Pneumonia Sanjay Kalra, MD, FRCP
|
|
- Joy Maxwell
- 7 years ago
- Views:
Transcription
1 Pneumonia Sanjay Kalra, MD, FRCP Associate Professor of Medicine Division of Pulmonary & Critical Care Medicine Mayo Clinic Rochester, MN
2 Disclosures NONE
3 Learning Objectives Define the subtypes of pneumonias Identify when to suspect and how to diagnose pneumonia Severity Staging Recognize empiric treatment decisions Discuss parapneumonic effusions/ empyema
4 Definitions Suspected community-acquired pneumonia is defined by acute symptoms and presence of signs of lower respiratory tract infection (LRTI) without other obvious cause New pulmonary infiltrate on chest radiograph is needed for definite diagnosis.
5 Definitions Hospital-acquired and Ventilator-associated Pneumonias HAP, or nosocomial pneumonia, arises 48 hours or more after hospital admission in the absence of signs or symptoms of pneumonia at the time of admission VAP is a subtype of HAP that develops after endotracheal intubation (Because only about 10% of patients with HAP are not mechanically ventilated, the terms HAP and VAP are often used interchangeably) Ottosen SCNA 2014
6 Definitions Health Care Associated Pneumonia American Thoracic Society (ATS) guidelines (2005): New category of infections to encompass recent inpatient or on ongoing treatment in a long-term or outpatient health care facility HCAP New pneumonia in: Any patient who was hospitalized in an acute care hospital for 2 or more days within 90 days of the infection Resided in a nursing home or long-term care facility Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection Or attended a hospital or hemodialysis clinic Ottosen SCNA 2014
7 Other Definition Issues Ottosen SCNA 2014
8 When should you think of pneumonia? Respiratory Symptoms plus Temperature > 37.8 C Pulse > 100/min Rales/Crackles Decreased breath sounds Absence of asthma Ann Intern Med 1990;113:664
9 The Cough + 1 Rule Suspect if New focal chest signs on examination At least one systemic feature No other explanation for the illness
10 Chest imaging is necessary for a definite diagnosis And helps to detect associated lung diseases to gain insight into causative agent (in some cases) to assess severity as baseline to assess response IDSA 1998 & BTS 2001
11
12
13
14
15 Other Diagnostic Tests Procalcitonin Alba Am J Med 2015
16 Alba Am J Med 2015
17 Inpatient vs Outpatient Treatment Medical Risk Assessment Psychosocioeconomic considerations Patient preference
18 Outpatient Stratification Medical Risk Outpatient Otherwise healthy adults Cardiorespiratory or other comorbidity Inpatient Floor Unit Intensive Care Unit
19 Index of Severity The Original BTS CAP Index R.U.B. Predicts Death Respiratory Rate > 30/min BUN > 20 mg/dl Diastolic blood pressure < 60 mm Hg Q J Med 1987:62;
20 RISK ASSESSMENT Defining low risk patients PSI Pneumonia Severity Index
21 The Pneumonia Severity Index PSI relies on 2 pre-existing patient features Age over 50 Co-existing chronic illnesses 5 Adverse clinical features Mental status* Respiratory Rate* SBP* Pulse Rate Temperature
22 PSI Pre-existing Condition: Scoring System for Risk Classes II-V Age Male No. of years of age Female No. of years of age - 10 Nursing home Add 10 points Add the patient's age in years (age -10, for females)
23 Risk Class Mortality Rates Risk Class Mortality Site of Care I (none) 0.1% Outpatient II (< 70 pts) 0.6% Outpatient III (71 90 pts) 2.8% Inpatient IV ( pts) 8.2% Inpatient V (> 130 pts) 29.2% Inpatient NEJM 1997;336:243
24 Risk Stratification Scores CURB65 Ottosen SCNA 2014
25 Assessment of Severity/Disposition Prina, Lancet 2015
26 Microbiological Testing Prina Lancet 2015
27 Empirical Therapy Prina, Lancet 2015
28 Bacteremia in CAP 5% False-positive culture leading to increased length of hospital stay Metersky AJRCCM 2004
29 Antibiotic Timing in CAP
30
31
32
33
34 Clinical Course/Timeline Prina, Lancet 2015
35 Ottosen SCNA 2014
36 Presumptive Pathogens Early Ottosen SCNA 2014
37 Presumptive Pathogens Late Ottosen SCNA 2014
38 VAP Diagnostic Surrogate CPIS Zilberberg CID 2010, Ottosen SCNA 2014
39 When things don t go as expected.. Ottosen SCNA 2014
40 Non-resolving Pneumonias Granulomatous Infection - TB, Fungal, Exotic Infection - Brucellosis, Tularemia, Ricketsial Drug Resistant Organisms Post-obstructive Pneumonia Non-infectious Causes Pulmonary embolism Alveolar hemorrhage Vasculitis CVD Sarcoidosis
