BUMC Basics.pdf - Anesthesia Home

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• Neoplasm:
Lymphoma, leukemia, carcinoma, etc.
• Others: Drugs, DVT, PE, adrenal insufficiency, etc.
Work-up — Consider if appropriate:
• Reassess medications
• Thorough history and physical exam
• Lab — CBC with diff, CMP, Blood cultures x2, UA, urine
culture, sputum gram stain and culture, Quantiferon Gold,
ESR/CRP, ANA, RF, LDH, CMV PCR, EBV PCR, HSV
PCR, Lyme titers, Hepatitis panel, HBV or HCV PCR, HIV
antibody or PCR, fungal complement panel, D-dimer
• Imaging — TTE followed by TEE if indicated, CXR, CT
of targeted area, LE Doppler, CT chest with PE protocol,
bone/gallium scan
• Procedures — Lumbar puncture, bone marrow biopsy,
temporal artery biopsy
PNEUMONIA
Use pneumonia admission protocol
SEPSIS
Define the condition of your patient in your notes
using the following:
• SIRS — 2 out of the 4 following criteria:
- T>38 or 90
- RR>20 or PaCO212,000 or >10 percent Bands
• Sepsis — SIRS in response to a documented or
suspected infection (does not have to have proven
infection to call it sepsis)
• Severe sepsis — Sepsis PLUS signs of organ
hypoperfusion or damage, such as:
- Capillary refill >3 sec
- Mottled skin
- Uop 4 mmol/liter