———— Relevant EPIC orders: PPSV23 =’Pneumococcal Polysaccharide PPSV-23’ = ‘Pneumovax’ = ‘IMM53’ PCV13 = ‘Pneumocococcal Conjugate PCV 13’ = ‘Prevnar-13’ = ‘IMM78’ Please link to appropriate diagnosis: 1. ‘need for prophylactic vaccination against strep pneumococcus’ (Z23) added to Quick Dx section 2. also associate relevant diagnosis (asthma, copd, chronic immunosuppression) if <65 yo ——— More […]
Author: Jennings
Create a customized list in Epic containing specific diagnosis or other criteria
Under epic –> “My Reports” Then click LIBRARY Then search for “diagnosis” There is a heading that says “Find IP Generic Criteria” Under that heading is a search called “HFH Currently Admitted Patients w/Specific Diagnosis on Problem List” –> click edit. To edit this search term, Under the criteria tab, select the problem status and […]
Perioperative risk assessement
Here is calculator in excel for helping to estimate risk of postop complications.
ROSE study inclusion and exclusion criteria
INCLUSION 1. Age > 18 years 2. Presence of all of the following conditions for < 48 hours a. (I) PaO2/FiO2 < 150 with PEEP > 8 cm H2O. OR, IF ABG NOT AVAILABLE SpO2/FiO2 ratio that is equivalent to a PaO2/FiO2 < 150 with PEEP > 8 cm H2O (Appendix A1), and a confirmatory […]
ANTICOAGULANTS AND BRONCHOSCOPY
LAST DOSE BEFORE BRONCHOSCOPY< TIME TO RESTART MEDICATIONS AFTER BRONCHOSCOPY WITH BIOPSIES Heparin SubQ No Need to stop Not applicable Enoxaparin 1mg/Kg SubQ BID > 24 hours > 12 hours Enoxaparin 1.5mg/Kg SubQ QD > 24 hours > 12 hours Warfarin (Coumadin) 5 days (confirm INR < 1.5) immediately Heparin IV > 4 hours (check […]
GI Bleed Admissions
From Dr. Swiderek: Due to high MICU patient volume and MICU remaining over capacity, the SICU and MICU teams have been working on a plan to redistribute patients with non-cirrhotic GI bleeds to the SICU. The goal is to open up MICU beds and to allow for a more consistent patient population to be admitted […]
Timing for lung transplant referral
From A consensus document for the selection of lung transplant candidates: 2014—An update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. The Journal of Heart and Lung Transplantation, 34(1), 1–15. COPD
Clinical talks
List of Clinical Talks (Friday) can be found here.
Workflow for thoracentesis in the Bronchoscopy Suite
Inpatient The GPU residents/staff will order diagnostic/therapeutic thoracentesis through EPIC. Arrangements have been made through EPIC, so that every time a thoracentesis order is typed, there will be 2 options: Thoracentesis-Pulmonary and Thoracentesis (radiology). Once Thoracentesis-Pulmonary is selected, the name of the patient will go to a workqueue in the bronchoscopy suite. If […]
Coagulation requirements for thoracenteses in the bronch suite
INR Less than 2.0 for Therapeutic Thoracentesis (includes the use of drainage catheter-6.0 Fr from the Thoracentesis Kit) Less than 2.5 for Diagnostic Thoracentesis (includes the use of NEEDLE ONLY, but no catheter). Average amount drained with needle is 20mL (depends on the procedure staff) Platelet Count More than 50,000 for Therapeutic Thoracentesis […]