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    This document provides an overview and guidelines for medical students' duties and responsibilities during their third-year clerkships. It discusses general rotation information like rotation dates and schedules. It also outlines common ward duties like writing daily notes, presenting to rounds, and assisting with procedures. The document provides templates for writing different types of notes, including SOAP notes, admission/discharge orders, and procedure notes. It offers abbreviations commonly used in notes. Overall, the document aims to prepare medical students for the expectations and tasks they will encounter during their clinical rotations in the third year of medical school.

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    Scut Puppy

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    sgod34
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    This document provides an overview and guidelines for medical students' duties and responsibilities during their third-year clerkships. It discusses general rotation information like rotation dates and schedules. It also outlines common ward duties like writing daily notes, presenting to rounds, and assisting with procedures. The document provides templates for writing different types of notes, including SOAP notes, admission/discharge orders, and procedure notes. It offers abbreviations commonly used in notes. Overall, the document aims to prepare medical students for the expectations and tasks they will encounter during their clinical rotations in the third year of medical school.

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    This document provides an overview and guidelines for medical students' duties and responsibilities during their third-year clerkships. It discusses general rotation information like rotation dates and schedules. It also outlines common ward duties like writing daily notes, presenting to rounds, and assisting with procedures. The document provides templates for writing different types of notes, including SOAP notes, admission/discharge orders, and procedure notes. It offers abbreviations commonly used in notes. Overall, the document aims to prepare medical students for the expectations and tasks they will encounter during their clinical rotations in the third year of medical school.

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    © All Rights Reserved
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    1K views68 pages

    Scut Puppy

    Uploaded by

    sgod34
    This document provides an overview and guidelines for medical students' duties and responsibilities during their third-year clerkships. It discusses general rotation information like rotation dates and schedules. It also outlines common ward duties like writing daily notes, presenting to rounds, and assisting with procedures. The document provides templates for writing different types of notes, including SOAP notes, admission/discharge orders, and procedure notes. It offers abbreviations commonly used in notes. Overall, the document aims to prepare medical students for the expectations and tasks they will encounter during their clinical rotations in the third year of medical school.

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    At a glance
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    The document provides an orientation guide for third year medical students on their clinical rotations, covering information about rotation schedules and duties, computing resources, hospital details, and references.

    The main sections covered are: general rotation information, computing, hospital information, food, and reference/random useful info.

    The hospital information section provides details on Parkland Memorial Hospital, Children's Medical Center of Dallas, UTSW University Hospital, Veteran Affairs Medical Center, Baylor University Medical Center, UTSW University Hospital St. Paul Building, and Presbyterian Hospital.

    INTRODUCTION

    Twenty-first edition, 2005-2006


    scutpuppy (skut-pup-e) n., pl. pies. You. Low person on the totem pole.
    Finder of lost x-rays. Don of the late-night ER. Obtainer of tasty food snacks.
    Doer of impossible deeds by surpassing insurmountable odds.
    In 1984-85, the Southwestern 3rd and 4th year medical students completed a
    survey concerning their 3rd year rotations. The students reported that certain
    information would have been helpful in the transition from the classroom to the
    wards. The Scutpuppy Guide is a result of that survey. The Scutpuppy has been
    well received by the classes ever since; it has been revised for the class of 2007
    and includes information on writing notes, ward duties, computing, domestic
    violence assessment; up-to-date telephone listings; and an expanded list of useful
    Spanish phrases.
    Most of the hospitals continue to undergo renovations (which you will quickly
    come to lament), so please make note of changes in phone numbers and ward
    locations throughout the upcoming year.
    We would like to thank the following individuals for their contributions:
    Dr. Teresa Koscuik-Rowe, UTSW Class of 1987, Scutpuppy Guide originator
    Ms. Ann Wentz, Office of the Associate Dean for Student Affairs
    Mr. Jubal Mathis and Mr. Les Nini and the Staff of UTSW Printing Services
    Dr. Leonard Gomella, UKMC, author of The Clinicians Pocket Reference
    All of the previous editors of the Scutpuppy
    As the year progresses, remember the role of the physician:
    "To cure sometimes,
    to ameliorate often,
    to comfort always."
    - Sir William Osler
    "To scut is to heal.
    - Teresa Koscuik-Rowe, M.D.
    Best wishes for a rewarding and memorable year.
    Edward Lau, Chief Editor
    Fatema Uddin, Co-editor, Medical Spanish Editor
    Himani Kulkarni, Co-editor
    Chinelo Onuekwusi, Co-editor
    Toral Patel, Co-editor
    Hayden Schwenk, Co-editor
    Class of 2006

    TABLE OF CONTENTS

    I. GENERAL ROTATION INFORMATION


    Rotation Dates
    General Clerkship Information
    Ward Duties
    Chart Duties
    Presenting
    Books
    Pagers
    Rotation Info: Med, Surg, Peds, Psych, Ob, Fam
    Scrubs
    II. COMPUTING
    Parkland Computer Systems
    VA Computer Systems
    Childrens
    PDA and Handheld Computers
    Internet
    III. HOSPITAL INFORMATION
    Hospital Information Numbers
    Parkland Memorial Hospital
    Childrens Medical Center of Dallas
    UTSW University Hospital Zale Lipshy Building
    Veteran Affairs Medical Center
    Baylor University Medical Center
    UTSW University Hospital St. Paul Building
    Presbyterian Hospital
    IV. FOOD
    V. REFERENCE AND RANDOM USEFUL INFO
    Lab Shorthand and Normal Values
    Nutrition
    General Health Maintenance Recommendations
    Useful Patient Care Guidelines
    Domestic Violence Assessment
    Useful Spanish Phrases
    Call Room Information
    Abbreviations
    Blood and Bodily Fluid Exposure Protocol
    Campus Map

    3
    3
    4
    4
    4
    6
    7
    7
    8
    15
    16
    16
    18
    20
    20
    21
    22
    22
    23
    29
    32
    33
    37
    41
    44
    47
    47
    47
    49
    50
    51
    52
    53
    60
    61
    65
    69

    GENERAL ROTATION INFORMATION


    ROTATION DATES
    Dates for 2005-2006 MS3 Rotations
    GROUP A
    A1
    A2
    A3
    A4

    07/05/05 08/14/05
    08/15/05 09/25/05
    09/26/05 11/06/05
    11/07/05 12/18/05

    (6 weeks)
    (6 weeks)
    (6 weeks)
    (6 weeks)

    A5
    A6
    A7

    01/02/06 02/26/06
    02/27/06 05/07/06
    05/08/06 07/02/06

    (8 weeks)
    (8 weeks)
    (8 weeks)

    GROUP B
    B1
    B2
    B3

    07/05/05 08/28/05
    08/29/05 10/23/05
    10/24/05 12/18/05

    (8 weeks)
    (8 weeks)
    (8 weeks)

    B4
    B5
    B6
    B7

    01/02/06 02/12/06
    02/13/06 03/26/06
    04/10/06 05/21/06
    05/22/06 07/02/06

    (6 weeks)
    (6 weeks)
    (6 weeks)
    (6 weeks)

    Winter Break
    Spring Break

    12/19/05 01/01/06
    03/27/06 04/09/06

    Dates for 2005-2006 MS4 Rotations


    1
    2
    3
    4
    5
    6

    Jul 5 Jul 31
    Aug 1 - Aug 28
    Aug 29 - Sep 25
    Sep 26 - Oct 23
    Oct 24 - Nov 20
    Nov 21 - Dec 18

    7
    8
    9
    10
    11

    Match Day: 3/16/2006

    Jan 2 - Jan 29
    Jan 30 - Feb 26
    Feb 27 - Mar 26
    Apr 10 - May 7
    May 8 - June 2