41 Seven Degrees of Suppuration
42
43 MIST1 N=454 (427 randomized) with ph <7.2 or proven intrapleural infection SK IU bid x 3 days vs placebo No difference in deaths or surgical drainage rate at 3 months - 31% vs 27% No difference in in LOS, radiographic outcome Side effects 7% vs 3% (p=0.08)
44 Current Management of Parapneumonic Empyema in the High(er) Risk Patient Piccolo An Am Thor Soc 2014
45 Piccolo An Am Thor Soc 2014
46 Piccolo An Am Thor Soc 2014
47 Novel Strategies
48 Transmission Control Viruses
49 Transmission Control Bacteria
50
51
Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection
L14: Hospital acquired infection, nosocomial infection Definition A hospital acquired infection, also called a nosocomial infection, is an infection that first appears between 48 hours and four days after
More informationJames F. Kravec, M.D., F.A.C.P
James F. Kravec, M.D., F.A.C.P Chairman, Department of Internal Medicine, St. Elizabeth Health Center Chair, General Internal Medicine, Northeast Ohio Medical University Associate Medical Director, Hospice
More informationPrevention of Acute COPD exacerbations
December 3, 2015 Prevention of Acute COPD exacerbations George Pyrgos MD 1 Disclosures No funding received for this presentation I have previously conducted clinical trials with Boehringer Ingelheim. Principal
More informationChronic Critical Illness: Can it be prevented? Carmen C Polito, MD Pulmonary & Critical Care Medicine Emory University Atlanta, GA cpolito@emory.
Chronic Critical Illness: Can it be prevented? Carmen C Polito, MD Pulmonary & Critical Care Medicine Emory University Atlanta, GA cpolito@emory.edu Data free zone Disclosures A (Very) Old Case 65 year-old
More informationTuberculosis: FAQs. What is the difference between latent TB infection and TB disease?
Tuberculosis: FAQs What is TB disease? Tuberculosis (TB) is a disease caused by bacteria (germs) that are spread from person to person through the air. TB usually affects the lungs, but it can also affect
More informationDate: Referring Facility: Phone#: Anticipated Patient Needs (Please check appropriate boxes and include details within referral paperwork)
Barbara McInnis House Initial Referral Form Please fill form out completely. Include additional forms if prompted. Fax to Admissions Department. Follow up with a phone call. Patient Name: DOB: Gender:
More information3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients
Faculty Disclosures COPD Disease Management Tackling the Transition Dr. Cappelluti has no actual or potential conflicts of interest associated with this presentation. Jane Reardon has no actual or potential
More informationRecurrent or Persistent Pneumonia
Recurrent or Persistent Pneumonia Lower Respiratory Tract Dr T Avenant Recurrent or Persistent Pneumonia Definitions Recurrent pneumonia more than two episodes of pneumonia in 18 months Persistent pneumonia
More informationTB CARE EARLY DETECTION AND PREVENTION OF TUBERCULOSIS (TB) IN CHILDREN. Risk factors in children acquiring TB:
EARLY DETECTION AND PREVENTION OF TUBERCULOSIS (TB) IN CHILDREN Risk factors in children acquiring TB: Children living in the same household as a lung TB patient (especially children under 5) Children
More informationSPONTANEOUS PNEUMOTHORAX AS A COMPLICATION OF SEPTIC PULMONARY EMBOLISM IN AN INTRAVENOUS DRUG USER: A CASE REPORT
Spontaneous pneumothorax in an IV drug user SPONTANEOUS PNEUMOTHORAX AS A COMPLICATION OF SEPTIC PULMONARY EMBOLISM IN AN INTRAVENOUS DRUG USER: A CASE REPORT Chau-Chyun Sheu, Jhi-Jhu Hwang, Jong-Rung
More informationSepsis Awareness Month
Aon Kenya Insurance Brokers Ltd Aon Hewitt Healthcare Division Sepsis Awareness Month Issue 11 September 2015 In this Issue 2 Getting to understand Sepsis 3 Stages in Sepsis Advancement 4 Diagnosis & Treatment
More informationOriginal Article COPD and Hospital Stay Pak Armed Forces Med J 2014; 64 (1): 46-50. Ahmed Raza, Mahmood Iqbal Malik*, Yousaf Jamal**
Original Article COPD and Hospital Stay Pak Armed Forces Med J 2014; 64 (1): 46-50 COMPARISON OF NIPPV WITH STANDARD TREATMENT IN PATIENTS WITH ACUTE EXACERBATIONS OF COPD IN TERMS OF IMPROVEMENT IN ABGS
More informationTuberculosis Exposure Control Plan for Low Risk Dental Offices
Tuberculosis Exposure Control Plan for Low Risk Dental Offices A. BACKGROUND According to the CDC, approximately one-third of the world s population, almost two billion people, are infected with tuberculosis.
