Boise Va Resident Helper

COPD GOLD Guideline chart

Handy chart for COPD step-up therapy, bronchodilators, LABA, inhaled
corticosteroids etc.

http://www.goldcopd.com/download.asp?intId=560

DEPARTMENTS
ADMITTING 1109
ECHO 7431
EKG (Outpatient) 7432
ENDOSCOPY 1092
HELP DESK 1121
MEDICAL SERVICE
Teresa 1325
Karen 1309
Jay Keller 1314
Andy Wilper, MD 7626
O.T. 7168
ONCOLOGY 1545
LAB Main 7495
Blood Bank 7414
Chemistry 7408/7410
Hematology 7406
Microbiology 7409
PHARMACY
Inpatient use pager
Outpatient 7610/7615
P.T. 1368
PROSTHETICS 1346
PROTIME CLINIC 1344
PFTs 7430
RADIOLOGY
Main 1350
File Room 7485
CT 1327
Nuc Med 1330
Ultrasound 7411
MRI 1545
R.T. 1231
Home O2 Coordinator 1346
TRAVEL 1076
WARDS
ICU 1128
ICU Conference Room 7573/7572
MSDU 1126
2M 1190
2P 1125
CLC 1149
ER 1297
RESIDENT WORK ROOM 1543
CLINICS
GYN 7758
EYE 1072
SURGERY (Secretary) 1136
SURGERY (Scheduling) 1162
GOLD
Appointments 1335
Clerk 7187
Nurse 7468/7467
PURPLE
Appointments 1310
Clerk 7907
Nurse 7833/1535
RED
Appointments 1154
Clerk 7576
Nurse 7133/7637
SILVER
Front Desk Clerk 1005
Nurse 3303
MA 1011
Diabetic Retinopathy 3302
SPECIALTY CLINIC
Clerk 1050/1226
Nurse 7578/7579
LOCAL HOSPITALS
Cascade Medical Center Cascade 208-382-4242
Elmore Medical Center Mtn Home 208-587-8401
Gooding Memorial Gooding 208-934-4433
Holy Rosary Ontario, OR 541-881-7000
Idaho Elk's Rehab Boise 208-489-4444
Idaho State Vet's Home Boise 7447
McCall Memorial McCall 208-634-2221
Mercy Medical Center Nampa 208-463-5000
St. Alphonsus Boise 208-367-2121
St. Luke's 208-381-2222
Meridian 208-706-5000
Magic Valley
Twin Falls 208-737-2000
Sun Valley 208-727-8800
Steele Memorial Salmon 208-756-5600
Treasure Valley Hospital Boise 208-373-5000
Walter Knox Memorial Emmett 208-365-3561
Weiser Memorial Weiser 208-549-0370
West Valley Medical Center Caldwell 208-459-4641
SEATTLE HOSPITALS
UNIVERSITY HOSPITAL 206-598-3300
HARBORVIEW HOSPITAL 206-744-3000
SEATTLE VA 206-762-1010
Cardiology Attending 206-570-2522
Pat Stacey, Coordinator 206-699-7459
FAX NUMBERS
2M 208-422-1245
ICU 208-422-1090
MSDU 208-422-1248
SILVER CLINIC 208-422-1536
MSO Office 208-422-1319
OTHER
TRANSCRIPTION 1027
DICTATION 7780
PAGER NUMBERS
ATTENDING PHYSICIANS
ALBANESE, R (Med/Psych) MD 367
ARCOMANO MD 177
ANIM-APPIAH, D MD 157
BAEHR, P (GI) MD 389-0094
BARADZIEJ, M (Surg) MD 290
BOICE, J MD 346
BRANAHL, J MD 120
CARVALHO, P MD 451 (voice)
CLUKEY, K MD 188
COONROD, N MD 370
CUSACK, B MD 162
DELEON, R MD 309
ELZINGA, H MD 237
GETTELMAN, R MD 324
GREGG, M MD 340
HAHN, S MD 343
HARRISON, T MD 281
HINDSON, D MD 234
HINES, A (Psych) MD 106