    Graduation: 6/3/2006

    rd

    Surviving 3 Year Clerkships: A General Guide

    Congratulations, youve made it to 3rd year! For most of us, this is what
    medical school is really all about: observing and learning about patient care . . .
    getting up before the sun rises . . . learning to accommodate to a new level of
    sleep deprivation. But its fun! (No really, it is.) This section is designed to give
    you an overview of what to expect as an MSIII and what is likely to be expected
    of you. This year is an opportunity to see diverse areas of patient care, some of
    which you may not have the chance to see again, so make the most of this
    opportunity!
    Ward Duties
    In short, your duties are whatever your resident tells you they are. Typically,
    this means writing daily notes on your patients, following up on labs and special
    studies, playing liaison between the team and the patient, and assisting in
    whatever floor work is necessary. Floor work ranges from measuring daily
    weights on your patient to aiding in central line placement. In short, you are a
    scutpuppy! As you become more confident (i.e. competent), your responsibilities
    will be adjusted accordingly and you will soon realize that you are an invaluable
    member of the team. You will be responsible for knowing everything there is to
    know about your patients on the wards, so develop a system for tracking all of
    your information early. There are many versions of H&P and daily progress
    trackers floating around; get one from your intern or go to www.medfools.com.
    Dont ever complain about scutwork, or you will see it in your grade. Work
    tirelessly and with enthusiasm and it might make up a little for a few missed
    questions on the shelf exam.
    Chartwork
    In general, one of your daily ward duties will be to write a note on each of
    your patients in the morning before your team rounds. Be sure to reserve enough
    time to see each of your patients and write your notes. Your daily note is
    typically going to be a SOAP note; a general soap note is shown below and
    rotation-specific notes are in their respective sections. Once in a while, your
    resident/intern will ask you to write orders. Make sure he/she signs it, as orders
    from med students will be summarily ignored. One of the most common orders
    they will ask you to write are admit/transfer or discharge/pre-discharge orders,
    mostly because they follow a set format shown below. Also, if you assist or
    participate in a procedure, you may be asked to help write the procedure note.
    One key thing to remember: always date your notes and sign your name with
    your title at the end of your note.
    Typical Chartwork Abbreviations
    A+ O x 3 = Alert + oriented to person, place, time
    NAD = No apparent/acute distress
    RRR m/r/g = regular rate and rhythm; no
    murmurs, rubs or gallops
    CTAB = clear to auscultation bilaterally
    AB S/NT/ND/+ BS = Abdomen soft/nontender/non-distended/ + bowel sounds
    Ext WWP c/c/e = extremities warm and well
    perfused; no cyanosis, clubbing, or edema

    c = with
    s = without
    x = except
    p = after
    a = before
    s/p = status post

    Problem-Oriented Progress Note (Daily Progress Note)


    Use the mnemonic SOAP.
    Subjective: How does the patient feel? Any complaints? How did the patient
    eat and sleep? Anything the nurse/floor staff tell you. Include
    pertinent negatives.
    Objective: Vital signs (Tnow, Tmax, HR, BP, RR, I/O) (get the past days
    vitals from the patients bedside chart).
    Focused Physical Exam (generally include the following systems:
    General, HEENT, CV, Lungs, Abd, Ext).
    Lab Data and other Studies.
    Assessment/Plan: Write a one-sentence summary of your patient including
    age, gender, reason for hospitalization and status (Example: Pt is a 55
    y/o WF w/ acute pancreatitis currently stable awaiting ERCP). List
    each medical, surgical, psychiatric problem with its plan. When the
    problem is resolved, indicate its resolution and omit the problem from
    the daily progress note. Another approach this is to organize by
    systems rather than problems. Include discharge or transfer plans.
    Admission/ Transfer/ Post-Op Orders
    Use the mnemonic ADC VAN DISMAL
    Admit: location, floor, team, attending, house officer
    Diagnosis: admitting diagnosis
    Condition: (stable, fair, poor, guarded, critical)
    Vitals: temperature, pulse, blood pressure, respirations, weight, etc.; include
    orders as to how often vitals should be taken
    Activity: (ad lib, bathroom privileges, bedrest, etc.)
    Nursing Procedures: May include: Bed position, Preps, Respiratory Care,
    Dressing changes
    Notify house officer if. . . (ASK YOUR RESIDENT for values)
    ? >Temp >?
    ?> Pulse >?
    ? >RR >?
    ? >SBP >?
    ?> DBP >?
    urine output <?
    Diet: (regular, clear liquids, low salt, NPO, ADA diabetic, etc.)
    Ins & Outs:
    IV fluids (specify type and rate)
    Record daily intake and output.
    Studies/Special Orders: anything extra, i.e., EKGs, X-rays, etc.
    Medications: list meds patient will be on, including prn meds.
    Allergies: List if any; otherwise note NKDA.
    Labs: CBC, renal profile, mineral profile, etc.
    Discharge/Pre-Discharge Orders (Write Pre-D/C Order)
    Discharge to: (home, nursing home, etc.)
    Diagnosis:
    Condition: (stable, fair, poor, critical)
    Diet: (as tolerated, tube feeds, supplementation etc)
    Activity: (ad lib, restrictions)
    Medications:
    Follow-Up Appointments:
    Special Instructions:

    Procedure Note
    Procedure:
    Indication: (diagnosis)
    Position, prep, anesthesia used
    Materials/Equipment, procedure process, and result
    Specimens sent and tests ordered
    How the patient tolerated the procedure (complaints, blood loss)
    Discharge Paperwork
    On some rotations, you will be expected to help with discharge paperwork,
    while on others students are not allowed to fill out these documents. When asked
    to help pre-D/C someone, there are a number of defined things you can do at
    Parkland. They are 1) the yellow sheet which lists the service names, length of
    hospital stay, diagnosis, procedures, a brief summary of hospital course and
    summary of discharge instructions; 2) fax prescription order form that gets sent to
    the pharmacy with all of the patients outpatient meds that need to go home with
    them; 3) supplies request form, especially on surgery, when the patient needs
    dressing supplies to change dressings at home; and 4) pre-D/C orders. If you are
    asked to fill out a yellow sheet, ask your intern or resident if they want you to
    write out a summary of hospital course; some prefer a written version on the
    sheet while others will plan to dictate this themselves.
    Prescriptions
    Med: (Drug Name and its formulation)
    Sig: (Dosage and method of administration)
    Disp: (Total volume or number to dispense)

    Example:
    Benadryl 25mg
    1 tablet PO q4-6 H PRN
    Disp: 10 (ten) Refils: 0

    Presenting on Rounds
    It is important to realize that the only proper way to present is the way the
    presentee (Resident or Attending) wants it done. They wont hesitate to correct
    you when you falter, so dont get flustered when they criticize you. That said,
    presentations begin with an introductory sentence followed by information given
    in a SOAP format. Example: Mr. Jones is a 66yo black male with HTN for 10
    years and NIDDM for 5 years who presented to the ER yesterday with crushing
    substernal chest pain that was relieved by sublingual NTG given in the ER. He
    denies any chest pain or SOB overnight. His temperature this morning is 37.0,
    HR 85 . . .
    Emphasize the aspects of the physical exam relevant to the case, but always
    include chest, heart, and abdomen. With regard to labs, mention only abnormal
    values and pertinent negatives. For the assessment, give the tentative diagnosis.
    For the plan, discuss what studies are pending or possible therapeutic options. Try
    to discuss the plan with your intern before presenting (this is key to looking wellprepared).
    Remember that the key to a good presentation is to put the key facts up and be
    succinct. If you leave something out, they will ask you for it. Have lab data and
    vitals written on a note card, but do the presentation from memory. Establish
    good eye contact and act comfortable. Throwing in a comment about the
    patients social status (he needs a place to go after discharge, he needs alcohol

    counseling, etc.) lets your team know you actually talk with (and care about) your
    patients. Make sure to check with your intern for any new developments right
    before you present so you dont get blindsided during rounds in front of the staff.
    Above all, never bring up anything that the resident should have done but didnt.
    Remember, everything is pending, even if the gears arent really in motion yet.
    Books
    Which books you carry around with you will depend, in part, on whether you
    use a PDA and how proficient you are with it compared to paper. More info is
    available on this topic under the computing section. The one book
    recommended above all others as being useful on every rotation is the Pocket
    Pharmacopoeia. This reference will help you sort out the bewildering array of
    trade and generic names. It is updated each year, and is probably the best
    investment ($7.95) you can make. You can often scam a copy from your local
    drug rep, especially at Baylor. You can also download it for PDAs.
    Another key resource is The Sanford Guide to Antimicrobial Therapy, a
    handy guide to the bugs that attack us and how to kill them. This guide is also
    updated each year and available from the local pliers of the drug trade.
    The next best investment, in terms of both weight (very light) and useful
    information (packed), is Facts & Formulas, available for $6.50 at Majors. It has
    essentially every formula youll ever need, for electrolyte corrections, renal
    issues, etc. It also includes such things as ventilator settings, code drugs, and an
    acetaminophen nomogram.
    Many students find it useful to carry a general medical handbook such as Ferri
    or the Washington Manual on most rotations. However, they are both heavy in
    the coat pocket. Pocket Medicine is a relatively lightweight favorite.
    The books listed with each rotation include both the official recommended
    texts and the unofficial student recommended texts. Dont buy more than you can
    read. Look before you buy. Borrow if you can and buy used.
    Pagers
    Pagers can be rented on a monthly/yearly basis from the campus store or
    from independent paging services around the metroplex (usually cheaper). Your
    class presidents will likely arrange a group deal for your class. Ask your resident
    how to best identify yourself when you page him or her. Medicine teams often
    prefer that you add * and then your pager number after your message. Surgery
    teams often use *0 to identify lowly students. Pagers can be finicky at the VA; if
    you got your pager from an independent provider, check it the first time you have
    to go to the VA to make sure it works.