More informationManagement of exacerbations in chronic obstructive pulmonary disease in Primary Care
Management of exacerbations in chronic obstructive pulmonary disease in Primary Care Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant morbidity and mortality.
More informationSolid Organ Transplantation
Solid Organ Transplantation Infection Prevention And Control Transplant Atlantic 2011 October 13/2011 Kathy Hart Introduction In the past several years, the drugs that we use, the surgeries themselves,
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical
More informationProcedures for Coding Inpatient Medical Record Cases for the CCS Examination
Procedures for Coding Inpatient Medical Record Cases for the CCS Examination Instructions and official guidelines for coding medical records are included in the following resources: ICD-10-CM/PCS, CPT,
More informationSTATE OF NEBRASKA STATUTES RELATING TO RESPIRATORY CARE PRACTICE ACT
2012 STATE OF NEBRASKA STATUTES RELATING TO RESPIRATORY CARE PRACTICE ACT Department of Health and Human Services Division of Public Health Licensure Unit 301 Centennial Mall South, Third Floor PO Box
More informationQuality Scorecard overall heart attack care overall heart failure overall pneumonia care overall surgical infection rate patient safety survival
Quality Scorecard s are required to report quality statistics to the s for Medicare and Medicaid Services (CMS) and the Department of Health (DOH). This information is made available at www.hospitalcompare.hhs.gov
More informationC-Difficile Infection Control and Prevention Strategies
C-Difficile Infection Control and Prevention Strategies Adrienne Mims, MD MPH VP, Chief Medical Officer Adrienne.Mims@AlliantQuality.org 1/18/2016 1 Disclosure This educational activity does not have commercial
More informationThe Why and How of a CDI Program. Deb Neville, RHIA, CCS-P, Elsevier/MC Strategies Donna Bonno, CPC- CPC-I, QuadraMed September 12, 2012
The Why and How of a CDI Program Deb Neville, RHIA, CCS-P, Elsevier/MC Strategies Donna Bonno, CPC- CPC-I, QuadraMed September 12, 2012 Objectives Understand the reasons behind a Clinical Documentation
More informationSupplemental Technical Information
An Introductory Analysis of Potentially Preventable Health Care Events in Minnesota Overview Supplemental Technical Information This document provides additional technical information on the 3M Health
More informationANTIBIOTICS IN SEPSIS
ANTIBIOTICS IN SEPSIS Jennifer Curello, PharmD, BCPS Clinical Pharmacist, Infectious Diseases Antimicrobial Stewardship Program Ronald Reagan UCLA Medical Center October 27, 2014 The power of antibiotics
More informationMarilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL
Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT
More informationRight-sided infective endocarditis:tunisian experience
Right-sided infective endocarditis:tunisian experience L. Ammari, A. Ghoubontini, A. Berriche, R. Abdelmalek, S.Aissa, F.Kanoun, B.Kilani, H.Tiouiri Benaissa, T.Ben chaabane Department of Infectious diseases,
More informationSeptember 2008 [KT 168] Sub. Code: 2063 M.D. DEGREE EXAMINATION Branch XVII Tuberculosis and Respiratory Diseases NON-TUBERCULOSIS CHEST DISEASES Common to Part II Paper II - (Old /New/Revised Regulations)
More informationPregnancy and Tuberculosis. Patient and Public information sheet
Pregnancy and Tuberculosis Patient and Public information sheet Who is at risk of TB? Anyone can catch TB, but it is possible that pregnant women have a slightly higher risk of TB. Some people are more
More informationMaria Dalbey RN. BSN, MA, MBA March 17 th, 2015
Maria Dalbey RN. BSN, MA, MBA March 17 th, 2015 2 Objectives Participants will be able to : Understand the Pathogenesis of Tuberculosis (TB) Identify the Goals of Public Health for TB Identify Hierarchy
More informationECDC INTERIM GUIDANCE