HUNT, Nic (Renal) MD 859-1928
KHATAIN, K (Psych) MD 247
KILFOYLE, M MD 135
LaCROIX, C (Psych) MD 105
LEE, D MD 232
LEONE, J (Psych) MD 170
LYNCH, K MD 870-8380
MITTAL, M (Psych) MD 239
MURPHY, ED (Cards) MD 792
OLNES, A (Psych) MD 321
PALMA, A MD 176
PARIMON, T MD 287
ROY, M MD 144
Sekovsky, B MD 304
SMITH, S MD 227
SPIESS, J MD 231
STARR, J (Psych) MD 254
STEVENS, D (ID) MD 153
SULLIVAN, R (Rad) MD 164
THOMPSON, W MD 241
WEPPNER, B MD 148
WILPER, A MD 333
PHYSICIAN EXTENDERS
ACKERLY, J PA 184
BELAU, F PA 159
BERGLUND, T PA 138
COGAN, R NP 276
FIFE, A NP 295
EMORY, T (Onc) NP 202
HALL, S (CLC) NP 249
HENGST, T PA 337
HERRERA, I NP 341
JOHNSON, S PA 310
JONES, S (Surg) PA 810
KING, D (Surg) PA 895-7473
LANG, J PA 307
LAWRENCE, J PA 194
LINDBERG, G PA 323
MAHAFFEY, J (ER) NP 113
MARTIN, B PA 288-3040
MEBANE, K (Surg) PA 228
MEBANE, T PA 257
MILLWARD, T PA 306
NASH, M NP 270
RIGGS, R PA 893-2562
ROGERS, V PA 166
SIMS, M (Inpt Psych) PA 263
SPARRELL, M (Surg) NP 332
SPERO, H PA 219
STARK, N PA 187
THEIS, K NP 160
VILLARIMO, D NP 275
WOOD, J NP 338
CHIEF RESIDENTS
MCCLASKEY, DAN MD 761
MCCARREN, MEGAN MD 131
MEDICINE RESIDENTS
ARGYLE, NEIL MD 711
CHRISTOPHER, ANDREA MD 181
JOHNSON, ADAM MD 171
KUO, SACHA MD 791
LINK, SCOTT MD 721
PATHAK, VARSHA MD 101
PECK, ANDERS MD 601
SIMONS, ADAM MD 191
TULLOCH, LUIS MD 771
YANG, NELSON MD 691
ALLAN,EVAN MD 165
HEATH, ELISE MD 701
KISHORE, SARITA MD 651
MCDONALD, JAMES MD 621
PARIKH, ASHISH MD 751
SCHMUTZ, JOSEPH MD 681
FAMILY PRACTICE 741 & 781
PULMONARY FELLOW
WURTH, DENISE MD 214
PHARMACISTS
BLACK, PAUL PHARMD 204
BELL, AMBER PHARMD 212
CRANE, KENDALL PHARMD 145
GRIFFITHS, RANDI PHARMD 252
LIST, JORDAN PHARMD 250
Radiologists
Kennedy MD 7702
Sullivan MD 3312
Anderson MD 7413
SOCIAL WORK SERVICE
MASCALL, KAY (BLUE &RED) Ext 7769 cell573-2833
PLIES, ED (ORANGE & WHITE) Ext 7926 cell573-4530
PRITCHARD, BREANA (Silver Clinic) MSW 215
CASE MANAGER
Gumb, Angie (Silver Clinic) RN 342
Misc pgrs and #s
Corey Sitzmann VIRs coordinator RN 818
CHAPLAIN 802
DIETICIAN, INPT RD 221
MOVE PROGRAM (Mona Duron) RN 326
MARCUM, JULIE (PACERS) ext RN 167
O.T. 262
P.T. 216
PHARMACY (MSDU/ICU and after 5pm) 731
PHARMACY (2M) (6:30am to 5:00pm) 154
PHARMACY (DISCHARGE) 212
PSYCH STUDENT 209
RADIOLOGY TECH 152
R.T. 161
RNOD 151
Laundry 7075
Julia Allen RN (patient care coord) 941-1369
PETERSON, BARBARA (medical media) 1150
CONSULTANTS
Paul Baehr (GI) cell 866-5011
Nick Hunt (renal) cell 859-1928
Denny Stevens (ID) cell 412-3573
Skye Blue (ID) pgr 489-6811
Skye Blue (ID) office 338-0148
Sanders (optho) cell 761-9065

