Harbor-UCLA Emergency Department Newsletter
October 16, 2025
Your monthly update on ED operations, clinical guidelines, quality initiatives, and department news.
TL;DR
ED Ops
New Ortho Pre-Op CT Workflow — DHS fracture patients needing pre-op CTs can now get urgent outpatient CTs (often same day). Order as Routine CT → Future (1–2 days) → "ED Ortho" in comments. OB/GYN Guidelines now on WikEM → Harbor Main → Admin Updates. Triage: WOWs print to RME 🎉; "ED→UCC" script now in Spanish.
Joint Commission
Survey anytime through Spring 2026 — clean ultrasound probes, document all procedures, ketamine = deep sedation, complete full sedation PowerForm.
QI
Follow CA DPH vaccine guidelines per AB 144 (not CDC/ACIP); all ≥6 mo eligible for updated COVID shot.
EMS/Disaster
ShakeOut drill held 10/16; HERT training 11/12 (sign-up by 10/22); LA-DROP blood drives 10/22 & 10/31.
Peds ED
After-hours Peds consults now shared across DHS sites (full centralization Jan 2026). YAFT pts 21–25 seen faster.
Dept News
Dr. Ryan Pedigo graduates CA Health Leadership Program 🎓; Dr. Roh decluttered doc boxes — please keep clean!
🩺 ED Operations
🆕 Ortho Pre-Op CTs
Stable Ortho fracture patients no longer need to wait in the ED for pre-op CTs. DHS patients can now get urgent outpatient CTs — often same day!
Steps:
01
Confirm DHS status (Harbor Ortho is going to do surgery soon)
02
Order Routine CT → select Future (grace period 2 days) and add "ED Ortho" in comments.
03
If daytime (7a–3p), schedulers TEAMS you the appointment. If after 3p, they call the patient next morning.
04
Discharge the patient — schedulers contact Ortho on-call directly for questions.
📎 Laminated instructions are in every doc box. 👏 Shoutout to Dr. Jen Roh & Nancy (LEAN team) for launching this workflow!
⚕️ OB/GYN Consult & Follow-Up Guidelines
Now live on WikEM → Harbor Main → Admin Updates → OB/GYN. 📎 Direct link: OBGYN ED Consultation Guidelines Document. Thanks Dr. Wilhelm for helping to update this.
New C-Collars
Starting next week, you'll see the DeRoyal collar in supply carts. Please use existing Aspen collars first.
  • Continue MJ for short-neck/bariatric patients.
  • Pediatric collars unchanged.
  • Will monitor for any skin issues. 📎 DeRoyal Cervical Neck Collar Reference Guide.docx
Triage Updates
WOWs now print directly to RME 🎉
(thanks Mario, Lori Fields, and Dr. Roh!).
New Triage Guide coming soon
led by Heather Ngai, Hunter Jackson, and Erwin Yson.
"ED→UCC" script now available in Spanish
to encourage urgent care appointments.
📞 AED issues → Dr. Jen Roh
📞 OOP/ICE issues → Dr. Parveen Parmar (on leave 10/24–2/1 → contact Dr. Roh for OOP and Dr. Chappell for ICE)
📞 Ops issues → Dr. Brad Chappell
💉 QI & Clinical Corner

AB 144: California providers should follow CA DPH vaccine guidance instead of CDC/ACIP.
  • All Californians ≥6 months eligible for updated COVID vaccine.
  • As of 10/2, Employee Health does not yet have updated doses (but offers CAPR training).
📞 Contact Dr. Claudius, EM QI Director, for quality or safety cases.
☕ Joint Commission Coffee Break
🕵️‍♀️ The Joint Commission can survey any time now through Spring 2026. Stay survey-ready: clean, compliant, and well-documented.
Key Reminders
Ultrasound Hygiene
Wipe probes before and after use. Never leave visible contamination.
"It's both disgusting for patients and risky for staff," – Dr. Tim Jang
Procedure Documentation
Complete notes for all procedures, especially central lines and chest tubes.
Sedation
Ketamine = ALWAYS documented as Deep Sedation → Fill out Pre/Post-Sedation PowerForm with ASA & Mallampati scores.