    THE ROTATIONS

    Family Practice
    Program Directors: Dr. Scott Kinkade (6263 Harry Hines) (214)648-1399
    Laura Snell, MPH (6263 Harry Hines) (214)648-1399
    Education Coordinator: Christine Keenan (DS0.326) (214)648-1382
    Program Notes: Rotations in Arlington/Colleyville, Charlton Methodist-Dallas,
    UTSW/ St. Paul, John Peter Smith-Ft. Worth, Tyler, and Waco.
    Recommended Texts (Provided at sites):
    Manual of Family Practice, Taylor
    NMS: Family Medicine
    Swansons Family Practice Review: A Problem Oriented Approach
    General Info: Notes are usually written on a pre-printed form or on a
    computer. Responsibilities vary at different sites.
    For your white coat: Stethoscope, penlight, reflex hammer, Pocket
    Pharmacopoeia, and Sanfords Guide to Antimicrobial Therapy. Also, an
    OB wheel is helpful at many sites.

    Medicine
    Program Director: Dr. Hari Raja (CS 8.112) x82992
    Clerkship Administrator: Vera Johnson (F5.310) x85076
    Program Notes: Call every 4th night (PMH, VA, St. Paul), or every 5th night
    (Baylor). Six weeks at Parkland and six weeks at either Baylor Dallas,
    VA, or St. Paul. Schedule given one week prior to the rotation. Call
    schedule for VA/Baylor/St. Paul may not be available until the first
    day at each site. Make sure to note the phone number to your rounding
    room on your first day at a site.
    Recommended Texts:
    Harrisons (15th ed), Braunwald
    Cecil Essentials of Medicine, Andreoli
    Washington Manual of Medical Therapeutics, Carey
    Sanford Guide to Antimicrobial Therapy, Sanford
    Some Students Recommend:
    Pocket Medicine, Sabatine
    Karem/LSU notes
    Current Medical Diagnosis and Treatment, Tierney
    The Care of the Medical Patient, Ferri
    Clinicians Pocket Reference, Gomella
    Facts and Formulas (the little blue book)
    Harrisons Self-Assessment and Review, Stone
    Blueprints: Medicine
    NMS: Medicine
    Pretest: Medicine
    For your white coat: Stethoscope, penlight, reflex hammer, Pharmacopoeia
    (ePocrates is a suitable alternative), Sanford manual, and Pocket
    Medicine. Otoscope and ophthalmoscope are not necessary for daily
    use, but it is a good idea to bring one to store in the rounding room for
    your call days.

    Write-Ups: For write-ups, if you have a template from your MS2 write-ups,
    this may help save some time, especially in recording findings on
    physical exam. Expectations will vary from attending to attending,
    but typically the meat of the write-up will start with a problem list.
    The discussion should focus on one to two of the bigger problems
    (i.e., the reason for admission) with the generation of a differential
    diagnosis and a reasoned description of a plan that involves
    diagnostics, therapeutics, and prognosis.
    DAILY NOTE: For both the daily note and daily presentation, record all
    vitals including the ranges. For example, if your patient is
    hypertensive, record the BP range, but also when it hit the roof or
    bottomed out, and how that related to other events during the day (i.e.,
    just after medication, during an anxiety-provoking procedure, etc.).
    ALWAYS do a brief chest, heart, abdominal and peripheral pulse
    exam! Look in the chart in the orders section to see if something has
    been ordered that you dont know about and check the computer for
    results of any pending studies. Also check in the progress notes and
    make sure to look for new consults or SW notes.
    Obstetrics and Gynecology
    Program Director: Dr. Susan Cox (G6.220) x82646
    Clerkship Administrator: JoAnn Hing (G6.220) x84770
    Program Notes: Rotation broken up into 3 weeks of OB and 3 weeks of Gyn.
    Students are assigned to three weeks of OB antepartum/postpartum wards with
    call on L&D West (high risk) and three weeks of Gyn (surgery and clinic).
    Individualized schedule information is given prior to the rotation. The first day
    is lecture and orientation. There is a board shelf exam at the end of the
    rotation. Carry the OB wheel and Orientation pocketbook they give you at all
    times!! The book is very helpful.
    Recommended Text:
    Obstetrics and Gynecology, 3rd Edition, Beckmann
    UTSW Ob/Gyn CD with lecture notes, practice test, images
    Some Students Recommend:
    Appleton & Langes Review of OB/GYN, Vontver
    Obstetrics and Gynecology Recall, Bourgeois
    Blueprints in Obstetrics and Gynecology, Callahan
    Clinical Cases in Obstetrics and Gynecology, Caughey
    Case Files OB/GYN, Toy, Baker, Ross, Gilstrap
    Pretest OB/GYN,Wylen
    Gyn:

    2 days each at St. Paul Surgery, Parkland Surgery, Parkland Gyn Clinic,
    Maple Clinic on Harry Hines or Oak West Clinic, ICC Intermediate
    Care Center

    At the surgery sites, try to limit what you bring with you. Usually you
    have to leave your stuff randomly somewhere.

    One 12 hour call on L&D East (low risk). You should be able to deliver
    some babies here.

    OB:

    Call every 4th night. On pre-,pre-call afternoons you will be assigned to


    the ICC, L&D East, or Triage. On post call days you should be home
    early about 9 am. On call, you wont wear your white coat unless you
    leave the floor. Lock up valuables (they will give you lockers) but dont
    leave stuff overnight. You can leave your white coat and book bags out
    of the way in the resident lounge on L&D West when you are on call.
    On call you will spin blood to get crits, record it on the board, and also in
    the appropriate chart. You will help moms push (coach mom to push
    the child through the birth canal until the baby crowns) and then assist in
    the delivery of their babies. You will be expected to help tone charts
    (make sure they are complete). You will have to scrub into C-sections.
    You may also be able to do some vaginal exams to assess the progression
    of labor.

    C-section patients go home on Colace and Lortab. Fill out prescription


    sheet the morning of dispo (or earlier.)

    Do not sit in the green leather recliners in the doctors lounge.


    OB/GYN NOTE: Look in your OB/GYN Orientation book!!! Always ask
    about future birth control, breast-feeding. Look up Hep, RPR, HIV serologies
    on all patients. For C-sections note PO intake, flatus, bowel movement,
    fever, hypotension and clean/dry/intact bandage. For vaginal deliveries: PO
    intake, fevers, hypotension, vaginal bleeding.