ECDC INTERIM GUIDANCE Interim ECDC public health guidance on case and contact management for the new influenza A(H1N1) virus infection Version 3, 19 May 2009 ECDC intends to produce a series of interim
More informationMean Duration (days) ± SD b. n = 587 n = 587
Online Table 1. Length of stay in matched cohorts of patients with VA and patients without VA a MS-DRG opulation (Code) ECMO or tracheostomy with mechanical ventilation 96 hours or principal diagnosis
More informationElectronic Health Record (EHR) Data Analysis Capabilities
Electronic Health Record (EHR) Data Analysis Capabilities January 2014 Boston Strategic Partners, Inc. 4 Wellington St. Suite 3 Boston, MA 02118 www.bostonsp.com Boston Strategic Partners is uniquely positioned
More informationIrish Association for Emergency Medicine (IAEM) submission to the National COPD Strategy
31 st Irish Association for Emergency Medicine (IAEM) submission to the National COPD Strategy 1 Introduction Chronic obstructive pulmonary disease (COPD) is an important disease for patients, the health
More informationApril 2015 CALGARY ZONE CLINICAL REFERENCE PULMONARY CENTRAL ACCESS & TRIAGE
April 2015 CALGARY ZONE CLINICAL REFERENCE CENTRAL ACCESS & TRIAGE Introduction Pulmonary consulting services are organized through the Calgary Zone Pulmonary Central Access and Triage (PCAT). Working
More informationCCS Item Types FAQ. Outlined below are descriptions of each item type that is presented on the CCS exam.
CCS Item Types FAQ Background on New Item Types for the CCS exams: The Commission on Certification for Health Informatics and Information Management (CCHIIM) appointed a task force to conduct a comprehensive
More informationOutcome of Drug Counseling of Outpatients in Chronic Obstructive Pulmonary Disease Clinic at Thawangpha Hospital
Mahidol University Journal of Pharmaceutical Sciences 008; 35(14): 81. Original Article Outcome of Drug Counseling of Outpatients in Chronic Obstructive Pulmonary Disease Clinic at Thawangpha Hospital
More informationPreoperative Laboratory and Diagnostic Studies
Preoperative Laboratory and Diagnostic Studies Preoperative Labratorey and Diagnostic Studies The concept of standardized testing in all presurgical patients regardless of age or medical condition is no
More informationSponsor Novartis Pharmaceuticals
Clinical Trial Results Database Page 1 Sponsor Novartis Pharmaceuticals Generic Drug Name Indacaterol Therapeutic Area of Trial Chronic Obstructive Pulmonary Disease (COPD) Indication studied: COPD Study
More informationRoadmap. Community-Acquired Pneumonia. Specific Goals: Sources. Background Etiology Diagnosis Treatment Prevention
Community-Acquired Pneumonia Bradley A. Sharpe, M.D. Associate Professor Medicine Department of Medicine UCSF sharpeb@medicine.ucsf.edu Roadmap Background Etiology Diagnosis Treatment Prevention Specific
More informationPEOSH Model Tuberculosis Infection Control Program
PEOSH Model Tuberculosis Infection Control Program Revised November, 2004 NOTE: The information in this document is not considered to be a substitute for any provision of the PEOSH Act or for any standards
More informationJ of Evolution of Med and Dent Sci/ eissn- 2278-4802, pissn- 2278-4748/ Vol. 3/ Issue 65/Nov 27, 2014 Page 13575
EFFECT OF BREATHING EXERCISES ON BIOPHYSIOLOGICAL PARAMETERS AND QUALITY OF LIFE OF PATIENTS WITH COPD AT A TERTIARY CARE CENTRE Sudin Koshy 1, Rugma Pillai S 2 HOW TO CITE THIS ARTICLE: Sudin Koshy, Rugma
More informationPublication Year: 2013
IMPACT OF A CLINICAL DECISION SUPPORT TOOL IN THE EMERGENCY DEPARTMENT ON ANTIMICROBIAL PRESCRIBING PATTERNS FOR THE TREATMENT OF PNEUMONIA UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM Publication Year: 2013
More informationTransitioning Chronic Pain Patients Out of the Hospital. Rosemary Quirk, MD, DTMH ACP, November 7, 2014
Transitioning Chronic Pain Patients Out of the Hospital Rosemary Quirk, MD, DTMH ACP, November 7, 2014 Patients rate baseline chronic pain between 4/10-8/10 on clinic surveys This fact should fundamentally
