How do I give intrapleural tPA & Dornase?
- Instructions for giving intrapleural tPA & Dornase
I have a patient on a PCA (patient controlled analgesic) pump. How do gather data from the PCA?
- Watch this 4-minute practical video by Valley residents and palliative care attending Dr. Quinlan
What should I do if my patient has financial difficulties getting his/her medications?
- Check out Better Health Pharmacy:
- It is a drug-donation pharmacy that provides medications for patients who can’t afford it at no charge and with no copays
- It doesn’t carry every medication, but does carry many essential medications
What is the criteria for respite?
- Homeless patient who are vulnerable (i.e. at risk for re-hospitalization) who can walk 450+ ft and independently care for themselves
How do I order an outpatient stress test?
- In discharge order-set, search for “NM hospitalist CP Protocol” and fill out the EKG and Imaging orders. After the order is signed, call 2MED @ 52208 to schedule a time and date for the stress test. Inform your patient that they can’t be late to their appointment as they have very limited spots. Also remind your patient of the dietary & medication restrictions prior to stress test that is listed on the order-set.
How do I transfer a patient to EPS?
How do I arrange home antibiotics?
- Infectious disease needs to write a note stating the need for IV antibiotics. Afterwards, the case manager can arrange for a third-party company to teach the patient how to administer antibiotics and deliver the medications to the patient’s home.
How can I rule out TB if my patient can’t produce sputum?
- You can place an NG tube, place the patient on NPO at midnight, and obtain a morning gastric aspirate the next day before breakfast. Repeat for 3 days to collect 3 samples. Look at this guide for more information
How do I discharge a patient with active TB?
- You will need to fill out a GOTCH form and fax it to the TB Prevention & Control Program at (408) 885-2331. Additional information and forms can be found here
- The Infectious Disease Team should be consulted who can also help guide discharge
How can I interrogate a cardiac device?
- You can call the device manufacturer who will send a rep to interrogate the device. They usually come within 24 hours.
- Medtronic: 800-633-8766
- St. Jude: 800-722-3774
- Boston Scientific: 800-227-3422
- Biotronik: 800-547-0394
- ELA Medical: 800-352-6466
What are the rules on visitors in the hospital?
- Unfortunately, we had to limit visitors in the hospital due to Covid. See here for more details. Remember that you can always give family members the phone number to call the patient room directly
How do I discharge a patient with Naltrexone?
- If they meet criteria for naltrexone, under discharge orders, search for “Ambulatory Referral for Naltrexone/Vivitrol”
Help, I stuck myself with a needle!
- Notify the charge nurse on the floor. You will be directed to employee health on the 1st floor of VSC during normal business hours or to the ED if it is after hours. You will be given a packet at the end, which you’ll turn into Amy/Miranda the next day
Do overnight allocations change on holidays?
- No, short call still receives up to 4 patients on holidays. The residency program decided these rules, not the gold team/bed control/etc.
I’m getting a patient from PM&R, is it a transfer or discharge+readmit?
This depends on which bed the patient is currently residing in the PM&R floor. They have “med/surg” beds & “rehab” beds. If they are in a med/surg bed, it is a transfer. If they are in a rehab bed, it is a discharge & readmit. You are not expected to know which beds are which. Just call the charge RN on the PM&R floor and ask them if this should be a transfer or discharge+readmit.