    Pediatrics

    Program Director: Dr. Angela Mihalic (CMC D430) 214-456-2730


    Clerkship Administrator: Del Milite (CMC D430) 214-456-2730
    Badges: Check with clerkship administrator
    Program Notes: Four weeks of inpatient at CMC (General, Cardiology, GI or
    Renal), with q4 call. Four weeks of outpatient (private practice office, Medical
    Student Clinic/ER, PMH newborn nursery, and specialty clinics). Preference
    sheets for inpatient and specialty clinics are distributed prior to the rotation.
    Schedules are given on the first day. There are two exams:
    1. Three essay questions on the last Thursday of the rotation (this is factored
    into your outpatient grade).
    2. Board shelf examination on the last Friday of the rotation.
    Recommended Texts:
    Rudolphs Fundamentals of Pediatrics, 4th edition, 2002
    Nelson Essentials of Pediatrics, 2002, Behrman & Kliegman
    Oskis Essential Pediatrics, 2004
    Saunders Manual of Pediatric Practice, 2002, Finberg
    Pediatric Clerkship Guide, 2003
    Some Students Recommend:
    Appleton & Langes Review of Pediatrics, Lorin
    Blueprints in Pediatrics
    The Harriet Lane Handbook, Barone
    Pediatrics Recall, McGahren
    Case Files: Pediatrics

    10

    10

    General Info: On the wards, get there early enough in order to see/examine all
    of your patients, get their vitals and pick up any new arrivalsbefore
    conference at 9AM because most teams round with the attending
    immediately after the conference at 10:00AM.
    PEDS DAILY NOTE: You will need a calculator for drug dosages and I/O
    rates. Follow the SOAP format. KEY THINGS TO INCLUDE: Urine
    output, calculated in cc/kg/hour. For kids on formula or calorie counts,
    kcal/kg/day. Stool output if excessive.
    PEDIATRIC NUTRITION:
    Regular infant formula: 20kcal/oz
    Preemie infant formula: 24kcal/oz
    Nutritional requirements: 110-130kcal/kg/day
    PEDIATRIC ADMISSION/H+P: There are a few things on a Peds history
    that arent included in adult medicine.
    PMH: Birth History (prenatal, L&D, condition at birth, complications)
    Nutrition
    Developmental History
    Immunizations
    Previous Health (allergies)
    FH:
    Sick contacts
    Daycare
    Pertinent family history (esp. allergies, asthma)
    Exposure to smokers/pets
    PE:
    VS (head circumference, height, weight, percentiles)
    Evaluation of development
    Commonly used pediatric abbreviations:
    AFSF: anterior fontanel soft/flat
    TM: tympanic membranes
    WDWN: well developed, well
    nourished

    Rtxn: retraction
    OP: oropharynx
    MMM: mucous membranes moist
    FROM: full range of motion

    Developmental Milestones (1-12 months)


    1 Social smile
    2 Vocalize
    3 Head control (no head lag)
    4 Hand control (hold toy)
    5 Roll over (back to front)
    6 Sit alone

    7 Crawl
    8 Prehension (thumb/forefinger)
    9 Pull up to standing
    10 Walk with support
    11 Stand alone
    12 Walk alone

    Vital signs by Age


    AGE
    Newborn
    1 month
    6 month
    1-2 years

    HR
    94-145
    115-190
    110-180
    100-160

    BP (systolic)
    50-70
    70-90
    59-119
    66-126

    11

    RR
    40
    24-30
    24-30
    20-24

    Psychiatry

    Program Director: Dr. John Sadler, Course Director (NC5.828) x84960


    Dr. Timothy Wolff, Course Coordinator x87093
    Clerkship Administrator: Aida Ramirez-Boyce (NC5.838) x84958
    Program Notes: Rotations at CMC, PMH (consult/liaison, 8N inpatient, ER),
    Presbyterian, St. Paul, VA (multidisciplinary treatment teams covering
    mood disorders, psychosis, substance abuse, geriatrics, or anxiety),
    and Zale- Lipshy. Four or five ER call shifts (5pm-12am on
    weekdays; days, evenings, or nights on weekends) during the rotation.
    Site preference request forms are distributed about a month prior to
    the rotation and schedule information is provided about a week prior
    to the start of the rotation. All sites require a paper and may require an
    oral presentation.
    Recommended Texts:
    Clinical Psychiatry for Medical Students, Stoudemire
    DSM-IV
    Psychiatry for the House Officer, Tomb
    Kaplan and Saddocks Synopsis of Psychiatry (from the MS1 course)
    Some Students Recommend:
    Current Clinical Strategies: Psychiatry, Hahn (Little Green Book)
    Blueprints for Psychiatry
    Appleton and Lange Psychiatry
    Case Files: Psychiatry
    Items for your white coat: Current Clinical Strategies (the Little Green Book)
    Pharmacopoeia/ ePocrates, card with phone numbers of local mental
    health agencies (will be provided), card with an outline of the
    MMSE/MSE (will be provided), a summary of diagnostic criteria for
    psychiatric disorders (Current Clinical Strategies provides this, but
    your resident may be able to offer something compressed into one or
    two sheets), and stethoscope (some attendings insist!).
    PSYCHIATRY NOTE: The daily progress notes should follow the SOAP
    format. In the place of the physical exam, include the
    findings on the mental status exam.
    Mental Status Exam
    Appearance: grooming (well-groomed, disheveled), behavior (cooperative,
    non-cooperative), emotional facial expressions, attentiveness,
    alertness.
    Motor: any notable tics or gestures such as hand wringing, psychomotor
    retardation, gait abnormalities
    Speech: rate, rhythm, volume, amount, articulation, spontaneity
    Mood: how the patient describes how she is feeling
    Affect: what the examiner observes about the patients emotional state
    Sensorium: consciousness, orientation, memory, attention/concentration
    Thought process/ Thought Content: logical, tangential, loosening of
    association, hallucinations, suicidal/homicidal ideations, etc.
    Somatic Function: sleep, appetite, energy, sex

    12

    Mini Mental Status Exam


    ORIENTATION (1 pt each)
    Year/ month/ day/ date/ season
    State/ county/ city/ hospital/ floor
    REGISTRATION (1 pt each)
    Name 3 objects. Have the patient repeat them after
    you until he/she learns all 3 objects.
    ATTENTION & CALCULATION (1 pt each)
    Serial 7s. Stop after 5. OR spell world backwards
    RECALL (1 pt each)
    Ask the patient to repeat the 3 objects named earlier.
    LANGUAGE (1 pt each)
    Point to 2 objects. Have the patient name them.
    Have the patient repeat No ifs, ands, or buts.:
    Have the patient follow a 3-stage command:
    1) Take a paper in your right hand
    2) Fold it in half
    3) Put it on the table
    Have the patient read and obey the following:
    1) close your eyes
    2) write a sentence
    3) copy design
    Total Score

    Surgery

    Max

    Score

    5
    5

    __/5
    __/5

    __/3

    __/5

    3
    9

    __/3
    __/9

    __/30

    Program Director: Dr. Patricia Bergen (E7.118A) x82065


    Clerkship Administrator: JoAnna Nelson (E7.114) x82040
    Program Notes: Call may be no call, every third night, or every fourth night,
    depending on service. You may need trauma shears. On the floor, you
    can use the scissors found in suture kits. Carry tape, extra packing
    supplies, and gloves in your coat pocket. Schedule information may not
    be available until the first day of the rotation. Everyone gets two weeks
    of Trauma/TASC and two weeks on the Emergency General Surgery
    (EGS) service. The remaining assignment (4 weeks) is either general
    surgery, vascular surgery, hepatobiliary surgery, or pediatric surgery
    (although this may change). Most residents want a student scrubbed in on
    every case; alternate with teammates.
    Recommended Text:
    Essentials of General Surgery, Lawrence
    Essentials of Surgery, Sabiston
    Principles of Surgery, Schwartz
    Current Surgical Diagnosis and Treatment, Way
    Some Students Recommend:
    Surgical Recall, Blackbourne (a must-have)
    Abernathys Surgical Secrets, Harken (great for pimp answers)

    13

    SURGERY PROGRESS NOTES: Include PO intake, N/V, flatus and bowel


    movement (for abdominal surgeries). Record ins and outs and CBGs
    (capillary blood glucose). Record any drain output and appearance. Comment
    on what their wound looks like; you may have to change the dressing by
    yourself when you pre-round or just take it down and redress lightly if your
    team wants to look at it. Dont take down surgical dressings until told to do
    so. Have thick skin.
    Vascular: Record pulses in addition to items above. It is all about the pulses.
    Trauma/TASC: Just survive. The rotation is under construction at this time.
    Have one or two students in the OR and another in the trauma hall. Very little
    or no sleep on this rotation. Call every third night.
    OPERATIVE NOTES: You may be expected to write a pre-op or post-op
    note, depending on your team (examples below FYI). You will likely be asked
    to write a post-op check. After a surgery is finished, patients are taken to the
    PACU and either discharged in the case of day surgery or admitted. If they are
    admitted, do a post-op check.
    Surgery Post-Op Check (done 4-6 hours after surgery in SOAP format). Be
    sure to mention procedure (s/p appy, chole, whatever), include pain control,
    level of consciousness, vitals, including I & O's: urine output and surgical
    drains, brief physical exam, any pending post-op studies.
    Surgery Pre-Operative Note
    Pre-Op Diagnosis:
    Procedures:
    Labs: results
    CXR: results
    EKG: results
    Blood: (type x cross, etc.,)
    Orders: (e.g. 2gm cefoxitin on call
    to OR)
    Consent: signed and on the chart
    History and Physical: on the chart

    14

    Surgery Post-Operative Note


    Pre-Op Diagnosis:
    Post-Op Diagnosis: same
    (otherwise say what it is)
    Procedure:
    Surgeon:
    Assistant(s):
    Findings:
    Anesthesia:
    EBL/Drains:
    Specimens: (to pathology)
    Complications:
    Condition: (stable, fair, poor,
    critical)

    SCRUBS - where to find them, when to wear them.