More information81 First Responder Respiratory
81 First Responder Medical Scenarios Asthma Scenario: You are called to a local house for a woman with trouble breathing. You arrive to find a 67-year-old woman sitting upright in a chair. She states she
More informationTUBERCULOSIS (TB) SCREENING GUIDELINES FOR RESIDENTIAL FACILITIES AND DRUG
TUBERCULOSIS (TB) SCREENING GUIDELINES FOR RESIDENTIAL FACILITIES AND DRUG Tx CENTERS Tuberculosis Control Program Health and Human Services Agency San Diego County INTRODUCTION Reducing TB disease requires
More informationOmega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine April 2006;34(4):972-9
Omega-3 fatty acids improve the diagnosis-related clinical outcome 1 Critical Care Medicine April 2006;34(4):972-9 Volume 34(4), April 2006, pp 972-979 Heller, Axel R. MD, PhD; Rössler, Susann; Litz, Rainer
More informationTHE EFFECTS OF NURSE EDUCATION AND CERTIFICATION ON HOSPITAL- ACQUIRED INFECTIONS
THE EFFECTS OF NURSE EDUCATION AND CERTIFICATION ON HOSPITAL- ACQUIRED INFECTIONS Cassi Welch, BSN Honors Student Faculty Mentor: Emily Cramer, PhD Submitted to the University of Kansas School of Nursing
More informationTargeted Testing for Tuberculosis Infection
Targeted Testing for Tuberculosis Infection CONTENTS Introduction... 3.2 Purpose... 3.2 Policy... 3.2 When to Conduct Targeted Testing... 3.3 Approaches to increasing targeted testing and treatment for
More informationSymptom Based Alcohol Withdrawal Treatment
Symptom Based Alcohol Withdrawal Treatment -Small Rural Hospital- Presenter CDR Dwight Humpherys, DO dwight.humpherys@ihs.gov Idaho State University Baccalaureate Nursing Program Lake Erie College of Osteopathic
More informationDRG 475 Respiratory System Diagnosis with Ventilator Support. ICD-9-CM Coding Guidelines
DRG 475 Respiratory System Diagnosis with Ventilator Support ICD-9-CM Coding G The below listed g are not inclusive. The coder should refer to the applicable Coding Clinic g for additional information.
More informationThis profile provides statistics on resident life expectancy (LE) data for Lambeth.
Lambeth Life expectancy factsheet April 2014 This profile provides statistics on resident life expectancy (LE) data for Lambeth. Key facts Average life expectancy (LE) 2010-12: Males: 78.2 years Females:
More informationHOMEOPATHY AS AN ALTERNATIVE TO ANTIBIOTICS
HOMEOPATHY AS AN ALTERNATIVE TO ANTIBIOTICS Professor Dr. Michael FRASS Medical University of Vienna, Department Medicine I Doctor s Asscociation for Classical Homeopathy www.aekh.at President, Umbrella
More informationEliminating Pressure Ulcers in Ascension Health
Eliminating Pressure Ulcers in Ascension Health Cissy Shanks RN BSN CEN & Pam Kleinhelter RN MSN CNA-BC Nursing Managers St Vincent s Health System Jacksonville, Florida Objectives Participants will be
More informationSE5h, Sepsis Education.pdf. Surviving Sepsis
Surviving Sepsis 1 Scope and Impact of the Problem: Severe sepsis is a major healthcare problem that affects millions of people around the world each year with an extremely high mortality rate of 30 to
More informationChronic Thromboembolic Disease. Chronic Thromboembolic Disease Definition. Diagnosis Prevention Treatment Surgical Nonsurgical
Chronic Thromboembolic Disease Diagnosis Prevention Treatment Surgical Nonsurgical Chronic Thromboembolic Disease Definition Pulmonary Hypertension due to chronic thromboembolism 6 months post acute PE:
More informationGuidelines for Standards of Care for Patients with Acute Respiratory Failure on Mechanical Ventilatory Support
Guidelines for Standards of Care for Patients with Acute Respiratory Failure on Mechanical Ventilatory Support Copyright by the SOCIETY OF CRITICAL CARE MEDICINE These guidelines can also be found in the
More informationElectronic patient diaries in clinical research
