Localization — the answer sheet

What this hospital can do, answered by the site owner and the charge nurse. Fill it at a meeting; then type it in on YOUR SITE in the app, where every answer carries its date and is re-checked after a year. What you cannot answer, leave blank — the app shows TO CONFIRM, never a guess.

A · REFERRALS — DO WE KEEP THEM HERE? IF NOT, WHERE, IN WHAT ORDER

1 · Trauma critical trauma we do not keep

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 · Stroke thrombectomy candidates, telestroke

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 · STEMI no cath lab → where, in what order

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

4 · ICU critical care we cannot admit

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

5 · Pediatric inpatient children who need admission or PICU

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

6 · Psychiatry inpatient psychiatric care

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

7 · GI bleed unstable upper GI bleed, urgent endoscopy, TIPS

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

8 · Interventional radiology embolization, drainage

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

9 · Dialysis emergent dialysis

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

10 · Burns burn center criteria

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

11 · High-risk OB maternal transfer

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

12 · Newborn / NICU a newborn needing higher care

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

13 · Neurosurgery head bleed, spine

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

14 · Vascular surgery aortic, limb ischemia

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

15 · Hand surgery replant, complex hand injury

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

16 · General ortho fractures we do not fix here

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

17 · Ophthalmology the eye after canthotomy, open globe

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

18 · Toxicology / poison poison control, antidotes we lack

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

19 · Hyperbaric CO, decompression

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

20 · ECMO ECPR / ECMO center

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

21 · SANE sexual assault nurse examiner

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

22 · ENT post-tonsillectomy bleed, airway ENT

Do we keep these patients here? YES — WE KEEP THEM NO — THEY GO OUT SOMETIMES — WITH A RULE

If SOMETIMES — the rule

1 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

2 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

3 DestinationNumberTHROUGH THE TRANSFER CENTER DIRECTWhat goes there

B · HALO PROCEDURES — HERE AND WHO · WHO WE CALL · WHAT IS STOCKED · WHERE AFTER

1 · Cricothyrotomy (eFONA — adult)

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually ICU

2 · Pediatric difficult airway / FONA (pediatric CICO)

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Needle cric + jet ventilation Scalpel-bougie kit (peds) Kit, where it lives

Where does the patient go after? A referral category from part A — usually Pediatric inpatient

3 · Resuscitative thoracotomy

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually Trauma

4 · Pericardiocentesis

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually ICU

5 · Lateral canthotomy / cantholysis

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually Ophthalmology

6 · Finger thoracostomy to tube thoracostomy

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually ICU

7 · Resuscitative hysterotomy (perimortem cesarean)

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually High-risk OB

8 · Transvenous pacemaker placement

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually ICU

9 · Minnesota / Blakemore tube placement

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Sengstaken-Blakemore — gastric 250–300 mL Minnesota — gastric 450–500 mL Kit, where it lives

Where does the patient go after? A referral category from part A — usually GI bleed

10 · Emergency delivery

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually High-risk OB

11 · Escharotomy

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually Burns

12 · Catastrophic post-tonsillectomy hemorrhage control

Do we do it here? YES NO Who: ED physician Surgeon on call Anesthesia Other

Who do we call for help, live? NameNumber

What is stocked? Kit, where it lives

Where does the patient go after? A referral category from part A — usually ENT

Answered by ______________________ on ____ / ____ / ________ · one sheet per site · the same 22 referral categories and 12 HALO procedures the app asks · cairnready.org/site/