📎 Resources: Joint Commission Pearls → WikiEM: Harbor Main
📘 Full Handbook: "TJC Booklet for QR code\_9.23.25"
🚨 EMS & Disaster Updates
🌎 ShakeOut 2025
Millions practiced earthquake safety today (10/16 @ 10:16am). Download the MyShake App for early alerts.
📸 Shoutout to Manny for infection-prevention-approved towel seating!
🧯 HERT Training Drill
📅 Nov 12 @ LACoFD Del Valle
  • 3–4 base-trained PGY3–4 residents + 1 alternate.
  • PGY1–2 may observe.
📅 Sign up by 10/22: Microsoft Form
📎 More info: DHS HERT Training Site
🩸 LA-DROP Blood Drives
Support our patients & LA-DROP:
  • Oct 22: Dollarhide Community Center (Compton)
  • Oct 31: Harbor-UCLA Medical Center
👩‍⚕️ Dr. Kelsey Wilhelm, EMS Medical Director
👶 Pediatric ED Updates
🧬 Centralized Pediatric Consultations
DHS is centralizing after-hours pediatric specialty consults.
  • This month: GI, Genetics, Surgery, Cardiology.
  • Full centralization by Jan 2026.
  • Check Intranet/MedHub for daily coverage.
📞 Contact Dr. Patricia Padlipsky if issues arise.
👩‍⚕️ YAFT
Young Adult Fast Track is working!
  • 21–25 yr olds seen faster, fewer LBTCs.
  • ESI 4–5 → PED; ESI 3 → AED MSE/workup first, then PED if appropriate.
💦 Urine Cultures
Bag UA OK for screening febrile infants; if positive → send cath culture. If unable: document reason (refusal, adhesions, etc.). Explain rationale to parents when discussing caths.
🩺 Attendings
If a family is upset or requests another doctor, please step in to support residents.
🧰 Equipment
  • Otoscopes → PED doc box (bottom shelf).
  • Ophthalmoscopes/speculums → white drawer.
  • Eye care & ring removers → drawer under safe.
  • Return unused ortho supplies.
🌬️ Respiratory Season
  • RSV & Influenza activity still low.
  • For asthma (PAS ≥7) → use Aerogen ("neb vibrating mesh" route).
  • Full respiratory panels only for <13 yrs likely to admit.
  • Pertussis testing → send-out test (panel not sensitive).
Follow-up
  • line for rescheduling missed Harbor specialty appointments: 855-521-1718
Always feel free to reach out
📞 Dr. Patricia Padlipsky: 310-930-6387
🎉 Department News
🌟 Congratulations Dr. Ryan Pedigo!
Dr. Pedigo graduated from the CA Health Care Foundation Health Leadership Program — one of 32 statewide fellows. His project, "A Multipronged Approach to Enhancing Trainee Evaluations in EM," was chosen as a plenary presentation among 23 program cohorts.
Dr. Pedigo's education background includes UCLA, Stanford, Michigan, and Johns Hopkins. He serves as SAEM Awards Chair, ACGME UCLA Hub Co-Chair, and AEM Education & Training Editor. 🏆 Recipient of numerous teaching awards (SAEM, CORD, EMRA, ACEP, Kaiser-Permanente, and the Amy H. Kaji Faculty Teaching Award).
🗂️ Doc Boxes Organized & Decluttered!
Thanks to Dr. Roh, doc boxes are clean, organized, and labeled.
  • Please remove personal items — unclaimed items will be donated soon.
  • Please lean up food, drinks, EKGs, and supplies after shifts.
Rounding Room Updates!
Lost & Found! (see photo) Please take your items home! We will donate if no one claims in the next several weeks.
  • one old IKEA table was removed to make room for the new lactation/quiet corner. coming soon!
🎁 The Rounding Room Keurig machine was donated to staff breakroom — the nurses thank you!
🎃 Halloween is coming up! If you're on shift in the ED that night (bless). Channel your inner Lorax and conquer the chaos!
Thank you for your continued dedication to patient care and team excellence!
Thanks for reading until the end! Have photos, stories, or updates to share?
📧 Send to Dr. Jen Roh → [email protected]