RE: [Medr2] Rotation Descriptions (fwd)

For your scheduling so you don't have to try and figure out where on our page the descriptions are:

http://depts.washington.edu/uwmedres/program/Rotation%20descriptions%202010-11.pdf

[Medre] 52 in 52: week 37 (fwd)

Dear terrific residents,

Many of you are familiar with "The ICU Book" by Paul Marino. In it you will find (among other things) the Indications for Mechanical Ventilation:

RULE 1. The indication for intubation and mechanical ventilation is thinking of it.
RULE 2. Intubation is not an act of personal weakness.
RULE 3. Initiating mechanical ventilation is not the "kiss of death."

Are these rules steadfast? The article for this week studied the use of non-invasive ventilation in patients with acute exacerbations of COPD (you at the VA: pay attention). You're probably familiar with the take-home message but now you'll be able to cite the literature. Attached is the following article:
-Brochard et al N Engl J Med. 1995 Sep 28;333(13):817-22
It will be discussed this week at intern reports at the 3 hospitals.

Want something a little more recent? PubMed is your friend, but if you're lazy like me, you'll find two more articles (recent reviews) attached.

(non)-invasively yours,
--Tristan (for the chiefs)

Dental Problems

If you have a vet with teeth and mouth problems and need a dentist, it can be challenging. A VA dental consult can be obtained, but usually folks are only eligible for intervention if they are 100% service connected or service connected for a mouth issue. In other cases, here are some dental providers with icome based sliding scales.

Terry Reilly Health Services, Boise Dental - Boise - 208-336-8801
Terry Reilly Health Services, Canyon Dental - Nampa - 208-466-0515
ISU Dental Resident Training Program - Boise - 208-331-0182
Boise Dental - Boise - 208-336-8801
Melba Dental - Melba - 208-495-1011
Homedale Dental - Homedale - 208-337-6101

GI Consult Information

During the day (0700 to 1630 or so) someone will be at the Endoscopy desk, 422-1092 if you wish to ask us questions on scheduling, want to know who the Gastroenterologist is for the day, other non critical questions. Craig or Angela, the clerks can bring questions they can’t answer to Lessie or to the GI doctor or transfer your call or your person to the correct information source.

If you have an inpatient you wish to present to the gastroenterologist, please call x 1092 or come by endo, or you can even page Lessie to coordinate with the doctor (pager 5-327).

Routine GI consults – you all know how to enter a consult already.

On evenings, nights, weekends or holidays, please send a GI consult for non emergent needs. For emergent GI consult , there is a procedure to be followed:

Contact the RNOD, pager 5-151, and ask him/her for the GI Doctors contact number. Call the IGA gastroenterologist and present your case.
IF there is to be a Endoscopy procedure done on the off hours, please ask the GI doc when he /she is coming so you can tell the RNOD the patients name, the doctors name and the procedure to be done. The RNOD then calls the GI ON-Call Nures/Tech to alert them of the need to come in and when.
The patient MUST be in the ICU for the procedure. (There is a posted policy type note in ER for any emergent food impactions and how to send them out if that is what must be done to expedite their care and they do not need to be admitted).
The IGA doctor may ask you to get a procedure consent prior to them coming to save time. If it is to be a consent by family or POA, be sure to get it before the IGA doctor comes.
ICU nursing staff may ask the resident to give them an order for the VERSED and FENTANYL as they need an order in CPRS and often the IGA docs will be in a hurry and some of them don’t ever order drugs at the VA, so that is helpful to do prior.
Place a fee-basis GI consult for off hours procedures.

