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23 OBTAINING A CONSULT AT BAYLOR Obtaining a consult at <strong>BUMC</strong> is different than at a county system. Rather than consulting a service, you consult a specific physician within a service, or whoever is taking call for that physician if it is after hours. Call consults as early in the day as possible. If you call a consult after 5pm, this implies that it is emergent. If you need a consult, first ensure the attending physician agrees and ask if they have anyone specifically they would like you to call. Also, review old records and if a physician has seen the patient previously from a service, re-consult the same physician or group if that person is not available. Then, refer to the above list for whom you would like to consult (May not be all inclusive, but is a start for who to call). When you call, be sure to have the patient’s name, room number, date of birth, and pertinent history, exam, and labs. There are a few ways to consult. The best is to call the physician’s office or answering service and ask who is taking new consults for that day/night. Then ask them to be paged with the information. You can also call the ER, who has a list for who is on call. If you do not hear back, and you feel it is appropriate, then page the physician directly. Some physicians prefer text messages with name and room number, and they will let you know that when you work with them. Here are a few specifics regarding particular consults: • GI: The hepatologists rotate call every 3 rd night listed above. Also, if you need an ERCP or EUS, physicians that do one or both are noted with an asterisk under the GI contacts. GI Bleeders often require an emergent GI consult. For more information, see GI section for obtaining a consult. • Neurology: There is someone on call M-F now for neurology. Call page operator to find out who is on call. • Psychiatry: To obtain a psych consult, you may either write an order for psych consult, or call the ER and ask who is on call for Psych and call the office or answering service to have them paged. • Pulmonary Critical Care: This consult is required if your patient is on the ventilator more than 48 hours.
Page 1 and 2: BUMC BASICS
Page 3 and 4: • Status Epilepticus • Stroke m
Page 5 and 6: 5 Welcome to Baylor University Medi
Page 7 and 8: 7 Rounding on your patients: • Se
Page 9 and 10: 9 2. gloves only. During codes, if
Page 11 and 12: 11 • There is one resident and 3
Page 13 and 14: Chest pain 13 DDx to consider • M
Page 15 and 16: SOB DDx • Pneumonia • PE • An
Page 17 and 18: 17 • Heparin • Lidocaine • Ni
Page 19 and 20: 19 TPC (cont’d) Pager Cell Phone
Page 21: 21 Gen Surgery Neurologists Urgent
Page 25 and 26: 25 • Enter 2 initial zeros and th
Page 27 and 28: 27 • Albuterol/Atrovent nebulizer
Page 29 and 30: 29 CARDIOLOGY CCU IN GENERAL You ar
Page 31 and 32: 31 Unstable Angina/NSTEMI • Can u
Page 33 and 34: 33 Post PCI Complications — In yo
Page 35 and 36: 35 function, elevated troponin T is
Page 37 and 38: 37 **0-1 point non-cardiogenic, 2 p
Page 39 and 40: 39 • Erythromycin • Phenothiazi
Page 41 and 42: 41 Therapy — Therapy is guided by
Page 43 and 44: 43 Nitroglycerine (Onset in 2-5 min
Page 45 and 46: 45 Treatment: • Vasovagal: Recogn
Page 47 and 48: 47 GI/HEPATOLOGY GI CONSULTS AND GR
Page 49 and 50: 49 hepatitis, obesity), then they p
Page 51 and 52: 51 timing and necessity of ERCP for
Page 53 and 54: 53 the liver transplant ICU) where
Page 55 and 56: 55 GI bleeding (**See above under G
Page 57 and 58: 57 • Barium Enema (clear liquids
Page 59 and 60: 59 Pseudomonas: • Piperacillin/Ta
Page 61 and 62: 61 • Neoplasm: Lymphoma, leukemia
Page 63 and 64: 63 mortality. It lowers mortality i
Page 65 and 66: Pneumonia (immunocompromised) (cont
Page 67 and 68: 67 BRAIN DEATH EXAM • Can order b
Page 69 and 70: 69 SEIZURES Can use BZD ativan IV o
Page 71 and 72: 71 3. Stop anticoagulants and rever
Page 73 and 74:
73 ONCOLOGY THE ACUTE LEUKEMIC “T
Page 75 and 76:
Timeline*: 75 Day 0 (admit) — Bon
Page 77 and 78:
77 PALLIATIVE CARE AND CLINICAL ETH
Page 79 and 80:
79 release oxycodone, and hydromorp
Page 81 and 82:
81 • Institutional Ethics and Pal
Page 83 and 84:
83 PULMONARY ARDS Definition: Need
Page 85 and 86:
85 MECHANICAL VENITALTION Oxygen su
Page 87 and 88:
87 • Ineffective respiratory effo
Page 89 and 90:
89 - Daily sedation vacations at 07
Page 91 and 92:
91 • After 1 wk of intubation det
Page 93 and 94:
93 - Sustained changes in the heart
Page 95 and 96:
95 PULMONARY EMBOLUS (PE) Evaluatin
Page 97 and 98:
97 RADIOLOGY RADIOLOGY HINTS IF YOU
Page 99 and 100:
Superficial Abscess/Mass Abscess/Ma
Page 101 and 102:
101 RENAL ACID/BASE DISTURBANCES Qu
Page 103 and 104:
103 ACUTE KIDNEY INJURY Acute Kidne
Page 105 and 106:
105 Mg
Page 107 and 108:
107 CHRONIC KIDNEY DISEASE Stage GF
Page 109 and 110:
Hypovolemic Hyponatremia EABV low R
Page 111 and 112:
111 fluid pulled off and into the p
Page 113 and 114:
113 Colorectal Surgery, and Plastic
Page 115 and 116:
115 • Social work: Circle Social
Page 117 and 118:
Ear Health Antipyrine/Benzocaine ot
Page 119 and 120:
Magnesium Oxide 400mg tab Prenatal
Page 121 and 122:
121 DUEWALL’S FAVORITE MNEMONICS
Page 123:
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