    Parkland - Scrub dispensing machines (Pyxis) are used to control scrub
    inventory. For Surgery, you will need to obtain a form from the OR admin
    office across from the scheduling board on the surgery floor, complete the form
    and return it with a $45 to get three sets of scrubs. The Pyxis is in the surgery
    lounge. They can be returned and your $45 recovered at the end of the rotation.
    For OB/GYN, get the form from the OB admin office near the male locker room
    on L&D West. The Pyxis is near the male locker room on L&D West. Scrubs are
    not appropriate for clinic. On other rotations, ask your intern about the dress
    code.
    Zale-Lipshy - Good luck. Bring your own for surgery.
    Children's - Good luck. Bring your own for call days.
    VA You will be provided with a set of scrubs on the first day of your surgery
    assignment. For medicine, your best bet is to bring your own on call days.
    St. Paul - Ask at the surgery desk. The people there are generally very helpful.
    Baylor - Forget it. Residents wear royal blue monogrammed.

    15

    COMPUTING
    Parkland Computer Access
    QUICK TIPS:
    1. FOR PASSWORD RESETS, CALL:
    PHHS: 25999 UTSW: 87600 ZLUH:86241
    2. Beware on rounds if you just check Oacis because as soon as you say labs
    aren't back, someone is going to ask if theyre in the computer (been poised)
    or have they been collected. Oacis won't tell you, only POIS will.
    3. Also POIS seems to get lab results quicker than Oacis, so you pretty much
    have to check both Oacis and POIS each morning before rounds to make sure
    you have all their info. Netware-This is the network used by Parkland. The
    computers are generally logged in at all times. If you have to log onto a cold
    computer, just ask the HUC for that floor's login.
    Oacis (CDR: Clinical Data Repository)
    Login: Same as Groupwise login
    Password: Not picky. For CDR password problems, call 8-7600. Press 1. Call
    Help Desk for support. PHHS: 25999 UTSW: 87600 ZLUH:86241
    Used for: Lab results, EKGs (back to 10/1999), radiology, discharge
    summaries, and pathology reports.
    Shortcomings:
    Lab values slower than POIS to return from the lab.
    Microbiology/cultures not yet available and must be accessed through
    POIS.
    Old records may be accessed using the old-style dumb terminals or by
    going to Medical Records to retrieve old records.
    To access/use program: Select the 'Oacis' icon on the desktop OR look in the
    'Start' menu under "Clinical Applications."
    1. Input your Sign On ID in the Name field, then hit Tab.
    2. Type your password in the Password field, then press Enter.
    3. Your current Pt list should come up.
    Keeping Track of Patients:
    1. On any roster, click Pt. List
    2. Search by either name or MRN (MRN works better) and press Enter to
    begin search.
    3. Click on the desired patient, then click the arrow to add to your current
    roster. Click OK.
    Keep track of labs/studies:
    1. New/unviewed labs and studies appear in bold.
    2. Filtering: click on one lab value (Hematocrit, etc.) to highlight it, then go to
    "filters" in the upper left corner of the screen, and then click on the drop down
    menu that comes up and set it to the "=" sign. Oacis will give you a sequential
    listing of that one value (HCT, etc.) for every date it has. It's an easy way to
    watch the trends on pt's labs over time without having to scroll down through
    all the other values you don't care about.

    16

    Logging off: Sign off before leaving a workstation! Leaving a workstation


    signed on is a violation of UTSW's security policy!
    POIS: (The Parkland Order Information System)
    Login: "MS*####" where * equals year of graduation and
    #### equals last 4 of SS#
    Password: Picky. Your password will be given to you in your student
    mailbox 2nd year or at the tutorial session. Password resets after every few
    months. 6-8 characters (letters + numbers). Call Help Desk for support.
    PHHS: 25999 UTSW: 87600 ZLUH:86241
    Used for:
    1. Lab values (return from the lab the FASTEST).
    2. The best way to get microbiology/culture.
    3. Get census information (list of patients by Service/Floor).
    4. POIS will also tell you if a lab has been ordered, collected, or received in
    the lab. This is also the system used by the HUCs for entering lab orders, so
    you may hear about your orders being 'poised'.
    5. MICROMEDEX function is a great drug information program.
    Shortcomings:
    This system is extremely moody. It is very bad about locking up when trying
    to scroll through lab values. If it locks up on you, sometimes pressing the ESC
    key anywhere from once to thrice will unlock the screen. If not, the only
    option is to close the application and open it again.
    To access program: Select the 'POIS' or 'Extra' icon on the desktop. OR
    Look in "Start" menu under "Clinical Applications."
    1. 'NC-ACCESS'. Is what you should see after selecting POIS. If you are
    unable to log in at this screen, call 590-5999.
    2. Input your Sign On ID.
    3. Hit tab (NOT enter!!) to advance to next line.
    4. Input your Password.
    5. Press enter, and hopefully you are in!
    If the computer locks up, don't panic or turn it off. A small clock icon appears
    at the bottom of the screen when the system is busy. The esc key should cancel
    the current function. If this does not work and you have waited a long time,
    close the POIS window and log in again.
    Keeping track of pts:
    There are several ways to find information on a particular patient. First, if you
    know it, you can do a search by MRN, which pretty much always works. If
    you know what ward the patient is on, you can use the NURSING CENSUS
    menu and select a patient by location. A fantastic feature for keeping track of
    who you are supposed to be keeping track of is the CENSUS function. You
    will need to know the 'service code' for your team, but you can look it up in
    POIS. This will give you a list of all patients in the hospital assigned to your
    service. If you find a patient on your list that doesn't belong, call Bed Control
    (ADT).
    Keeping track of Labs/Studies: You will need to access a patient file by
    location or MRN to see lab results. Once you have selected a patient, you can
    chose a number of options, including PATIENT PROFILE (will give MRN,

    17

    age, location), LABORATORY RESULTS or NON-LAB RESULTS, where


    you can see radiology reports. To specifically view microbiology reports, first
    go to LABORATORY RESULTS then select MICROBIOLOGY (a little
    arrow will appear next to the word) then the time frame during which the labs
    were DRAWN (if you have a culture that is a week old, use the past 7 days
    feature) then hit ENTER. Other specific lab results can be accessioned in a
    similar way by choosing what you want to view. You may have to scroll
    through several pages.
    Logging off: If you forget to sign off and try to log in at a new terminal - you
    will have to FORCE it. This means going through steps above under "If YOU
    CAN'T START POIS", and at the prompt where you would follow step 5 you
    type 'FORCE' instead. This removes you from the old terminal and allows you
    to sign on again, so repeat steps 1-6 as usual.
    Dumb Terminals: (Found mainly in the ER, MICU, CCU, and L&D)
    These computers are relics of the modern age and should be in a museum. Some
    of the computers have no light pen or mouse - but you need them to locate ER
    patient info that doesn't appear on the POIS system and patient information
    greater than about 18 months old. These things are amazing. They are archaic
    yet you have to use them to get old path reports sometimes. I think you can still
    find stuff on Kennedy in them. Just memorize the next 6 things. There is no
    logic to this system.
    To access/use program:
    1. At logon prompt type '333'
    2. The password is 'PMH'
    3. At the prompt type 'PR' to get lab results or 'AI' to get path reports
    4. You can use either the medical record number or patient's name
    5. Type 'A,A' and hit return to get lab results, the most recent first, for ALL
    admissions.
    6. Type 'X' to exit the system
    ACIS: This system is currently in use in the COPC only. Current plans are to
    extend this system to the Emergency Department and other outpatient clinics.
    CIMS (Cardiology Information Management System): Contains echo
    results, electrophysiology reports, etc. This system is currently accessible by
    residents but not students. Ask your resident for their login as you won't have
    one.