The GI ON-CALL staff person(nurse or tech) is always carrying the GI cell phone in the evening and weekends. It is 573-9647, but remember that is NOT the doctor, it is the person who will assist the gastroenterologist. During the weekday day time call x 1092.

Also the GI cell phone is NOT for PICC line needs. PICC line calls must go through the PICC nurses who are also Protime nurses at x 1344. PICC nurses do not place or repair PICCs on weekends or off tour hours. PICC’s here at the VA are not for emergency access. PICC repairs go through the RNOD.

Lessie is the charge nurse in ENDO and doesn't mind people paging her if there is something simple. She can usually be reached here in ENDO through x 1092 or even at home if need be, just ask the RNOD for her number.

NightHawk Contact Number

1-866-329-4295
Note, you will first speak to someone who cannot see your patient's record, tell them it's a "Military" patient and they will foward you to a person in the US.

Who Needs Post Call Notes?

Does you new patient need a post-call addendum or note?

Are they in the ICU? The ICU resident will write one, on weekdays. Weekends YOU need to.
Are they on MSDU or 2M? In that case, they only need a addendum if they had a major event overnight.

Who Needs a Discharge Summary?

Patients that are transferred from medicine to 2P (Pscyh) do NOT need a d/c summary, although a day of tranfer note is often helpful.

Patients who are tranferred to the CLC DO need a discharge summary, as this is a separate admission.

Antibiotic Renal Dosing

The oh so useful "green card" (or yellow card?) from harborview. Rapid dosing information for common antibiotics based on renal clearance.

Sepsis Protocol Checklist

From survivingsepsis.org this is the Severe Sepsis Protocol Checklist. Run through it on you new potentially septic ED patient!

Harborview Guidelines for sepsis and Early Goal Direct Therapy (EGDT). This includes guidance on initial choice of antibiotic based on suspected source of infection!

PICIS - getting ICU vitals and fluids data (i's and o's)

1. Click the PICIS icon on the desktop (note machines must say "PICIS" on a label on the monitor.

2. Log in with your CPRS login and password.

3. Select a patient and click OPEN on the bottom right

4. For fluid status (i's and o's, ins and outs) click this icon in the top toolbar

5. Click the "Week" tab at the bottom. This will now show you daily fluid balance for the past few days!

6. To see Vitals (Vital Signs), click "ICU Flowsheet in the lefthand list. "Resolution" at the top left will allow you to view by hour, by shift etc.

Important phone numbers:

Dr. Sekovski cell 208-841-7823
Julia case manager cell 941-1369
Ed SW 7769 cell 573-2833
Kay SW 7926 cell 573-4530
St. Al's access center 208-367-2337; 208-367-8855
Fee basis doc (Harlan Bengtsom) 422-1384

Log someone else off a locked computer

1. User ID: vhaboiunlock
2. Password: LogoffNow1.
3. Don't forget the period (.) ! beep.

Text Paging, Pager Server

If you are unable to get onto the text-paging system (WirelessOffice Messenger), you need to type in the following pager server key:

BOI067PPH112811

This code is also on the card of phone numbers we were given. It is in the gray box labeled Pger Server.

Transfer to SNF or Rehab

1. Write Discharge orders. Orders (tab)/discharge patient orders (left panel). Note the discharge appointment needs to be within an hour of the time the patient is actually going to leave. If you don't know and want to leave it for cross cover, you can fill out the orders but leave them unsigned. Cross cover can edit them and sign!
2. Fill out a Interagency Med Recon Note. Notes/New Note/Interagency Med Recon Note. This will then autopopulate with all meds, delete what you don't want. The SNF will provide all the meds you leave on here. They will not get the OP meds on their list. If you order certain narcotics, you may need to sign a hard copy and or fill out triplicate forms!