Get the free ADULT ECMO REFERRAL INTAKE FORM - Scripps Health

Patient Identification Central Transfer Center Transfer Line: 8586786205 Transfer Fax: 8586786456TRANSFER CENTER REQUEST Along with this sheet, please fax a face sheet, H&P & current day progress

How to fill out adult ecmo referral intake

How to fill out adult ecmo referral intake

1. To fill out the adult ECMO referral intake, follow these steps:
2. Begin by gathering all necessary patient information, including name, age, and medical history.
3. Assess the patient's current condition and determine if they meet the criteria for ECMO therapy.
4. Contact the ECMO referral center or specialist to initiate the referral process.
5. Provide the required information about the patient's condition and the reason for the referral.
6. Complete any necessary paperwork or documentation as requested by the referral center.
7. Ensure all supporting medical records and test results are included with the referral.
8. Submit the referral intake form and any additional documents required to the designated contact at the referral center.
9. Follow up with the referral center to confirm receipt and discuss any additional steps or information needed.
10. Maintain open communication with the referral center regarding the patient's progress and any updates to their condition.
11. Adhere to any instructions or recommendations provided by the referral center for the best possible outcome for the patient.

Who needs adult ecmo referral intake?

1. Adult ECMO referral intake is required for adult patients who meet the criteria for ECMO therapy. ECMO, Extracorporeal Membrane Oxygenation, is a life-support technique used for patients with severe respiratory or cardiac failure. Typically, patients who are critically ill and have exhausted conventional treatment options may need adult ECMO referral intake to be considered for ECMO therapy. The decision to proceed with ECMO therapy is made by a specialized ECMO referral center after a thorough assessment of the patient's condition and suitability for the treatment.

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What is adult ecmo referral intake?

Adult ECMO referral intake is the process of referring adult patients for extracorporeal membrane oxygenation treatment.

Who is required to file adult ecmo referral intake?

Healthcare providers, physicians, or medical staff responsible for the patient's care are required to file adult ECMO referral intake.

How to fill out adult ecmo referral intake?

Adult ECMO referral intake can be filled out by providing patient information, medical history, reason for ECMO referral, and other required details in the designated form.

What is the purpose of adult ecmo referral intake?

The purpose of adult ECMO referral intake is to assess and determine the eligibility of adult patients for extracorporeal membrane oxygenation treatment.

What information must be reported on adult ecmo referral intake?

Information such as patient demographics, medical history, current condition, reason for referral, and contact details must be reported on adult ECMO referral intake.