Eating Disorders Admission Criteria
(The following evidence based criteria is used in medical decision making when considering admission to CMKC)
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Heart Rate/EKG |
- < 50 bpm while awake, < 45 bpm while sleeping or any noted arrhythmias
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Blood Pressure |
- BP < 90/45 with associated symptoms
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Orthostatics |
- HR increase > 20 bpm or a systolic BP decrease > 10 bpm, with associated symptoms
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Temperature |
- Hypothermia (body temperature < 96o F or 35.6o C)
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Electrolytes |
- Requires replacement therapy or monitoring that is not feasible or safe to complete in the outpatient setting
(i.e., glucose < 60 mg/dL and potassium < 3.0 mmol/L should prompt a call to the Eating Disorder on-call provider)
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Other |
- Frank hematemesis (suggesting Mallory-Wiese tear or GI bleed)
- Hypovolemic shock
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Behaviors |
Those that have caused a medical complication requiring acute and/or frequent monitoring, such as:
- Prolonged food refusal (as defined by outpatient treating provider)
- Uncontrollable vomiting (with high risk of EKG changes, electrolyte abnormalities or severe dehydration)
- Other eating disorder behaviors (i.e., hiding food, over-exercising, researching eating disorder facts)
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High risk of refeeding syndrome |
Risk factors for severe refeeding syndrome include:
- < 75% total body weight
- Rapid and prolonged weight loss
- Prolonged, severe PO (by mouth) restriction (defined as 500 kcal/day or less for > 7 days)
- Significant carbohydrate restriction (< 30% of total daily intake)
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Suicidal |
After adult mental health services (AMHS)/mental health provider has completed their evaluation:
- Medically unstable - consider hospitalization
- Medically stable - outpatient or acute psych based on AMHS recommendations
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