The Regions Direct (RD) call center performs two tasks: arranging transfers from referring hospitals and communicating with EMS to trigger trauma activations.
Transfers in – RD will call the bat phone with every potential transfer for both trauma and acute care surgery patients. They will provide basic demographic information that may allow you to locate additional patient information in Epic. The operator will then connect you to the referring physician to discuss the case. In general, we will always accept the transfer, since the provider on the phone is either uncomfortable with or unable to provide the care needed.
If you are unable to take the call, RD will call the backup surgeon.
There are two clinical conditions that we generally do not accept because we do not have the expertise available 24/7:
- Distal esophageal / proximal gastric perforation (insturmentation / Boerhaave)
- Complications of bariatric surgery
When accepting the patient, a determination must be made as to whether they should be sent to the ED or can be a direct admit to a ward or ICU bed. Here are some guidelines to aid this decision:
- Inpatients at the referring hospital can only be a direct admit to the appropriate unit (ward vs ICU)
- Pediatric patients (< 16 years) should always be sent to the ED
- Patients who require urgent operation or other procedure should be sent to the ED since the process is much faster
- Patients who will require sedation for management of fractures should be sent to the ED
- Patients who have had a complete workup and you are comfortable that major injuries have been identified may be directly admitted to a ward bed
- ICU level patients should be sent to the ED first to ensure the workup is complete
If the patient is being sent to the ED, either have RD include them in the call, or have RD connect you to the emergency physician after the referral call is complete. Provide some basic info and your expectations of them (e.g. call consult on arrival vs perform evaluation then call).