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Admission Criteria

Eating Disorders Admission Criteria

(The following evidence based criteria is used in medical decision making when considering admission to CMKC)

Heart Rate/EKG
  • < 50 bpm while awake, < 45 bpm while sleeping or any noted arrhythmias
Blood Pressure
  • BP < 90/45 with associated symptoms
Orthostatics
  • HR increase > 20 bpm or a systolic BP decrease > 10 bpm, with associated symptoms
Temperature
  • Hypothermia (body temperature < 96o F or 35.6o C)
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)
Other
  • Frank hematemesis (suggesting Mallory-Wiese tear or GI bleed)
  • Hypovolemic shock
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)
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)
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