Policies Manual
Table of Contents [PDF]
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Policies Regarding Admissions / Dispositions
34.6 Admission of Hip Fracture Patients from the Emergency Department [PDF]
34.8 Admission of Patients with Diabetes Mellitus and Foot Ulceration or Infection [PDF]
34.3 Admissions to Medicine [PDF]
34 Admitting Policy [PDF]
34.1 ED Attending Authority to Admit [PDF]
10 ED Referrals to OPD Clinics for Follow-up [PDF]
67.1 Emergency Discharge Policy [PDF]
6 Employee Health Service Referrals [PDF]
4.3 Inter-Institutional Transfer of Patient [PDF]
10.1 Referral to Clinics for Initial Treatment [PDF]
8 Return of a Discharged Patient by a Placement Facility [PDF]
34.2 Responsibility of ED Attending to Primary Attending [PDF]
38.0 Transport of Emergency Department Patients [PDF]
34.5 ICU Consults and Admissions[PDF]
45 Procedures Which May Not Be Performed in the ED [PDF]
Policies regarding Consultations / Interactions with Other Departments
34.7 Initial Care of Pregnant Patients Presenting to the Hospital [PDF]
35 OR Availability [PDF]
20.6 Emergency Department and Inpatient ophthalmology consults [PDF]
20.7 Hyperemisis of Pregnancy Consult Protocol [PDF]
58.1 Endoscopy in the PER [PDF]
58 Endoscopy, Adult [PDF]
62 Ocular Emergencies [PDF]
21 Psychiatric Evaluation in the Emergency Department [PDF]
21.1 Psychiatric Patient Transport from Psych Clinic to ED [PDF]
22 Radiology Services [PDF]
61.3 Registration and Handling of Stillborns in the ED [PDF]
61.2 Registration of Mother and Live Newborns in ED [PDF]
45 Procedures Which May Not Be Performed in the ED [PDF]
Medical Protocols
42.3 AER Asthma Protocol and Standing Orders [PDF]
49 Alcoholism Protocol [PDF]
56 Care of the Diabetic Patient [PDF]
28 Death Management Protocol [PDF]
47.1 EKG Transmission and Interpretation [PDF]
52 Ischemic Chest Pain Protocol [PDF]
44 Immunizations-Pediatric Emergency Room [PDF]
60.1 Infection Control - Tuberculosis Identification/Management [PDF]
60 Infection Control Guidelines [PDF]
62 Ocular Emergencies [PDF]
24.3 Laboratory Services for Poisoning Overdose Ingestion [PDF]
61.1 Management of Mother and Newborn in ED [PDF]
64.1 Multiple Trauma - Early Management [PDF]
63 Management of Poisonings [PDF]
41.2 Obtaining Narcotics / Controlled Drugs from AER for Radiology [PDF]
56.1 Protocol for Administration of C1-Inhibitor (CinrzyeTM) to Patients with Hereditary Angioedema (HAE) [PDF]
52.1 Protocol for the Initial Evaluation and Management of Patients with Ischemic or Hemorrhagic Stroke [PDF]
Medical Protocols Concerning Environmental Emergencies / Bites
50 Animal Bites and Wounds [PDF]
50.1 Monkey Bite Protocol [PDF]
59.1 Exposure to Hazardous Materials [PDF]
59 Management of Exposure to Blood/Body Fluids [PDF]
51 Burns - Initial Management [PDF]
Medical Protocols Concerning Special / At-Risk Populations
26.2 Elder/Institutional Abuse [PDF]
26.3 Domestic Violence [PDF]
26.1 Management of Suspected Child Abuse or Neglect [PDF]
26.4 Sexual Assault Protocol (Code 11) [PDF]
Policies Regarding Diversion / EMS / Disasters
7.2 EMS Diversion Protocol [PDF] (Diversion Form) [PDF]
7.1 EMS Exchange Requirements with Pre-Hospital Personnel [PDF]
5 Emergency Preparedness Plan (EPP) [PDF]
5.1 Emergency Response for Medical Center [PDF]
5.2 Overcrowding and SURGE Management Plan [PDF]
7 Pre-Hospital Care from EMS and Others [PDF]
4.1 Relationship with Specialized Referral Center - EMS Advisory [PDF]
61.5 Peds ED to Clinic Diversion [PDF]
Nursing Policies
40.1 Guidelines for Nursing Orders on Admitted Patients [PDF]
39.3 Nursing Triage Assessment Guidelines [PDF]
41 Medication Administration by ED Personnel [PDF]
46 Saline Locks [PDF]
38 Standards for Nursing Care and Vital Signs [PDF]
39 Triage and Retriage of AER and PER Patients [PDF]
39.2 Triage of Direct Admission [PDF]
39.1 Triage of Psychiatric Emergency Patients [PDF]
40 Protocol for Nurse Initiated Laboratory Studies in Treatment Area [PDF]
23 Restraints and Locked Seclusion [PDF]
40.2 ED Nurse Initiated Pain Protocol [PDF]
Technicians / BAs / Registrar Policies
47 EKG Request and Performance of 12 Lead EKG's [PDF]
23.2 Constant Observation of Patients [PDF]
10.3 Telephone Tree for ED Registrars [PDF]
61.4 Registration of an ED Patient [PDF]
Job Descriptions / Roles / Employee Expectations
18 Role of Emergency Department Attending [PDF]
6.1 Toxicology Testing of Employees in the ED [PDF]
Policies Concerning Patient Consent & Rights / Social Services / Telephone Encounters
12.1 Acknowledgment of Receipt of Notice of Privacy Practices [PDF]
12 Confidentiality of Patient Information [PDF]
14 Consent, Adults [PDF]
67.2 Discharge Against Medical Advice [PDF]
67 Discharge of Patient from the ED [PDF]
67.3 Discharge of Undomiciled Patients [PDF]
16 DNR [PDF]
15 Health Care Proxy [PDF]
26.5 ED Policy for Digital Photography [PDF]
17 Organ Donor Policy [PDF]
27 Patient Grievance Mechanism [PDF]
31 Patient Property, Care of [PDF]
39.3 Undomiciled/ homeless care in the ED [PDF]
32 Visiting Policy [PDF]
48.1 Recall of Patients with Missed Fractures / X-Ray Interpretation [PDF]
48 Recalls and Reportable Diseases [PDF]
10.2 Telephone Advice in the ED [PDF]
30 Security-Police Intervention [PDF]
26 Social Work Services in the ED [PDF]
29 Interpreteam - Language Translation and Interpreter Service [PDF]
26.2 Elder Abuse [PDF]
Policies Regarding the Handling of Blood / Specimen / Lab Equipment
25 Location, Storage and Procurement of Blood Supplies [PDF]
33.1 Equipment Maintenance [PDF]
24.4 Gem 3000 Point of Care Blood Analysis [PDF]
24.1 Laboratory Alert Values [PDF]
24 Laboratory Services [PDF]
24.2 Surgical Specimen Handling [PDF]
Administration
3 Emergency Care Services at Mount Sinai - General Statement [PDF]
13 Medical Record and Reports [PDF]
13.1 Medical Record Forms - Other [PDF]
13.2 Maintenance of Medical Record [PDF]
3.2 Mission Statement [PDF]
3.3 Vision Statement [PDF]
1 Table of Organization [PDF]
ED - Table of Organization [PDF]