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-Admit a patient to the NICU, particularly when there are no beds?

1)      Does your patient need to be in the neuro-ICU? Would another unit be acceptable?

  • Patients with cerebrovascular disease or ICP issues NEED to be in the NICU, they should not go to a different unit.

2)      Look at the NG patients in the NICU and see if any of them can be triaged to another unit (floor or ICU).

3)      If there are no NG patients that can be triaged, page the neurosurgery resident on-call (pager 31777) to determine if they have a patient who can be triaged to another unit.

4)      If neurosurgery has no patients who can be triaged, call the intensivist for help.

Also, please remember to call the intensivist for all patients who get admitted to the NICU (or another ICU), even in the patient is just boarding.



– Dictate a note?




– Add a lab to blood that has already been drawn?
  1. Be ready with the patient's name and reg #.
  2. Call the lab at 6-6777.
  3. Ask them to add a test or tests to previously drawn blood work.
  4. The lab will determine whether there is a sample to which the desired test may be added.
  5. Confirm the request with your doctor #.
  6. OR order on Michart other "Add on Labs"





– Request a closed (i.e. trochar) muscle biopsy?
  • Fill out a consult request for the patient to be seen by Ann Little in the Medical Procedures Unit.
  • Fill out a consult request for pathology to review the muscle biopsy.
  • Give both forms to the scheduling staff at the front of clinic in Taubman.




– Request a skin biopsy for small fiber density?
  • Fill out a consult request for the patient to be seen by Ann Little in the Taubman clinic.
  • Fill out a consult request for pathology to review the skin biopsy.




– Schedule an appointment for a patient in the PFO clinic?
  • E-mail CVCCallCtr@med.umich.edu with the patient's name, reg #, and if you would like the CVC to call or mail the patient with an appointment date and time.





– Obtain copies of medical records (for a patient or an entity that a patient wants their records sent to)?
  • Go to http://www.med.umich.edu/i/him/coding/obtaining.html
  • Select "Authorization to Release Patient Information from UMHS"
  • Complete the form.
  • Have the patient (or their representative) sign the form.
  • Send the form to Health Information Management as indicated on the webpage or the form.




– Obtain medical records from an outside physician or hospital pertaining to a patient?
  • Ask Julie Beddingfield. If that doesn't work....
  • Go to http://www.med.umich.edu/i/him/coding/obtaining.html
  • Select "Authorization to Request Patient Information From Another Organization"
  • Complete the form.
  • Make sure you include contact information so the outside provider can reach you in case they have other questions about the request.
  • Have the patient (or their representative) sign the form.
  • Send the form to the outside physician or hospital.





– Clean my white coat?
  • You have two options:
    1. Take it home and wash it yourself.
    2. Empty the pockets, take off any pins, then put it in the box marked "Unclean Lab Coats." The box is next to the copier in the office by the faculty mailboxes. When the university cleaners are done (usually in about two weeks, sometimes longer), the coat will be hung on the coat rack behind the door to the residents room.

-- How to set up an outpatient infusion of solumedrol for MS patients (from inpatient service or from ED)
  • Consider giving patient 1,250mg of PO prednisone daily to finish the three day course as similar efficacy and easier to set up.
  • Otherwise, on Michart. send an encounter to Nursing (TC NEU CLIN SUP) to arrange, next available solumedrol infusion. Nursing will set up orders and forward to MIST (infusion scheduling-phone734-232-2655) and they will arrange in next available location. 5TACU (on 5C-transplant), Taubman, East Ann Arbor, Northville or Canton infusion Center. 

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