PROCEDURE TO FOLLOW FOR POTENTIAL ICU CANDIDATES

A patient may not be kept in the resuscitation rooms of the Emergency Department
for longer than 6 hours.
1. The consultant on call from the discipline needing an ICU bed should contact
the consultant on call from ICU, to discuss the case and to determine whether
there is a potential discharge from ICU.
2. The Medical Officer on call for ICU should go and assess the patient that needs
an ICU bed. After assessing the patient, the Medical Officer must discuss the
patient with the Consultant on call for ICU, to determine whether the patient is
a candidate for ICU (using the ICU admission protocol)
3. The consultant on call from ICU must notify the consultant on call for the
referring discipline, about the outcome of the discussion.
4. If the patient is not a candidate for ICU, the patient must be admitted to
the ward for conservative treatment.
The consultant on call from ICU must personally document the decision
in the patients clinical notes
5. If the patient is a candidate for ICU, the patient will be transferred to the
ICU by the two Medical Officers of the two disciplines.
6. If the patients fate is in doubt (i.e. he must be observed for clinical
improvement that might change his further management), a definite decision
must be taken at 6 hours after his admission to the Resuscitation Room.
7. If the patient is a candidate for ICU, but there are no beds available
in ICU the consultant on call for the referring discipline must contact
Bloemfontein to enquire whether the patient can be transferred to them.
8. If the patient is not accepted by Bloemfontein, the consultant on call for the
referring discipline must contact the Matron on Call at Medi-Clinic to enquire
whether there is an ICU bed available that Kimberley Hospital Complex can
use.
9. If there is a bed available at Medi-clinic, the consultant on call for the referring
discipline must contact the clinical manager of Kimberley Hospital Complex to
authorise the admission to Medi-clinic.

The referring discipline must write the initial prescription, ventilation

and nursing orders. This may happen in consultation with the doctor on
call for ICU.
The patient stays the responsibility of the referring discipline for the duration
of
stay at Medi-clinic.
A joint round between the referring discipline and ICU must be organized on
a daily basis to discuss the management of the patient.
As soon as a bed opens up in the ICU at Kimberley Hospital, the patient
must be transferred back to Kimberley Hospital Complex.

10. If there isnt a bed available at Medi-Clinic, the patient must be admitted to
the next appropriate bed in the ward. The patient may not be kept in the
resuscitation rooms of the Emergency Department for longer than 8 hours.

Author: Clinical Head

Date: 2010.01

Authorization: CEO
2010.02
2011.01