Admission Criteria

Eating Disorders Admission Criteria

(The following evidence-based criteria are used in medical decision- making when considering admission to CM)
*Please note that any one finding does not always indicate medical instability and the full clinical picture should be considered

• < 50 bpm while awake, < 45 bpm while sleeping or any noted arrhythmias

• BP < 90/45 with associated symptoms

• HR increase > 20 bpm or a systolic BP decrease > 10 bpm, with associated symptoms

• Hypothermia (body temperature < 96^o F or 35.6^o C)

• 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)

• Frank hematemesis (suggesting a Mallory-Wiese tear or GI bleed)
• Hypovolemic shock

Those that have caused a medical complication requiring acute and/or frequent monitoring, such as:

• Prolonged food refusal (as defined by the 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)

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)

After the acute 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