Triage Standing Orders for Lab and X-rays

Can you put a phlebotomist in the ER?

That would not be needed. I neglected to say that the labs we have standing orders for are strep screens, Urine for C&S, and UCG. We rarely send blood off from triage and that would involve a consult/order from the ER attending.

How do things get done for critical patients whose labs can't wait? The 3 ERs where I have worked have all had a "quick reg" mechanism which gets the patient in the system and spits out an armband and a sheet of labels. Your IS dept. or software provider needs to make this happen. Alternatively, will your lab accept hand-written labels with the patient's name, DOB & MR number? I bet they would, as they would have to if there is ever unexpected computer down time.

How do things get done for critical patients whose labs can't wait? The 3 ERs where I have worked have all had a "quick reg" mechanism which gets the patient in the system and spits out an armband and a sheet of labels. Your IS dept. or software provider needs to make this happen. Alternatively, will your lab accept hand-written labels with the patient's name, DOB & MR number? I bet they would, as they would have to if there is ever unexpected computer down time.

:nmbrn:

Where I am at the pt reg can get them in and printed in 2-3min, what happens when you have a code with STAT labs?

All I can say is I'd hate to work there. I don't know what I'd do if I couldn't put in initial orders for patients (ie: cbc, cmp, ua, pcxr, etc). That is a major bottleneck for an ED. I guess your department must not be busy but in the department I work in we see 60,000+ patients a year and generally it is up to the discretion of the nurse to put in the initial orders for the patient due to the amount of patients we see. We have an initial protocol that has orders for just about every patient we see.

We keep a paramedic in triage with the nurse that will draw blood or start an iv on patients if it is necessary. The nurse will put the initial orders in the computer, the medic will get the blood then send it off.

If the triage nurse is able to write down the tests s/he wants in triage (on scrap paper if needed) then when the chart gets printed the secretary can place the scrap with the chart and order the indicated tests in the computer. If you need a permanent record of what the triage nurse requests use an outpatient lab slip to make the order.

Thanks for your ideas. Since I posted the original message I have worked it out our ER registration folks to register the patient in a timely manner to eliminate the problem I originally had. All is well for now...thanks