Topics Electronic diaries in Clinical Trials Electronic diaries versus Paper Electronic patient diaries in clinical research Case Study: Novel detection of exacerbations of COPD with patient reported outcome
More informationObjective of This Lecture
Component 2: The Culture of Health Care Unit 3: Health Care Settings The Places Where Care Is Delivered Lecture 5 This material was developed by Oregon Health & Science University, funded by the Department
More informationThe Initial and 24 h (After the Patient Rehabilitation) Deficit of Arterial Blood Gases as Predictors of Patients Outcome
Biomedical & Pharmacology Journal Vol. 6(2), 259-264 (2013) The Initial and 24 h (After the Patient Rehabilitation) Deficit of Arterial Blood Gases as Predictors of Patients Outcome Vadod Norouzi 1, Ali
More informationA. Sue Carlisle, PhD, MD Professor of Anesthesia and Medicine Associate Dean for UCSF at SFGH
A. Sue Carlisle, PhD, MD Professor of Anesthesia and Medicine Associate Dean for UCSF at SFGH VIEW FROM 23RD STREET 10 10 100,000 individuals seen/year 600,000 outpatient visits 16,500 admissions 6000
More informationNational Learning Objectives for COPD Educators
National Learning Objectives for COPD Educators National Learning Objectives for COPD Educators The COPD Educator will be able to achieve the following objectives. Performance objectives, denoted by the
More informationTuberculosis (TB) Screening Guidelines for Substance Use Disorder Treatment Programs in California
Tuberculosis (TB) Screening Guidelines for Substance Use Disorder Treatment Programs in California 1 of 7 Table of Contents Preface 2 TB Symptoms and TB History 2 Initial Screening 2 Follow-Up Screening
More informationEMPHYSEMA THERAPY. Information brochure for valve therapy in the treatment of emphysema.
EMPHYSEMA THERAPY Information brochure for valve therapy in the treatment of emphysema. PATIENTS WITH EMPHYSEMA With every breath, lungs deliver oxygen to the rest of the body to perform essential life
More informationDocumenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC
Documenting & Coding Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Sr. Provider Training & Development Consultant Professional Profile David Brigner currently performs
More informationCARDIO/PULMONARY MEDICINE FOR PRIMARY CARE. Las Vegas, Nevada Bellagio March 4 6, 2016. Participating Faculty
CARDIO/PULMONARY MEDICINE FOR PRIMARY CARE Las Vegas, Nevada Bellagio March 4 6, 2016 Participating Faculty Friday, March 4th: 7:30 am - 8:00 am Registration and Hot Breakfast 8:00 am - 9:00 am Pulmonary
More informationLung Disease. Lung Disease Veterinary Specialists of Rochester
Lung Disease Introduction The definition of pneumonia is defined as inflammation in the lungs. This inflammation can happen suddenly (acute) or develop over a more gradual period of time (chronic). Pneumonia
More informationTable E1: Antibiotic use in infancy and wheeze and asthma: longitudinal studies until January 2010
Table E1: Antibiotic use in infancy and wheeze and asthma: longitudinal studies until January 2010 Mai 2010, Sweden [32] Dom 2010, Belgium [33] Su 2010, USA [34] Sobko 2010, Sweden [49] Schmitt 2009, Germany
More informationPatient Education CONTENTS. Introduction... 12.2
CONTENTS Introduction... 12.2 Purpose... 12.2 General Guidelines... 12.3 Language and Comprehension Barriers... 12.4 Education Topics... 12.5 Medical Diagnosis... 12.5 Contact Investigation... 12.6 Isolation...
More informationHigh Impact Intervention Care bundle to reduce ventilation-association pneumonia
High Impact Intervention Care bundle to reduce ventilation-association pneumonia Aim To reduce the incidence of ventilation-associated pneumonia (VAP). Context The aim of the care bundle, as set out in
More informationRisk for Tuberculosis in Swiss Hospitals. Content. Introduction. Dr. med. Alexander Turk Zürcher Höhenklinik Wald alexander.turk@zhw.