    VA Computer Access
    CPRS:
    1. The computer system at the VA is comprehensive and easy to use.
    2. "Cut and paste" daily progress notes.
    3. Pay attention when they talk about making out your template for progress
    notes. If you spend some time on your template you can make the computer
    enter a lot of information for you automatically. It will save you time in the
    long run.
    Login/Password:

    18

    1. Access Code: Assigned.


    2. Verify Code: You pick it on the first day.
    3. Signature Code: You pick it on the first day.
    Used for:
    Everything except actual radiology images and cards stuff (ECHO, etc.)
    What's useful to find under each tab:
    Coversheet: Allergies, vitals (click on to see trends), clinical appointments,
    health maintenance
    Problems: Acute problems (PRETTY WORTHLESS)
    Meds: Active meds, inpt meds, outpt meds, expired meds
    Orders: All orders; particularly note diet, IVF, meds, labs ordered, imaging,
    consults (LOOK AT TO SEE WHAT IS BEING DONE TO YOUR PT)
    Notes: Progress notes, some consults (also look under Consults tab)
    Consults: Consults (also look under Notes tab)
    D/C Summaries: Self-explanatory (KEY FOR H+P)
    Labs: Labs, micro, path
    Reports: Imaging (See BRIT for actual images), path
    Shortcomings:
    1. No radiology images.
    2. No cards stuff (ECHO, etc.)
    To access/use program:
    1. Select 'CPRS' on desktop
    2. Enter Access Code + Verify Code
    Keeping track of pts: Learn during tutorial or ask a resident.
    1. When you select a new pt, a pop-up box will appear (to quick select a
    patient, enter *####, where * is the first letter of their last name and #### are
    the last four digits of the SSN.
    2. You can choose a roster based on provider, specialites, teams, etc.
    3. Enter which ever roster you would like to use
    4. Click on 'Save Pt List Settings'
    5. Now when you choose a new pt, the roster will show up
    Making a template:
    1. Click on the 'Notes' tab at the bottom of the page.
    2. On the Toolbar, click on 'Options'
    3. Click on 'Edit Template'
    4. Click on 'Shared Templates' or 'Create a New Template'
    5. Choose a name
    6. Start typing in the text box below
    Note: You can have the meds + vitals automatically show up each time you
    use the template. To do so,
    a. Go to the Toolbar and click on 'Edit'
    b. Then click on 'Insert Pt Data (object)'
    c. Click on any of the desired fields
    Using a template:
    1. Under the 'Notes' tab, click on 'New Note' at the bottom left
    2. Click on 'Templates'
    3. Double-click on the desired template and start typing

    19

    Logging off: Sign off before leaving a workstation! Leaving a workstation


    signed on is a violation of VA's security policy!
    BRIT: (radiology image viewer) BRIT is available on select computers. The
    bigger and newer the monitor, the better you will be able to see images. There
    is a common USER ID/Password. You will get this during orientation. Select
    pt based on last name or quick ID (first letter of last name + last 4 SS#)
    Choose which imaging sets you would like to see by clicking on the pictures or
    sets.

    Children's Medical Center Computer Access


    TecSys: This is a relatively new computer system for CMC. You will be
    given a username and password during the first week of your rotation. The
    system is fairly easy and straightforward to use. If you need further help and
    support call the Help Desk at 4636.
    Clinical Systems 2 (Blue Screen): Ask resident for ID/PW; use to track lab
    values and find patients. From the opening screen hit F12 and enter the MRN.

    PDAs and Handheld Computers:


    Recent years have seen a surge in the use of PDAs and handheld computers in the
    medical field. As you travel through the various hospitals, you will see PDAs
    used for correct dosing for drugs, determination of potentially dangerous drug
    interactions, patient tracking, differential diagnoses, ensuring one does not miss a
    very important meeting and of course, games. There are literally dozens, if not
    hundreds, of medical programs for Palm and PocketPC omputers. A DRUG
    REFERENCE IS ESSENTIAL. Other popular items include document readers
    (iSilo et al) with hundreds of free medical texts, medical calculators and patient
    trackers available. If you are electronics and gadget minded, you have probably
    already decided to get one and are in fact, reading this information right now on
    your PDA. Below is a listing of websites to browse for medical applications and
    non-medical applications.
    www.epocrates.com: Free drug reference with automatic updates.
    www.pdarounds.com: Site started by UTSW grads with a compendium of
    medical and non-medical PDA software with reviews
    www.eponyms.com: a great downloadable program with searchable eponyms,
    but also a link to Andrew Yees Medical Palm Info page, which has just about
    every possible medical PDA site! A great resource!
    www.healthypalm.com: a repository of medical applications.
    www.palmgear.com: another mega repository of palm programs, medical and
    non-medical alike.
    www.skyscape.com: popular titles (5Min Clinical Consult, Harrison's)
    www.iSilo.com - document reader (faster than Acrobat)
    www.pdamd.com: PDA software for sale
    www.handheldmed.com: PDA software for sale
    www.meistermed.com/isilodepot - tons of free stuff. Great resource.

    20

    The Internet
    If youve made it this far, chances are youve done just a teeny weeny bit of web
    surfing. Chances are, you rely on email. Chances are, you carry out some
    essential aspects of your life online. Online research is the new trend in medicine,
    and thanks to a variety of services, you can access everything from textbooks to
    drug packaging inserts online. It is definitely advisable to become familiar with a
    couple of sites for your research purposes; you will find current patient care
    information, an easy format to find exactly the information youre looking for,
    and probably save a trip to the library of thumbing through textbooks. Below are
    just a few useful sites; this is truly just the tip of the iceberg!
    www.mdconsult.com: Reference textbooks, full-text journals, complete drug
    information, ability to save searches. A great resource! This is a service that
    normally costs about $200 a year, but students can get an account via the
    school library. Account set-up information at UTSW library website.
    www.ncbi.nlm.nih.gov: the NIH medline search site. There are a variety of
    other ways to access medline, but this one works!
    www.uptodate.com: Truly the most up-to-date medicine available on the web.
    This in a subscription service that you will find many residents utilize. It is
    one of the most comprehensive resources available! Cost: $200 a year. There
    is one computer terminal in the library with a hard version (not web version,
    not updated as often); otherwise youll just have to subscribe or find someone
    to log you on! The VA has an institutional subscription when youre
    theremake sure to use it!
    www.merck.com/pubs : the Merck manuals online. Free. Very useful.
    www.freetranslation.com: translate from English to Spanish (or other
    languagesjust in case you have a patient who speaks exclusively
    Norweigian). Check it out just to amuse yourself in the wee hours of the night.
    www.nejm.com: The New England Journal of Medicine. Good source for
    review articles. Access account available upon request with UTSW library.
    Some other sites to check out in your spare time:
    www.scutwork.com
    www.medfools.com
    www.ECGlibrary.com
    www.amsa.com
    www.studentdoctor.net
    www.medicalstudent.com
    www.flash-med.com
    www.booksmd.com
    www.Emedicine.com
    www.studentdoc.com
    www.qfever.com (the Onion for med people!)

    21

    HOSPITAL INFORMATION

    UT SOUTHWESTERN PHONE NUMBERS


    Blood and Body Fluid Exposure (Students)
    Campus Pharmacy (Aston)
    Computer Services
    Financial Aid Office
    Learning Resource Center
    Library (M-Th 7a-12a, F 7a-10p, Sat 9a-6p, Sun 1p-10p)
    Parking Services
    Registrar
    Student Affairs Office
    Student Health Center
    Student Store (M-F 7:30a-4:30p)
    Student Center
    UT Police Department
    UT Police - Emergency
    UT Southwestern Information / Operator

    214 588-6263
    648-2422
    648-6500
    648-3611
    648-2607
    648-2001
    648-9600
    648-3606
    648-2168
    648-3320
    648-3615
    648-3578
    648-2081
    648-8911
    648-3111

    LOCAL HOSPITAL INFORMATION NUMBERS


    Aston Center
    Baylor University Medical Center
    Charlton Methodist Hospital
    Childrens Medical Center
    John Peter Smith Hospital
    Medical City Dallas
    Methodist Hospital
    Parkland Memorial Hospital
    Presbyterian Hospital
    UTSW University Hospital St. Paul
    Terrell State Hospital
    Texas Scottish Rite Hospital
    Timberlawn Psychiatric Hospital
    UT Health Center at Tyler
    VA Med Center (214-SIC-VETS)
    UTSW University Hospital - Zale Lipshy
    22

    214 648-3111
    214 820-0111
    214 947-7777
    214 456-2000
    817 429-5156
    972 661-7000
    214 947-8181
    214 590-8000
    214 345-6789
    214 879-1000
    972 524-6452
    214 521-3168
    214 381-7181
    903 877-3451
    214 742-8387
    214 590-3000

    PARKLAND MEMORIAL HOSPITAL


    5201 Harry Hines Blvd., Dallas, TX 75235

    214 590-8000
    On campus:
    Dial a '2' before all Parkland extensions.
    Dial an '8' before all UTSW extensions.

