A 57-year-old woman presents with worsening shortness of breath over the course of six months. She has lost seven pounds in the past three months and has developed a nonproductive cough. She has never smoked, and has no known mold or work-related exposures. Her only pet is a cockatiel she has had for 18 months. […]
PEEP in ARDS
A 45-year-old previously healthy woman is admitted to the intensive care unit for bacterial pneumonia and severe acute respiratory distress syndrome. She undergoes rapid-sequence intubation with ketamine and rocuronium and receives volume-limited mechanical ventilation with a tidal volume of 6 mL/kg ideal body weight, positive end-expiratory pressure (PEEP) of 10 cm H2O, and FIO2 of […]
New blog posts coming…
Posts have been on a brief break but will re-launch on Feb1st. Posts for both outpatient clinic as well as critical care topics will be uploaded. Stay tuned.
Management of Lung Nodule – continued
Your 54-year-old male patient who is a lifelong nonsmoker comes back to your office for followup of a RUL nodule after a recent biopsy you performed revealed stage IV non-small cell lung cancer. His oncologist said that a “signet ring” sign was seen on his biopsy and that he has a gene abnormality seen on […]
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 Bronchiectasis
Pulmonary Clinic Dr. Advice Line
Dr. Advice Line This will only be for outpatient pulmonary questions (when other physicians might have a question about patient being seen in clinic.) Any inpatient pulmonary questions should be directed to the ipd consult team (pager 2003). MICU-related calls will continue to the triage phone and to ICU on-call/WBH overnight staff. Secretaries to forward […]
Narcotic Script Handling
How to handle narcotic prescription: Nurses to verify contract on file à If no contract, patient can be referred back to primary care while physician is out. Patient will be sent a contract to review and bring to next visit. If contract in place, ok to refill short-term until primary pulmonary returns. Goal is for […]
Clinical talks
List of Clinical Talks (Friday) can be found here.
Pulmonary Infections
A new 35 yo patient is referred to you for evaluation of cough. She has had 2 weeks of non-productive cough that has been worsening, to the point of her having fits of cough and post-tussive emesis. Her symptoms started she experienced generalized malaise, but no fever or chills. She denies post-nasal drip, and has […]
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 […]