To:

From:

Date:

Re:

MEMORANDUM

All Memorial Hospital Medical and Nursing Staff
All Municipal EMS Services

Joe Oriti, Chief Administrative Officer, Memorial Hospital
Raymond Powrie, MD, Chief Medical Officer Memorial Hospital
Michael Dacey, MD

November 2017

Categories of Patients Capable of Being Served by Memorial Hospital after
November 13th, 2017

 

With the diminution of clinical capability at Memorial due to the closure of the Intensive Care
Unit, please note that patients with either suspected or diagnosed conditions listed below should
not be admitted to Memorial Hospital effective November 13th, 2017. We also suggest to EMS
services that they not transport to the Memorial Emergency Department patients with the
conditions listed below effective November 13th, 2017:

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15.

16.

17.
18.

Neurological:
Embolic stroke

Hemorrhagic stroke

Status epilepticus

Intracranial hypertension, regardless of cause
Acute demyelinating diseases, regardless of cause

Cardiovascular:

Acute myocardial infarction

Unstable cardiovascular status or hypotension, regardless of underlying cause
Cardiac sufficient to cause hemodynamic instability

Acute congestive heart failure or pulmonary edema

. Ventricular tachycardia
1 1.
12 .

Aortic dissection, regardless of location
Hypertensive emergency

. Leaking abdominal aortic aneurysm
14.

Shock, regardless of cause

Pulmonary:

Impending or actual acute respiratory failure, including patients with oxygen
requirements of more than 50% FiOg and those requiring non-invasive mechanical
ventilation

Severe chronic obstructive pulmonary disease and impending respiratory failure
Status Asthmaticus

Pneumonia with impending respiratory failure

Pulmonary embolism
Acute lung injury or acute respiratory distress 

Renal:
. Acute renal failure
Any patient requiring emergent dialysis

Gastrointestinal:
. Gastrointestinal bleeding, regardless of source
Acute liver failure
Hepatic encephalopathy
Acute ischernic bowel
. Acute pancreatitis, associated with organ failure

Other:

Sepsis or septic shock, regardless of cause

Compromised arterial blood ?ow to an extremity

Toxicological emergencies associated with mental status changes or cardiovascular
instability

. Major trauma

Rhabdomyolysis

Diabetic ketoacidosis

. Life threatening electrolyte disorders

. Severe alcohol withdrawal

36. Any patient deemed at risk of requiring ICU care during their stay not included in the

above categories

In addition to the above, please note that going forward, elective surgery will only be
performed at Memorial for low risk patients.

As questions arise regarding types of patients appropriate to be admitted or cared for at
Memorial Hospital, please direct them to the shift nursing supervisor, Dr. Powrie or Dr. Dacey.