    General Information
    ATM machines are located at UTSW, Parkland McDonald's, and
    CMC.
    Checks can be cashed at Children's or UTSW.
    Call Rooms: Codes will be given during orientation.
    Medicine: 2 rooms on 8W.
    Surgery: 1 room on 2E (day surgery).
    OB/Gyn: 1 room on 3N.
    Lockers: During surgery and ob/gyn you will be assigned a shared locker. There
    are lockers that have been donated by various groups and are located in the
    surgery call room and other parts of the hospital. These are first come first serve
    and generally should be used only for the rotation that you are on.

    RTAS (for dictated radiology reports)


    Call 6640. Press 1 to listen to reports or 2 for instructions. Enter the
    patient's 7 digit medical record number (omit leading zeros) and then
    the # key. The most recent dictation will play first.
    - # speeds up, * slows down playback (may be pressed repeatedly)
    - 2 to pause, 3 to resume, 49 to go directly to impression (if available)
    - 77 to rewind to beginning of report and begin playback
    - 8 to skip to next report, #5 to disconnect

    PMH PHONE NUMBERS dial 2 before all extensions


    STAT Page Operator
    Police/Fire Emergency
    Police Non-Emergency

    7890
    8104/8105
    8496

    Emergency Rooms
    Medicine
    Ob/Gyn
    Psychiatry
    Surgery/Trauma

    8824
    8145
    8761
    8108
    8630

    Page Operator
    23

    Parkland Memorial Hospital

    Emergency Numbers

    Parkland Inpatient nursing and physician stations


    Floor
    2nd

    Location
    2 North

    2 East
    2 West
    2 South

    3rd

    4th

    5th

    6th

    7th

    8th

    9th

    2 South South
    3 North
    3 East
    3 West
    3 South

    3 South South
    4 North
    4 East
    4 West
    4 South
    4 South South
    5 North
    5 East
    5 West
    5 South
    6 North
    6 East
    6 West
    6 South South
    7 North
    7 East
    7 West
    7 South
    7 South South
    8 North
    8 East
    8 West
    8 South
    8 South South
    9 North
    9 East

    Service
    SICU A(Neurosurgery)
    SICU B (Thoracic)
    SICU C (surgery/trauma)
    SICU D (surgery/trauma)
    Day Surgery
    General Surgery
    OR Scheduling
    OR Main Office
    Recovery
    Doctors' Lounge
    Day Surgery
    OB/Gyn
    OB/Gyn
    OB/Gyn
    Newborn Nursery
    L&D East (low risk)
    L&D West (high risk)
    L&D Triage
    Special Care/NNICU
    OB
    OB
    Gyn-Oncology
    Newborn Nursery
    OB Receiving Unit
    Surgery Specialties
    Neurosurgery
    Orthopedics
    High Risk OB (antepartum)
    Burn ICU
    Burn Acute Care Unit
    General Surgery
    GI Lab
    Private patients (insurance)
    Oncology
    General Research Center
    General Surgery
    Diabetes/Endocrinology
    Psychiatry
    PM&R
    Neurology / Stoke
    Acute Stroke Unit
    Neurophysiology
    Epilepsy Monitoring Unit
    Medicine ICU
    Infectious Disease/Isolation

    24

    RN
    6100
    6216
    6212
    6201
    7240
    7285
    8257
    8251
    8549
    ---8746
    7340
    7345
    7348
    4050
    7381
    8376
    8360
    6500
    7400
    7434
    7496
    4050
    7468
    7580
    7585
    7593
    7590
    7635
    7650
    7678
    8839
    7700
    7735
    8751
    7775
    7798
    6133
    8139
    7840
    7879
    7879
    8834
    6142
    7900

    MD
    ------------7242
    7287
    ------8466
    ---7340
    7347
    7347
    ---------------7419
    7439
    7499
    7459
    8382
    7582
    7587
    7593
    7635
    6154
    7652
    7679
    ---7719
    7737
    ---7777
    7797
    6137
    7802
    7842
    ------6110
    7902

    9 West

    10th

    9 South
    9 South South
    10 East
    10 West
    10 South
    10 South South

    Medicine/Telemetry/23hourobs
    Medicine/Pulmonary
    Geriatrics (GEM)
    Renal Transplant
    Acute Hemodialysis
    Telemetry
    Monitoring Room
    CCU
    Cardiovascular Lab
    Nuclear Cardiology
    Cardiac Rehab

    7910

    7912

    7905
    7915
    7000
    7005
    7010
    7017
    7040
    8395
    8395
    8236

    7907
    1442
    7002
    7005
    7012
    -------

    Parkland Outpatient Clinics/ACC Clinics


    Amelia Court
    Parkland Nutrition
    1st floor
    2nd floor
    3rd floor
    4th floor
    4 South
    5th floor
    6th floor

    Nutrition
    AIDS/HIV
    ACC
    Breast Screening
    Orthopedics
    Psychiatry
    Ob/Gyn
    Ob Screening
    Oncology
    Ophthalmology
    Pedi Fast Track
    Oral surgery/Dental
    Dermatology
    Kidney Transplant
    Surgery
    Epilepsy

    5478
    5647
    5479
    5512
    5616
    5524/5218
    5536/5267/5268
    5560/5306
    7380
    5582
    5499
    8835
    5489
    5686
    5656
    5685
    5689

    Parkland Center for Internal Medicine (7th Floor C/D Clinics)


    For nursing issues, nursing visits:
    Randal Dygert, RN (Blue team)
    25715
    Mary Young, RN (Red team)
    25661
    Virginia Darden, RN (Green team)
    25716
    Annie Andrews, RN (Yellow team)
    25661
    Cheryl Petr, RN (Charge Nurse)
    20050
    For interim visits, short-term or hospital follow ups, procedures:
    Tina M. Kaufman, PhD, PA-C (Blue/green teams)
    25390
    Sara Wick, GNP (Red team)
    25741
    Christi Bartz, PA-C (Yellow team)
    25666
    For diabetic education: Sue Friberg, RN, CDE
    25696
    For nutritional counseling/education: Sheral Cade, RD, CDE
    25719
    For medication counseling: Elizabeth Moss, PharmD
    28209
    For Social Work: Janis Moore, SW (<60 years)
    28164
    Loretta Jackson, SW (>60 years)
    28164
    For administrative issues:Charla Edwards, UM
    25575
    For appointment scheduling: Ruby Wimley
    28753

    25

    214-786-3310
    214-786-2638
    214-786-2142
    214-786-2266
    214-786-0380

    214-786-8074
    214-786-1881

    Parkland Laboratory Information


    Blood Bank/Transfusion Services
    Lab Central (all general lab results)
    Cytogenetics lab
    Cytology
    Flow Cytometry
    Hematology
    Histology
    Immunology/Serology
    Microbiology/Mycology
    Molecular Diagnostics
    Outpatient Clinic Lab
    Phlebotomy
    Phlebotomy Coordinator
    Special Coag Lab/Bone Marrow
    Surgical Pathology (in OR)
    Toxicology
    Virology (Dr. Luby's lab)

    8211
    LABS (5227)
    8-3782
    8743
    8-4078
    5227
    8237
    8571
    5426 / 5420
    8-4075
    5423
    6687
    6648
    8-0203/80204/80205
    8691
    LABS (5227)
    8-3635

