BUMC Basics.pdf - Anesthesia Home

James Trotter, MD
Liverresources.com
48
GENERAL GI/LIVER TOPICS
How do I get a GI consult?
In general, you can call whomever you want. There are a
few things to keep in mind- there is no consult schedule or
GI service. Some gastroenterologists predominantly focus
on outpatient Gastroenterology, and some have special
areas of interest. Of course if a patient has a established
relationship with a Gastroenterologist, then you should call
that particular Gastroenterologist. You can usually find this
information on EMR but it can be tricky.
What do I tell the Gastroenterologist?
Basic patient information; GI issue; Does the patient need
to be seen today? Active bleeding? What/where do you
think they are bleeding from? NSAIDs? Prior endoscopy
(when, where whom) Is the patient NPO, Is a procedure
needed?
When do I call for an urgent GI consult?
Active upper GI bleeding, specifically variceal bleeding.
Most lower GI bleeding (diverticular) stops and is only
occasionally brisk and persistent.
How do I get a Hepatology/Liver consult?
There is an inpatient “liver service.” All consults go to the
general number. The inpatient hepatologist is on service
for a week at a time (usually Monday to Monday). All
established hepatology patients (ie, those previously seen
in the Hepatology clinic or who are on the transplant list)
are admitted by the TPC hospitalist group, so in general
hepatology is already seeing these patients.
What do I tell the Hepatologist?
Basic patient information. Newly diagnosed cirrhosis? If
calling for hepatitis — results of viral serologies,
autoimmune studies, suspected medications.
When do I call for an urgent Hepatology consult?
Acute liver failure — in general, defined as new onset of
encephalopathy, jaundice and coagulopathy. Remember,
if they have risk factors for cirrhosis (EtOH, Chronic viral