Skip to main content

Assorted Notes

You have three hours from when stroke symptoms start to treat the patient successfully.

Pack Years​

  • 1 pack per day x 30 years = 30 pack years
  • Half-pack per day x 20 years = 10 pack years

Complete Blood Count​

Blood test used to evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia.

  • Red blood cells, which carry oxygen
  • White blood cells (WBC) which fight infection
  • Hemoglobin (Hbg or Hb), the oxygen-carrying protein in red blood cells
  • Hematocrit (HCT), the proportion of red blood cells to the fluid component, or plasma, in your blood
  • Platelets (Plt), which help with blood clotting

How this is recorded:

Basic Metabolic Panel​

Chemistry panel where multiple chemistry tests are grouped as a single panel for ease of ordering

Hepatic Function Panel​

info

Comprehensive Metabolic Panel = Basic Metabolic Panel + Hepatic Function Panel

Hepatic Function Panel (HFP), also known as liver function tests (LFTs), is a group of seven tests used to evaluate the liver for injury, infection, or inflammation.

7 Components of HFP:

  • Alanine aminotransferase (ALT)
  • Albumin (Alb)
  • Alkaline Phosphatase (AP)
  • Aspartate aminotransferase (AST)
  • Direct Bilirubin (DB)
  • Total Bilirubin (TB)
  • Total Protein (TP)

Culture​

It used to be that residents basically lived at the hospital with very little handoff. See the case of Libby Zion. It was a culture thing. Attendings would go home. It was called “being a Gunner”. Hustle culture but for physicians. Things were a bit different back then: you lived at the hospital if you were a resident. You couldn’t call the attending unless the patient was actually dying (“Code Blue” = Stopped Breathing).

I-PASS the BATON - Handoffs​

These happen in person with a laptop. Printouts may be involved. Some things involve the EHR (like EPIC) and some are done verbally.

  • You and the person need to show up with notes, lists and not do this from memory.
  • You need to do this in person.
  • You need to go through each patient.
  • You need to set apart dedicated time to do this. Administration needs to help here.
  • Try not to do it towards the end of the day when you’re raring to GTFO of there.
LetterSectionDescription
IIntroductionIntroduce yourself and your role/job (include patient).
PPatientName, identifiers, age, sex, location.
AAssessmentPresent chief complaint, vital signs, symptoms and diagnosis.
SSituationCurrent status/circumstances, including code status, level of (un)certainty, recent changes and response to treatment.
SSafetyCritical lab values/reports, socioeconomic factors, allergies and alerts (falls, isolation, etc.).
BBackgroundComorbidities, previous episodes, current medications and family history.
AActionsExplain what actions were taken or are required. Provide rationale.
TTimingLevel of urgency and explicit timing and prioritization of actions.
OOwnershipIdentify who is responsible (person/team), including patient/family members.
NNextWhat will happen next? Anticipated changes? What is the plan? Are there contingency plans?

Tachycardia and Heart Rate​

Happens a lot: you measure a high heart rate bu in the PE (Physical Exam) it may be noted as normal because that’s the default on the form.