How to Admit a Patient to the Hospital
Posted on August 13, 2013 by Survivor DO
hospital sign
I spend most of my time rambling on here on Surviving Gray’s but today I thought I would provide some practical advice. Medical school is heavy on treating disease but light on the practical side of actually making sure your patient receives these treatments. Something every medical student and intern will need to learn is how to admit a patient to the hospital.
So you go see a patient in the emergency room and do the H&P. You present to your attending and you both agree the patient should be admitted. The attending gives you a few words of advice and then promptly disappears. Now what. You need to write the orders to actually admit the patient to the hospital. Like everything in medicine, it is good to have a system. Mine is ADCCCVAANDISML.
A – Admit to
Admit to Dr. Robinson, GMF
First step. Get the patient through the door. First you need to decide what type of bed they are going to. Typical options are
•Observation – the patient’s stay is likely to be less than 24 hours
•GMF – the patient can go to a general med/surg floor without additional monitoring
•Tele – the patient can go to a general med/surg floor but should have telemetry monitoring. Basically any cardiac patient gets this.
•Step-down – you want more frequent monitoring than GMF but the patient doesn’t require ICU
•ICU – the patient’s condition is life threatening and they require the highest level of care
Deciding which of these fits your patient requires experience, your best bet in the beginning is to just ask your attending what they want.