tylenol-Motrin.

	===Fever in Infants less than 90 days===		===Fever in Infants less than 90 days===

JenniferH: /* Abdominal Pain */

2020-12-02T11:50:41Z

Abdominal Pain

← Older revision		Revision as of 11:50, 2 December 2020
Line 15:		Line 15:
	These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.		These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.
	===Abdominal Pain===		===Abdominal Pain===
	These patients can usually go in to Bethel ER commercially, sometimes requiring an escort after the pain is treated either with IM morphine or PO TC3 or Tylenol-Motrin.		That has a concerning exam (for example: RLQ tenderness with rebound pain) and not responding to GERD or constipation treatment. These patients can usually go in to Bethel ER commercially, sometimes requiring an escort after the pain is treated either with IM morphine or PO TC3 or Tylenol-Motrin.

	===Fever in Infants less than 90 days===		===Fever in Infants less than 90 days===

JenniferH: /* Ortho */

2020-10-28T13:24:33Z

Ortho

← Older revision		Revision as of 13:24, 28 October 2020
Line 4:		Line 4:
	Refer to [[OB_RMT#Labor in the Village\|OB RMT Labor in the Village]]		Refer to [[OB_RMT#Labor in the Village\|OB RMT Labor in the Village]]

	==Ortho ==		==[[Orthopedics/Telerad\|Ortho]] ==
	Other than the 3 recognized truly Orthopedic Emergencies		Other than the 3 recognized truly Orthopedic Emergencies
	* compartment syndrome		* compartment syndrome
Line 10:		Line 10:
	* knee dislocation		* knee dislocation
	that should likely require both a call to ANMC Ortho + medevac activation, you can likely send an ortho patient to Bethel ER with splint-sling-ice-elevation-pain control-crutches as indicated once you establish an intact neuro-vascular exam.		that should likely require both a call to ANMC Ortho + medevac activation, you can likely send an ortho patient to Bethel ER with splint-sling-ice-elevation-pain control-crutches as indicated once you establish an intact neuro-vascular exam.
	For some cases, like a hip fracture for example, the patient may go directly to ANMC. You might be able to save one leg of a medevac (instead of a ramp-to-ramp transfer) and send the patient directly to ANMC. To do this, get an accepting doc at ANMC and then you can have LifeMed activate the Anchorage team instead of the Bethel team.		For some cases, like a hip fracture for example, the patient may go directly to ANMC. You might be able to save one leg of a medevac (instead of a ramp-to-ramp transfer) and send the patient directly to ANMC. To do this, get an accepting doc at ANMC and then you can have LifeMed activate the Anchorage team instead of the Bethel team.

	==Sick patients that probably need to come in==		==Sick patients that probably need to come in==
	These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.		These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.

JenniferH: /* Abdominal Pain */

2020-09-24T06:57:58Z

Abdominal Pain

← Older revision		Revision as of 06:57, 24 September 2020
Line 14:		Line 14:
	These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.		These patients either have a compelling initial presentation or they have worsened in village follow-up. If vitals and exam are reassuring and spO2 is not <90%, they can probably come to Bethel ER or clinic on the next commercial flight or boat-ice road vehicle. If transport is unlikely or the clinical situation does not allow it, the next decision that needs to be made in conjunction with the CHA’s comfort level and resources available as well as weather conditions, is whether a medevac or more local treatment is indicated. Sometimes weather forces decision-making.
	===Abdominal Pain===		===Abdominal Pain===
	These patients can usually go in to Bethel ER commercially, sometimes requiring an escort after the pain is treated ~~neither~~ with IM morphine or PO TC3 or Tylenol-Motrin.		These patients can usually go in to Bethel ER commercially, sometimes requiring an escort after the pain is treated either with IM morphine or PO TC3 or Tylenol-Motrin.

	===Fever in Infants less than 90 days===		===Fever in Infants less than 90 days===
	[[media:Fever_less_than_90_days.pdf\|Stable See guidelines]]		[[media:Fever_less_than_90_days.pdf\|Stable See guidelines]]

JenniferH: /* OB in possible labor */

2020-04-14T11:13:49Z

OB in possible labor

← Older revision		Revision as of 11:13, 14 April 2020
Line 2:		Line 2:
	Refer immediately to inpatient emergency RMT provider		Refer immediately to inpatient emergency RMT provider

	Refer to [[OB_RMT#Labor in the Village]]		Refer to [[OB_RMT#Labor in the Village\|OB RMT Labor in the Village]]

	==Ortho ==		==Ortho ==