Policy

This policy outlines that each Emergency Department (ED) has a standardized Code Stroke Protocol based on the Canadian Stroke Best Practice Recommendations. This protocol aims to improve outcomes for stroke patients by supporting rapid diagnosis, appropriate treatment within critical time windows, and standardized care across facilitie

Key Objectives

1. Timely Assessment and Treatment: Ensure suspected stroke patients are assessed immediately for eligibility for thrombolysis (within 4.5 hours of symptom onset) and Endovascular Thrombectomy (EVT) (usually within 11 hours of last seen normal).
2. Immediate Neuroimaging: Mandate immediate neuroimaging (Non-Contrast CT head scan and multiphase CT Angiogram) for patients within the time window for acute interventions.
3. Standardized Care Pathways: Provide clear guidelines for the management of stroke patients, including transport to facilities with the necessary imaging capabilities and interventions.
4. Swallow Screening: Ensure patients remain nothing by mouth (NPO) until a stroke swallow screen is completed to prevent complications.
5. Post-EVT Care: Outline the process for repatriating medically stable patients following EVT to the sending facility.
6. Access to Stroke Unit Care: Ensure patients with acute stroke, TIA, or suspected stroke are admitted to a stroke unit as soon as possible, ideally within 24 hours of hospital arrival, and provide equal access to stroke unit beds.

This policy supports staff in providing appropriate care and support to patients who have experienced sexual assault. The policy aims to provide compassionate, patient-centered care while respecting the patient’s autonomy and legal rights.

Key Objectives

1. Informed Consent: Ensure that consent is obtained from the patient at three critical points: for treatment, for the Sexual Assault Nurse Examiner (SANE) response, and for the collection of forensic evidence if the assault occurred within the past seven days.
2. Direct Patient Consent: Prioritize obtaining consent directly from the patient whenever possible. If the patient is unable to provide consent within the acute care period, consent should be obtained from the Substitute Decision-Maker (SDM).
3. Forensic Evidence Collection: Provide guidelines for the collection of forensic evidence, even if the patient does not consent to SANE involvement or cannot be transported to a SANE response site. Ensure confidentiality and proper handling of evidence.
4. Consultation with SANE: Encourage consultation with the on-call SANE for guidance on forensic evidence collection, using non-identifying information until consent is obtained.
5. Patient Autonomy: Respect the patient's right to determine who is present during medical care and evidence collection.
6. Reporting: Clarify that reporting of sexual assault is not required unless mandated by legislation or professional standards. Provide guidance for staff who are unsure of their reporting responsibilities.

This care directive (CD) authorizes Health Care Providers (HCPs) with the required competency practicing within an applicable area, to assess patients with pyrexia and provide the treatment outlined in this policy.

Key Objectives

Autonomous Implementation: Allow RNs and Paramedics to implement CDs autonomously in closed Emergency Departments (EDs), Urgent Treatment Centres (UTCs), or Urgent Care settings when an AP is not available, ensuring timely patient care.

1. LPN Autonomy: Enable LPNs to implement CDs autonomously if specific conditions are met, such as known client needs, established care plans, and consistent patient responses. If these conditions are not met, LPNs must collaborate with RNs or other healthcare providers.
2. Inclusion and Exclusion Criteria: Provide clear criteria for when CDs can be implemented, including specific patient conditions and exclusions, to ensure appropriate and safe care.
3. Emergency Physician/AP Assessment: Require that patients be assessed by an Emergency Physician or AP prior to discharge, either in person or virtually, to confirm the appropriateness of the care provided.
4. Transfer Protocols: Outline protocols for transferring patients to open EDs or for virtual assessments when an Emergency Physician/AP is not available in person, ensuring continuity of care.

Overall, the policy aims to enhance the efficiency and effectiveness of emergency and urgent care services by empowering healthcare providers to make timely clinical decisions while maintaining patient safety and care standards.

This Care Directive (CD) authorizes the Health Care Providers (HCPs), practicing in an applicable area with the required competence, to assess Patients for the presence or absence of pain, and administer pain analgesia as outlined in this document.

Key Objectives

Autonomous Implementation: Allow Registered Nurses (RNs) and Paramedics to implement CDs autonomously in closed Emergency Departments (EDs), Urgent Treatment Centres (UTCs), or Urgent Care settings when an Authorized Prescriber (AP) is not available, ensuring timely patient care.

1. LPN Autonomy: Enable LPNs to implement CDs autonomously if specific conditions are met, such as known patient needs, established care plans, and consistent patient responses. If these conditions are not met, LPNs must collaborate with RNs or other healthcare providers.
2. Emergency Physician/AP Assessment: Require that patients be assessed by an Emergency Physician or AP prior to discharge, either in person or virtually, to confirm the appropriateness of the care provided.
3. Transfer Protocols: Outline protocols for transferring patients to open EDs or for virtual assessments when an Emergency Physician/AP is not available in person, ensuring continuity of care.
4. Inclusion and Exclusion Criteria: Provide clear criteria for when CDs can be implemented, including specific patient conditions and exclusions, to ensure appropriate and safe care.

Overall, the policy aims to enhance the efficiency and effectiveness of emergency and urgent care services by empowering healthcare providers to make timely clinical decisions while maintaining patient safety and care standards.

This policy provides directions to staff for when patients present to an emergency department (ED) with psychiatric symptoms. The policy aims to ensure the patient receives a comprehensive medical assessment to determine their stability/ medical needs before undergoing a mental health assessment. It promotes ongoing collaboration between medical and mental health Health Care Professionals (HCPs).

