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Transfer from ICU

Robert Smith rfsmithmd at comcast.net
Tue May 3 15:13:42 BST 2011

Dr. McSwain,

Funny, you sort of assume everyone is doing things more or less the same.

At County all significant trauma is triaged to Trauma. We would have taken all trauma but as it is, only minor lacerations or simple ortho goes to the ED. There is a physically separate Trauma resuscitation area, separate dedicated staff, separate Trauma ICU, Obs unit etc. Whoever is on call in house "gets" all the trauma patients for a 24hr period starting at 8:00 AM. The patients stay on the Trauma service until Trauma feels they are stable to have a single system issue dealt with by another service like Ortho. So even if they're discharged to the floor, they're still on the Trauma service and are rounded on by the Trauma service. No other service is allowed to write orders on Trauma patients, and/or  the nurses are not allowed to act on them.

Rob Smith

On May 3, 2011, at 6:14 AM, McSwain, Norman E wrote:

> Of late, it seems that many of our patients get transferred out of the
> ICU, to the floor to the general surgery service, to ortho, to
> neurosurgery and others, without adequate communication from the ICU
> service to the receiving service. We have tried several methods,
> transfer forms, voice communication, transfer notes in the chart, etc.
> None of the systems work (ICU staff forgets, receiving service is not
> available, phone calls are not returned, etc). This did not happen when
> the patient was cared for by the primary surgeon both in the ICU and on
> the floor after ICU care as there was no transfer of provider only
> location of care was different. Now that the ICU team and not the
> primary surgeon takes care of the patient, the transfer of care not
> ideal. I would like to know what system that you have found in major
> trauma centers that works. What mechanism have you found that works
> consistently
> Thanks for your input
> Norman
> Norman McSwain MD, FACS
> Professor, Tulane School of Medicine
> Trauma Director, Spirit of Charity Trauma Center, ILH/MCLNO 
> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 
> 504 988 5111
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