The fellows who are on the ER/CL rotation will be responsible for seeing any child psychiatric consultations in the ER (age 17 or below) and any appropriate pediatric floor consultations.
Historically, this team was a combined service with the Child Psychology team, however in Feb 2020 the service was split into two separate teams. The Child Psychology team consists of multiple rotating psychology interns and they carry the pager 98703 and the Child Psychiatry team consists of multiple rotating CAP1 fellows and they carry the pager 97801.
|Child Psychiatry CL Service||Child Psychology CL Service|
|Psychiatry is consulted for: All ER consults, some floor consultsQuestions regarding psychotropic medications, including for acute agitation, confusion or non-responsiveness. Patients with complex psychiatric history on psychotropic medications. Page p97801 8-5pm M-F (“PSYCHIATRY-CHILD CONSULTS TO PEDS” in the paging system) Director: Jena Chung, MD||Psychology is consulted for: Floor consults onlyCases that do not meet the criteria for psychiatry consults (on the left)Consult either psychiatry or psychology for all other indications. They will triage to each other based on caseload and indication, if appropriate. Page p97803 8-5pm M-F (“PSYCHOLOGY-CHILD CONSULTS TO PEDS” in the paging system) Director: Natacha Emerson, PhD|
Triaging CL Consults:
When you begin the ER/CL rotation, you will have to create patient lists and add the system lists for New CL patients and Follow up CL patients. Your chief fellows will review this process with you at orientation. You will use these lists to track your floor patients and monitor any new consults that are ordered. As a policy, our team does not see new consults until we have been paged and have spoken to a member of the primary team.
Once you are paged about a new consult, call it back and obtain the basic information of the case and the consultation question. It is important to determine if primary teams have a question about medications, agitation, delirium or non-responsiveness as these cannot be triaged to the Psychology service. Do not see the consult until you have written a brief summary of the consult and emailed that out to Child Psychiatry and Child Psychology attendings and all of the Psychiatry fellows and Psychology interns on the CL rotation. After you send this email, the psychiatry and psychology attendings will discuss the caseloads of each team and determine who will see the patient. Even if it is an obvious medication question for the Psychiatry team, it is still important to send this email and notify the Psychology team as they frequently have been involved with cases before our team is consulted.
Once you have sent out that email and it is determined that the Psychiatry team will see the consult, you should see the patient, staff with the attending and document your note using the appropriate “.PSYEDCLNOTE” template. You will alternate consults with your co-fellow.
ER Consults #
For quick reference on call, see the ER Workflows on page 68 and use the Psy ED Navigator tab in Care Connect.