Risk for Tuberculosis in Swiss Hospitals 17. Tuberkulose Symposium Münchenwiler Risk for Tuberculosis in Swiss Hospitals Dr. med. Alexander Turk Zürcher Höhenklinik Wald alexander.turk@zhw.ch 1 Content
More informationInpatient Heart Failure Management: Risks & Benefits
Inpatient Heart Failure Management: Risks & Benefits Dr. Kenneth L. Baughman Professor of Medicine Harvard Medical School Director, Advanced Heart Disease Section Brigham & Women's Hospital Harvard Medical
More informationWHO Guidelines for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and other Influenza Viruses
WHO Guidelines for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and other Influenza Viruses 20 August 2009 Table of contents EXECUTIVE SUMMARY... i Other recommendations...iii 1. INTRODUCTION...
More informationWeaning the Unweanable
Weaning the Unweanable Gerald W. Staton, Jr, MD Professor of Medicine Pulmonary & Critical Care Medicine Emory University School of Medicine Atlanta, GA gerald.staton@emory.edu Disclosures Pulmonary Program
More informationMeasure Information Form (MIF) #275, adapted for quality measurement in Medicare Accountable Care Organizations
ACO #9 Prevention Quality Indicator (PQI): Ambulatory Sensitive Conditions Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Data Source Measure Information Form (MIF)
More informationPerson-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment
Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment Donna Zazworsky, RN, MS, CCM, FAAN Vice President: Community Health and Continuum Care Carondelet Health
More informationCOPD with Respiratory Failure Case Study #21. Molly McDonough
COPD with Respiratory Failure Case Study #21 Molly McDonough Patient: Mr. Hayato 65 year old male Brought to ER with severe SOB Past History of emphysema Longstanding chronic obstruction pulmonary disease
More informationPneumonia. Pneumonia is an infection that makes the tiny air sacs in your lungs inflamed (swollen and sore). They then fill with liquid.
Pneumonia Pneumonia is an infection that makes the tiny air sacs in your lungs inflamed (swollen and sore). They then fill with liquid. People with mild (not so bad) pneumonia can usually be treated at
More informationDepartment of Surgery
What is emphysema? 2004 Regents of the University of Michigan Emphysema is a chronic disease of the lungs characterized by thinning and overexpansion of the lung-like blisters (bullae) in the lung tissue.
More informationImproving Appropriate Use of Proton Pump Inhibitors as Gastrointestinal Prophylaxis in the Hospital Setting
Improving Appropriate Use of Proton Pump Inhibitors as Gastrointestinal Prophylaxis in the Hospital Setting DATE Educating for Quality Improvement & Patient Safety 1 The Team Division CS&E Participants
More informationInpatient Treatment of Diabetes
Inpatient Treatment of Diabetes Alan J. Conrad, MD Medical Director Diabetes Services EVP, Physician Alignment Diabetes Symposium November 12, 2015 Objectives Explain Palomar Health goals for inpatient
More informationRural Pulmonary Rehab Program-
Rural Pulmonary Rehab Program- Saskatchewan s s First Presented by: Sandra Pieterse, Nurse Practitioner and Lia Boxall, Nurse Practitioner Kelsey Trail Health Region Kelsey Trail RHA 41,500 population
More informationSeniors Health Services
Leading the way in care for seniors Seniors Health Services Capital Health offers a variety of services to support seniors in communities across the region. The following list highlights programs and services
More informationDIVISION of SUBSTANCE ABUSE SERVICES. Tuberculosis Control Guidelines for Alcohol and Drug Abuse Treatment Programs
DIVISION of SUBSTANCE ABUSE SERVICES Tuberculosis Control Guidelines for Alcohol and Drug Abuse Treatment Programs 1. Purpose: This policy provides guidance and instruction to identify and prevent tuberculosis
More informationThe Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy
The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy Cindy Goodrich RN, MS, CCRN Content Description Sepsis is caused by widespread tissue injury and systemic inflammation resulting
More informationInhibit terminal acid secretion from parietal cells by blocking H + /K + - ATPase pump
Chris J. Taylor, Pharm.D., BCPS Clinical Pharmacist Phoenix VA Health Care System Review pharmacology of PPIs Discuss possible association between PPI use and development of the following: Pneumonia (community-acquired
More informationCCG Outcomes Indicator Set: Emergency Admissions
CCG Outcomes Indicator Set: Emergency Admissions Copyright 2013, The Health and Social Care Information Centre. All Rights Reserved. 1 The NHS Information Centre is England s central, authoritative source
More informationCeftriaxone Therapy Vs. Ciprofloxacin In Treatment Of Typhoid Fever In Adult Patients.
