SFMH ED Newsletter

August 2013

J. Sun, MD Medical Director & T. Edison, Nursing Director

Pilot program to identify moderately septic patients:

We have noticed a distressingly high mortality in a group of patients who seem 'moderately septic.' So to specifically help these patients, in conjunction with the Sepsis-COI committee, we are currently in a pilot program to:

- get lactate result within 45min of patient meeting SIRS criteria <bug firing>

- consider giving appropriate antibiotics within an hr if lactate is >2.0

- consider giving IVF BOLUS of 30cc/kg if lactate is >2.0

To make this pilot effective RNs and EDMDs will need to work together to ensure these time markers are met! So communicate! Communicate! Communicate!

Fluids- please make sure you have an accurate weight documented on the patient and that they get 30cc/kg if lactate is >2.0. Remember FLUID BOLUS means STAT not 999 on pump. Hang it wide open and use a pressure bag. Get that fluid in !

Thank you everyone for your hard work on this!!


Go live was a success! There were a few glitches but all has been worked out. For patients arriving with field IV Fluids, please document this in the events column and in the I & O section. This is critical.

Visiting medical students

- Please welcome Tuulia Simpanen and Jeremy Loh for the summer! Tuulia is here now and will be working until mid-August. Jeremy will be here end of Aug until September. They are both from King's College.

New faces

- Please welcome Dr. Eduardo LaCalle in August! He is a Bay Area native who recently finished residency in New York. He will be working mainly night shift and will be splitting his time between Saint Francis and San Mateo.

- Amy Grubert, PA will be joining our team as a new part-time physician assistant in September. She currently works in Antioch but lives in the East Bay and wanted to experience what San Francisco has to offer.

-Robert Settles will be joining us as a per diem Unit Clerk.

-Armand Ching RN and Sarah Wells RN are back as perdiem RNs

-Molley Hilldebrand RN will be joining us from St. Josephs in Stocken. She is taking a full time night shift position

Fond Farewells

- Part-time PA Megan Rodgers will be leaving SFMH and Emergency Medicine to pursue a career in Orthopedics. Good luck Megan! We enjoyed having you at Saint Francis!

- Full-time PA Jay Frazer will be leaving his position with us to work with VEP on the Northern California coast. His last FT shift will be in Sept but he hopes to still work the occasional shift at Saint Francis. It goes without saying, that Jay's energy and enthusiasm has made a huge impact while at Saint Francis. We wish him all the best in his future endeavors!

- Our long time perdiem RN Judy Deniz has resigned. She will be missed but we wish her well in her retirement


Joanne & Theresa

PI ~ A. Fulgado, RN SN III

Hi everyone!!

*Please be sure to LABEL the Central Line insertion form before turning them in. I have received them filled out without labels a lot recently. Also do not forget to put the part the MD signs in the chart.

*I am still doing my audits:) I audit all patients with a Lactic over 2.0. Keep up the good work on getting blood cultures before abx and getting abx within 3hrs of arrival.

Thank you

Amy Fulgado SNIII

Meet the New Hire! ~ Tamara Al-Yassin

1) How's your experience been in this ER so far?

"It has been fantastic! I am learning new things everyday so it really helps to feel so supported. "

2) What is your favorite diagnostic test used in ED?

"I really like the istat machines. There is something about instant results that is very satisfying."

3) What is something you learned (outside of work) in the last week?

"I tried stand up paddle boarding. It was easier than I thought and I think may be a new hobby for me. Who knows, maybe I'll even try surfing one of these days."

4) What is your favorite thing to do on your day-off?

"I love food. I like to try new restaurants. I am also a big road trip person, so when I have extended days off I like to get away. "

5) If you could eliminate one thing from your daily schedule what would it be?

"I really hate washing dishes. I need a dishwasher pronto."

Any thoughts or feedback?

Let us hear from you! Newsletter is the perfect place if you have any announcement to make or simply something to share with your team members in the department. We also welcome any feedback or suggestion on the newsletter itself - its format, frequency, topics to be included, etc. Anything to make our communication better!

Thank you for reading:)

Respectfully submitted by:

Yvette Bassett, SNIV

Minami Oya, RN