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 […]
Pulmonary Infections
A 38-year-old Korean woman who immigrated to California 6 monthsago complains of weight loss, fever, cough, arthralgia,and frequentbouts of hemoptysis for the past 4 months. She has had no perceptible fever. Chest roentgenograms show a 4.0-cm cavity in the right upper lobe with associated infiltrate. There is a BCG scar on her left arm associated […]
Obstructive Lung Diseases 2
Your 25-year-old female patient with a history of asthma returns to clinic again after you sent additional testing. Her FEV1/FVC of 70% and FEV1 60% predicted are unimproved despite your inhaler therapy. How did you classify her asthma? You performed HRCT of the chest which revealed multiple areas of bronchoarterial ratio >1, thickened bronchial walls, […]
Management of Lung Nodule – Part 2
Your 54-year-old male patient is undergoing evaluation for dyspnea. He is a lifelong nonsmoker. A CT scan was performed by his primary care physician and a 2.5cm RUL lesion with spiculated border is noted, with a 1.4cm satellite nodule in the same lobe of the lung. There is a 7mm subcarinal lymph node seen, but […]
Obstructive Airway Disorders – Part 1
You’re seeing a 25-year-old female patient with a history of asthma for a new patient evaluation. She is a lifelong nonsmoker, and gives a history of 1-2 tablespoons of sputum production daily. On review of systems she has a history of intermittent crampy abdominal pain that hasn’t been formally evaluated yet. Results of in-office spirometry […]
Management of Lung Nodule – part 1
Your 54-year-old male patient is undergoing evaluation for dyspnea. He is a lifelong nonsmoker. A CT scan was performed by his primary care physician and a 2.5cm RUL lesion with spiculated border is noted, with a 1.4cm satellite nodule in the same lobe of the lung. There is a 7mm subcarinal lymph node seen, but […]
Graduated Supervision and Patient Care Responsibility Policy
This policy was developed to ensure high level patient care, appropriate supervision of trainees, and to meet the ACGME Program Requirements for Graduate Medical Education in the specialty of Critical Care Medicine. The overall goal of the fellowship in Critical Care Medicine is to provide trainees with the intellectual environment for acquiring the knowledge, […]
Quality Improvement Curriculum
PCCM_QIcurriculum_2018_revised-2
Green MICU Service
Green Service Fellow Role Senior fellows (2nd and 3rd year) assigned to green service will expected to function in a junior attending capacity. They will run rounds with the APPs at 930am. Senior staff will observe and provide input and advice as needed when there are any questions. First year fellows assigned to green […]
Airway Management Curriculum
Curriculum Rotation Objectives and Educational Purposes: The ability to place a secure airway in myriad clinical situations is a necessary skill of critical care physicians and is an ACGME requirement of fellowship training. Airway management in the ICU can be complicated due to many factors, and the incidence of failed airways in the ICU is […]