Dec QMJ VOL.5 No.8 Ceftriaxone Therapy Vs. Ciprofloxacin In Treatment Of Typhoid Fever In Adult Patients. Radhi F.Alshaibani* الخلاصھ لا زالت حمى التایفوید سببا مھما من اسباب الامراض وفقدان ساعات العمل
More informationAs the Director of The Clinical Center of Excellence at Rutgers University, I am speaking on
Department of Environmental and Occupational Medicine Rutgers, The State University of New Jersey EOHSI 170 Frelinghuysen Road Piscataway, NJ 08540 Email: udasin@eohsi.rutgers.edu Phone: 848-445-6016 Fax:
More informationLong term care coding issues for ICD-10-CM
Long term care coding issues for ICD-10-CM Coding Clinic, Fourth Quarter 2012 Pages: 90-98 Effective with discharges: October 1, 2012 Related Information Long Term Care Coding Issues for ICD-10-CM Coding
More informationTable 1 Performance Measures. Quality Monitoring P4P Yr1 Yr2 Yr3. Specification Source. # Category Performance Measure
Table 1 Performance Measures # Category Performance Measure 1 Behavioral Health Risk Assessment and Follow-up 1) Behavioral Screening/ Assessment within 60 days of enrollment New Enrollees who completed
More informationProving Respiratory Therapy value in the Affordable Care Pay Structure
Proving Respiratory Therapy value in the Affordable Care Pay Structure The Curve 2 2 No Margin No Mission (FFS) Outcomes 3 * 2001 study in five states found that medical debt contributed to 46.2% of all
More informationICD-9 Basics Study Guide
Board of Medical Specialty Coding ICD-9 Basics Study Guide for the Home Health ICD-9 Basic Competencies Examination Two Washingtonian Center 9737 Washingtonian Blvd., Ste. 100 Gaithersburg, MD 20878-7364
More informationLung Cancer. Public Outcomes Report. Submitted by Omar A. Majid, MD
Public Outcomes Report Lung Cancer Submitted by Omar A. Majid, MD Lung cancer is the most common cancer-related cause of death among men and women. It has been estimated that there will be 226,1 new cases
More informationA Comparison of COPD Patients Quality of Life Using the Harmonica as a Means of Pulmonary Rehabilitation. Sharon Miller RN, BSN, CCRN
A Comparison of COPD Patients Quality of Life Using the Harmonica as a Means of Pulmonary Rehabilitation Sharon Miller RN, BSN, CCRN Background Very little research has been done on COPD patients playing
More informationCIBMTR Infection Data and the New Infection Inserts.
CIBMTR Infection Data and the New Infection Inserts. Marcie Tomblyn, MD, MS Scientific Director, CIBMTR Infection and Immune Reconstitution Working Committee Overview Indication for expanded data collection
More informationHospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care
Hospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care Charley P. Starnes, RRT, RCP Clinical Respiratory Specialist- COPD Education Important Milestones July 2011-
More informationWhy and how to have end-of-life discussions with your patients:
Why and how to have end-of-life discussions with your patients: A guide with a suggested script and some basic questions to use The medical literature consistently shows that physicians can enhance end-of-life
More informationBreathing Easier In Tennessee: Employers Mitigate Health and Economic Costs of Chronic Obstructive Pulmonary Disease
Breathing Easier In Tennessee: Employers Mitigate Health and Economic Costs of Chronic Obstructive Pulmonary Disease By John W. Walsh, Co-Founder and President of the COPD Foundation Breathing Easier In
More informationESCMID Online Lecture Library. by author
Do statins improve outcomes of patients with sepsis and pneumonia? Jordi Carratalà Department of Infectious Diseases Statins for sepsis & community-acquired pneumonia Sepsis and CAP are major healthcare
More informationLong-term Care - TB Risk Assessment
Montana DPHHS Tuberculosis Program Long-term Care - TB Risk Assessment Long-term Care, Residential Treatment, ESRD (outpatient), Hospice (inpatient) Today s Date Facility Address Phone County Completed
More informationRespiratory Concerns in Children with Down Syndrome
Respiratory Concerns in Children with Down Syndrome Paul E. Moore, M.D. Associate Professor of Pediatrics and Pharmacology Director, Pediatric Allergy, Immunology, and Pulmonary Medicine Vanderbilt University
More information