7.1. Emergency Care of Veterans with SCI/D
Non SCI Center Setting. Veterans with SCI/D requiring emergent, or immediate medical attention in a non-SCI/D setting must be evaluated by staff trained in the Medical Care of Persons with SCI Module in the Veterans Health Initiative (VHI), available at the SCI intranet site http://vaww.sci.va.gov/ (NOTE: This is an internal Web site not available to the public) under the training link or with appropriate equivalent experience. Once this evaluation is completed, the patient's medical condition needs to be discussed with the Veteran's SCI/D primary care physician if there are follow-up needs, or when consultation is deemed urgent. Patients with SCI/D requiring surgical intervention need to receive care in a VA medical center with a designated SCI Center. If urgency requires that treatment be provided at a non-SCI Center, the Chief of the nearest SCI Center must be advised of this fact as soon as possible. Typically, such patients are retained in a non-SCI Center only until they can safely be transferred to a VA medical center with an SCI Center. Staff in the SCI Centers and SCI Coordinators in the non-SCI Center facilities need to use the tools available in the Computerized Patient Record System (CPRS), SCD Registry, or SCIDO to review patient care for unscheduled visits and follow-up care needs.
Community Referrals. Referrals received from the community to a VA medical center without an SCI Center are handled as a transfer of care from the local VA medical center for Veteran convenience and travel arrangements; however, the Veteran is admitted directly to the SCI Center. Referrals received from the community directly to an SCI Center are to be handled as a direct admission, and if the Veteran desires, follow-up care is subsequently coordinated with the local VA medical center.
NOTE: Transportation for scheduled appointments and transfers to SCI Centers must be in accordance with national VA policy.