Key Objectives

1. Medical Stability Assessment: Ensure that a thorough medical assessment is conducted to identify any comorbid medical conditions that may affect the patient's psychiatric symptoms.
2. Comprehensive Physical Health Assessment: Mandate a physical health assessment that includes a history, a brief neurological screen, direct cardiovascular, respiratory, and abdominal examinations, and urinalysis for elderly patients, along with a review of vital signs.
3. Upfront Medical Assessment for Referrals: Require that patients referred to EDs from community sources, such as family doctors, receive an initial medical assessment, including a brief triage history and full vital signs.
4. Documentation and Communication for Transfers: Ensure that a medical assessment is completed, documented, and communicated to the receiving care team before transferring a patient to another facility.
5. Reassessment if Stability Concerns Arise: Mandate a medical reassessment if concerns about the patient's medical stability arise during the psychiatric assessment at the receiving facility.
6. Timely Assessments for Acute Cases: Require that both psychiatric and medical assessments be completed as soon as possible for patients who are acutely agitated, violent, or brought in by the police.
7. Collaboration Between Departments: Promote systematic collaboration between emergency department staff and mental health and addictions crisis response clinicians to ensure high-quality patient care.
8. Regular Communication: Establish a process for regular communication to resolve issues and ensure that any problems are flagged and discussed promptly between ED and mental health and addictions staff.

This policy supports staff in their efforts to provide children presenting to the Emergency Department (ED) with symptoms of croup with timely and standardized care. It aims to streamline the treatment process and improve patient outcomes.

Key Objectives

1.  Authorization and Competency: Healthcare providers (HCPs) in the ED who are competent in managing croup can independently implement the Croup Treatment Pathway.
2. Standardized Care: Children with symptoms of croup (e.g., barky cough) are to be treated according to a specific pathway, ensuring consistent and effective care.
3. Collaboration: HCPs must be available for consultation and collaboration with registered nurses (RNs) in the ED.
4. Patient Assessment: Every patient started on the Croup Treatment Pathway must be assessed by an HCP.
5. Initiation and Medication: HCPs can start the Croup Treatment Pathway and administer medications to patients who meet the criteria.
6. Physician Involvement: The policy outlines specific roles and responsibilities for ED physicians, although the details are cut off in your message.

This policy supports staff in their efforts to provide children presenting to the Emergency Department (ED) with symptoms of acute gastroenteritis (AGE), such as vomiting and diarrhea, with timely, standardized, and effective care. It to aims to streamline the treatment process, and improve patient outcomes.

Key Objectives

1. Standardized Care: Children with symptoms of AGE are to be treated according to a specific Vomiting and Diarrhea Treatment Pathway, ensuring consistent and effective care.
2. Authorization and Competency: Healthcare professionals (HCPs) in the ED who are competent in managing vomiting and diarrhea can independently implement the treatment pathway.
3. Initiation and Medication: HCPs can start the Vomiting and Diarrhea Treatment Pathway and administer the medications to patients who meet the inclusion criteria.

This policy promotes early identification and timely management of sepsis in patients presenting to the Emergency Department (ED). It aims to improve patient outcomes by facilitating prompt recognition and treatment of sepsis, which can be life-threatening if not addressed quickly.

Key Objectives

1. Early Screening: All patients are to be screened for sepsis at triage using appropriate tools for adults and children, ensuring early detection.
2. Continuous Monitoring: Patients with abnormal vital signs during their ED stay must be re-screened for sepsis, highlighting the importance of ongoing assessment.
3. Documentation: The time of screening must be recorded in the patient's health record if they screen positive for sepsis, ensuring accurate and thorough documentation for effective treatment and follow-up.

This policy supports staff in providing patients presenting in the Emergency Department (ED), Urgent Treatment Centre (UTC), or Urgent Care with timely and appropriate care, in life-threatening situations such as anaphylaxis or allergic reactions. It provides clear direction for managing critical situations, so the patient receives prompt and effective care.

Key Objectives

1. Autonomous Implementation: Registered Nurses (RNs) and Paramedics are authorized to independently implement the care directive (CD) in emergent situations, particularly when an Emergency Physician or Authorized Prescriber (AP) is not available.
2. Licensed Practical Nurse (LPN) Role: LPNs can also implement the CD autonomously if specific conditions are met, such as known patient needs and consistent responses to interventions. If these conditions are not met, LPNs must collaborate with an RN or other healthcare professionals.
3. Inclusion and Exclusion Criteria: Healthcare providers (HCPs) must assess patients for signs and symptoms of anaphylaxis or allergic reactions and ensure they meet the inclusion criteria. Patients under 16 years of age are excluded.
4. Physician Assessment: Patients must be assessed by an Emergency Physician or AP before discharge. In cases where an Emergency Physician or AP is not available, the patient must be transferred to an open ED for assessment.

This policy supports staff in providing pediatric patients, presenting with signs of anaphylaxis or allergic reactions timely and appropriate care, even in settings where an Emergency Physician or Authorized Prescriber (AP) may not be immediately available.

Key Objectives

1. Autonomous Implementation: Registered Nurses (RNs) and Paramedics are authorized to independently implement the care directive (CD) in life-threatening situations, especially in closed EDs, UTCs, or Urgent Care settings when an Emergency Physician/AP is not available.
2. Licensed Practical Nurse (LPN) Role: LPNs can implement the CD autonomously if specific conditions are met, such as known patient needs and consistent responses to interventions. If these conditions are not met, LPNs must collaborate with an RN or other healthcare professionals.
3. Inclusion and Exclusion Criteria: Healthcare professionals must assess patients for signs and symptoms of anaphylaxis or allergic reactions and ensure they meet the inclusion criteria. Exclusion criteria include allergies to medications in the CD, requests to see a physician before treatment, and more likely alternate diagnoses.
4. Physician Assessment: Patients must be assessed by an Emergency Physician/AP before discharge. In cases where an Emergency Physician/AP is not available, the patient must be transferred to an open ED for assessment.