ER Buddy Shift Check List General Operation 1. Do we have protocols or standing operating procedures?

● Mass casualty events & disaster planning ● Stroke ● Cooling post Vfib arrest ● Sepsis ● ACS/STEMI 2. What specialties do we have on site and are they available 24/7? ● General Surgery ● Neurosurgery ● Orthopedics ● Obs/Gyne ● Radiology 3. What other health professionals are working within our department, what are their scopes of practice and hours? ● Social worker ● Pharmacist ● Respiratory Therapist ● Nurse Practitioner ● Psychiatric Nurses ● EMS (are they intubating, what drugs can they give (opioids, sedatives, RSI meds) ● Outpatient educators (asthma, diabetes, etc) 4. How do we access medications after hours that are not stored in the ED? 5. Who can I call for help with toxicology? 6. How do I arrange patient transfers? What is the phone # of the service that arranges these transfers? 7. What is our department plan for unexpected increases in patient volume? Is there a second physician who can be called in? 8. Do we have a Code Blue or Medical Emergency Team (MET) within the hospital? Am I expected to respond to a code blue within the hospital or for certain departments? 9. How are we handling organ donation? Is there an organ donation team within our area? When and how do we get them involved? How can I assist them in their function? 10. Who makes the call on when to give thrombolytics in Stroke and STEMI? Who administers the medication? 11. What is the policy for procedural sedation: Two docs, one doc plus RT, one doc plus RN?

12. Do we have orthopedic technicians? Where do orthopedic cases get follow up? Imaging 13. What imaging modalities are available, and after certain hours, do we have to call anyone in from home to obtain imaging? 14. What scans require a radiologist’s permission? KUB, CT scans, etc. 15. Does our department have reserved imaging slots in the morning for U/S or CT? Department Administration 16. What are the expectations within our group for shift handover? 17. To whom do I report patient-safety, administrative, and operational problems/concerns? 18. Who organizes the shift schedule and shift changes? Trauma 19. Where is the nearest level one trauma centre? 20. Do we have a trauma team? In what situations are they activated? 21. What is the ER physician’s role depending on the level of trauma? Cardiac 22. Where is the nearest cardiac catheter lab? 23. How are we/cardiologists packaging/managing STEMI & NSTEMI? Academic 24. Are there any patient groups that may be candidates for inclusion into research studies at our institution? 25. What residency programs work in our department? Is there a set curriculum for each level of study? What is expected of me as an instructor? Medical Legal & Documentation 26. What is the law for substitute decision makers in our area/state/province? Is there an in house/consultable ethics board? 27. What is the age of consent? 28. What is the process for involuntary admission for psychiatric patients? 29. Is there any law for providing the police with information on a case? Eg. serum blood ETOH level? Disposition 30. Can family physicians admit patients? 31. How can I set patients up with outpatient:

● IV therapy ● Anticoagulation ● IV antibiotics ● Dressing changes 32. How can I arrange home care for patients, and are there transition services within the department? 33. Where is the nearest: • Detoxification centre - what are the admission requirements? • Homeless shelter 34. Do we have a crisis response team for non-psychotic, low suicide-risk patients? 35. Is there a team dedicated to sexual assault case presentations? Do we have a sexual assault kit in the department? Who is expected to complete it? 36. Are we writing admission orders for consultants? 37. As a group, are we ordering non-emergent tests for patients and referring them back to their family physicians or a specialist? 38. For those patients requiring follow up in 24 – 48 hours for re-examination or additional blood tests, are we seeing them again in the ER or are they following up with their family physician 39. What are we doing as a group regarding prescription renewals? Does our policy vary depending on the medication? What about benzodiazepines, opioids and other potential drugs of abuse? 40. Are we doing STI testing in high-risk patients? Is there a follow up plan for positive results? • Are we treating on speculation for Gonorrhea & Chlamydia? Who will follow the swab/urine PCR results? • For blood borne infections like syphilis, HIV, Hepatitis, do we have any testing or treatment protocols? 41. When are we required to inform public health of an illness and what is the process for doing so? 42. What end-of-life resources are available, and how do I access them? Are there cultural and religion specific services? 43. Do we have pre-printed order sets? Where are they? 44. Do we have taxi vouchers to get lower-income people home?

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