Nausea
This dopamine antagonist is often the first PRN antiemetic ordered on the inpatient floor. It is important to take note of this EKG finding.
What is: QT interval?
Check electrolytes and replete, can give mg 1-2 grams
Think about this pain med when your pt has flank pain 2/2 to kidney stone (no other known CI)
This is our go to resource for local antibiotics resistance
What is: The Antibiogram
The number to call a rapid
What is: 6555
This first-generation antihistamine is useful for nausea related to BPPV or motion sickness
What is: meclizine
Watch out for drowsiness, anticholinergic SE
You get a call that your 101-year-old pt is getting agitated at night, what is your first step?
What is: Reorientation, delirium precautions, ask for a sitter, DC lines/ interventions that are not necessary, see if family can come to bedside
This is where to find the most up to date antibiogram
What is: home page -> policystat
How do you consult psychiatry?
What is: Message FO Psychiatry Inpatient Consults
This is an extremely high yield consult to order when you have a pt that comes in with bronchiectasis and mucous plugging
What is: RT consult for bronchopulmonary hygiene
This off-label galactagogue can also be used to treat nausea if your go to nausea medicines are not successful
What is: Reglan
Often prescribed for acute/recurrent diabetic gastroparesis
This cardiac condition is the most important reason to avoid diltiazem for rate control in atrial fibrillation with RVR because its negative inotropic effects may worsen the patient's hemodynamics
What is Heart failure with reduced ejection fraction?
Its 7:30 pm, you get a purple phone call. The lab calls you with gram positive cocci blood cultures. The pt is comfortable w/o sx, stable vitals, asx. What order do you consider placing besides making sure they are on the right abx and repeating blood cx?
What is: echocardiogram
Note: you dont necessarily need to do this if you have gram positive RODS
How do you consult Virginia Cancer Specialists?
What is: Call the outpatient office. There is no way to epic message them. They are not on extend page.
What is: Dr Benton
This antiemetic is often the preferred choice for nausea associated with migraine headaches in the ED
What is: Compazine
Sometimes the ED will co-administer with benadryl to prevent/ treat extrapyramidal SE (akathisia) and acute dystonic reactions (invol muscle contractions of mouth, neck). I have seen it IV - so if your pt is sleepy/sedated this could be why!
You get a call from a nurse at 3 am, she tells you she is calling from fair oaks for a 97 year old pt who has had a 6 week hx of worsening dementia (no specified dx) w/ hallucinations and erratic behavior. She has a sitter, and the team has tried to reorient for 1 hour. Her QTC is 420. What is a safe oral antipsychotic to consider?
What is: Seroquel?
This is the key difference between merrem and ertapenem
What is: Ertapenem does not cover for pseudomonas
What is: Text him on the hospital phone
How do you page anesthesia to help you with your PCA?
What is: 4271
This antiemetic does NOT prolong the QTC, often used in chemo related nausea
What is: Aprepitant, at our hospital there is a hard stop for pediatric use only (for now?)
3 big CI to giving haldol for agitation?
What is: Parkinsons, Lewy Body, prolonged QTC
This is the biggest difference between cefepime and zosyn
What is: anaerobic coverage
How do you consult rheumatology? (2 steps)
What is: Message FX IP Rheumatology and ask your nurse to set up the ipad in the pt's room
What is the order name to *activate* a transfer/ get the attention of transfer group chat?
What is: Transfer Center Order (different from the transfer order under navigators)