    Parkland Radiology Information


    Central Number
    Body CT reading room
    Bone reading room
    Chest reading room
    GI reading room
    Neuro reading room
    Special Procedures reading room
    Ultrasound reading room
    Angiography suite (visceral)
    Angiography suite (Neuro)
    CT Scan
    CT Fax
    CT scheduling
    Echo results
    File Room
    Fluoroscopy suite
    Interventional Radiology Scheduling
    Mammography
    MRI (Meadows at Aston)
    MRI (Meadows dictation reports)
    MRI (Rogers at North Campus)
    Nuclear Cardiology lab
    Nuclear Radiology (V/Q, bone scans)
    Ob Sonogram
    Outpatient Radiology Scheduling
    Portable Film Requests

    26

    8596
    6669
    8679
    8720
    8677
    8712
    8919
    6668
    6798
    6459
    8413
    2622
    0062
    7165
    8682
    8555
    6798
    5071
    4525/4500
    5898/6640
    8-5800
    7176/8395
    6363/5120
    5578
    8582
    8596

    Parkland Radiology Information - continued


    Radiologist paging
    Radiologist on call
    RTAS (dictation)
    Special Procedures
    Transcription
    Ultrasound
    Ultrasound Fax
    X-Ray Therapy (Radiation Oncology)

    8500
    8023
    6640/6641
    1629
    8412
    8474
    6927
    8-2296

    Parkland: Collections
    All lab specimens are taken to Central Receiving on the ground floor
    (South). Remember to time, date and initial all blood specimens and obtain
    a requisition slip for each specimen/lab order.
    Phlebotomy services: There are several daily blood draws. Orders must be
    poised in the computer approximately two hours prior to scheduled draw
    times. Stat/special timed orders must be drawn by your team. All blood
    cultures must be drawn by your resident, intern or you. Lab draws are as
    follows:
    0200 Women's Services Only
    0330 NNICU, CCN
    0500 Internal Medicine
    0600 Surgery
    0700 Women's Services (Mothers only)
    0730 Womens Services (Babies only)
    0930 Surgery, Medicine, and Women's Services
    1130 Surgery, Medicine, and Women's Services
    1230 Womens Services (Babies only)
    1430 Surgery, Medicine, and Women's Services
    1600 Womens Services (Babies only)
    1800 Surgery, Medicine, and Women's Services
    2100 Surgery, Medicine, and Women's Services
    2330 Surgery

    Parkland: Other Essential Information


    ADT (Bed Control)
    8920
    Anesthesiology and Pain Management
    8329
    Appointment Desk (Outpatient Services)
    5555
    Autopsy/Pathology
    8-6344/6693
    Alcohol/Drug Counseling
    8770
    Alcoholics/Narcotics Anonymous Referrals
    2783
    Business Office
    8566
    Cardiac lab (Electrophysiology)
    5055
    Cardiac lab (Cardiac cath)
    8617
    Cardiovascular Lab (TEE, ECHO, Holter, MUGA) 8395
    To make appt.
    7169
    Central Supply
    5440
    Chaplain
    8512
    Computer Help Desk (POIS, Oacis)
    5999

    27

    Parkland: Other Essential Information - continued


    Diabetic Foot Nurse
    Dietary Services
    Drug Information Center
    Electroencephalography(EMG, Sleep Studies)
    Electrocardiography (inpatient EKG)
    Epilepsy Outreach Program
    Epilepsy Monitoring Unit
    Geriatrics
    GI Lab
    Hemodialysis
    Home Care Program
    Housekeeping
    Hydrotherapy/PM&R
    Infection Control
    Interpreters
    Medical Records
    Medical Records Fax
    Nutrition
    Page operator (in house)
    Page operator (outside PMH)
    Pastoral Care
    Pathology Administration
    Pathology Results
    Pathology Results (FNA/Cytology)
    Patient Food Services
    Patient Advocacy/Information
    Patient Relations
    Patient Transport
    Pharmacy (inpatient)
    Pharmacy Administration
    Physical Medicine & Rehab (PT,OT,Speech)
    Pulmonary Function Lab
    Respiratory Therapy
    Residents Library Fax
    Security (escorts)
    Social Services
    Transplant Services
    Urology
    Vascular Lab (at Aston)

    Other important numbers

    28

    5449
    8186
    8210
    8334
    8414
    8878
    8834
    7470
    8839
    7005/5793
    8295
    8161
    8139
    8127
    8945
    5455/6540
    5402
    5479
    8630
    214 590-5901
    8512
    8661/8662/5414
    8686
    8743
    8186
    8153
    8945
    2255
    8711
    8714
    8139
    8167
    8193
    6994
    8496
    8164
    5656
    6307
    8-2926

    CHILDREN'S MEDICAL CENTER


    1935 Motor St., Dallas, TX 75235

    214 456-2000 (operator)


    General Information
    ATM machine is located on the first floor near the admission desk. The
    second is located on the fourth floor of the Bright building adjacent to the
    Skybridge.
    Checks can be cashed at the cashier's window nearby.
    Phones: CMC phones require only the four-digit extension when in house.
    Call Rooms: The students share the resident call rooms on the first floor
    near the ER. There are two rooms and two showers. Plus a small library.
    CMC IDs are required for access.
    Rotation Info: Dr. Mihalics secretary Del. She can be reached at 2730.

    CMC EMERGENCY NUMBERS


    STAT page operator
    Security
    Emergency Room

    5060
    2889
    5100/2100

    Childrens Floor Listings


    5100
    8796
    2033
    2022
    2333
    2044
    7600
    2972
    2972
    2055/5900
    2793/7688
    2060
    7600
    2333
    7870
    7256

    Childrens Laboratory Information


    Main Lab
    General
    Chemistry
    Hematology
    Histology
    Metabolic

    6300
    2321
    2321
    2320
    2318
    6130

    29

    Children's Medical Center

    1st Floor ER
    Starbucks/Whistle Stop
    2nd Floor Pedi ICU
    Surgery
    3rd Floor Cardiology
    th
    4 Floor General Peds
    5th Floor General Peds
    Renal
    GI/Liver
    Psychiatry
    Sleep/Epilepsy (EMU)
    6th Floor General Peds
    th
    7 Floor General Peds
    8th Floor Cardiology
    9th Floor
    10th Floor Heme/Onco Ward
    Heme/Onco Treatment

    Childrens Laboratory Information - continued


    Microbiology
    Pathology
    Scheduling

    2316
    2322
    2319

    Childrens Outpatient clinics


    Note: These numbers and locations are subject to change due to ongoing construction.

    Ground floor
    1st Floor
    2nd Floor

    Resident/Medical Student Clinic


    Emergency Room
    GI
    Liver Transplant
    Surgery
    3rd Floor
    Cardiology
    Neurosurgery
    th
    4 Floor
    Down Syndrome
    Genetics/Metabolism
    Neuro Oncology
    th
    5 Floor
    Hemodialysis
    Nephrology
    Peritoneal Dialysis
    Renal
    Sleep
    Specialty Gynecology
    6th Floor
    Hematology
    Oncology
    Ophthalmology
    Sickle-cell
    Bright Building ARMS (AIDS/HIV)
    Lobby
    Adolescent clinic
    Genetics and Metabolism
    Down Syndrome
    Dermatology
    Low Birth Weight
    REACH
    st
    1 floor
    Hematology/Oncology
    Orthopedic Clinic
    2nd floor
    Asthma /Immunology
    Cystic Fibrosis Clinic/ Medical Chest
    Endocrine
    Rheumatology
    3rd floor
    ENT
    Audiology
    Voice Disorders
    Bank One Bldg Craniofacial
    Dental
    Urology
    Plastic Surgery

    30

    2844
    5100
    8000
    8412/8600
    2766
    2333
    6660
    2357
    2357
    6139
    2780
    2980
    2983
    2980
    2793
    2980
    2382
    2382
    2383
    2382
    6500
    6500
    7978
    7978
    5030
    6500
    6134
    2382
    7697
    2084
    2361
    5959
    5648
    2386
    6178
    6177
    8888
    8800
    2444
    8888

    Childrens Outpatient clinics - continued


    Speech Pathology
    Neurology
    Psychiatry

    8710
    2768
    5900

    Childrens Other Essential Numbers


    Admissions
    Anesthesiology
    Asthma Education
    Asthma Clinic
    Asthma Care
    Cardiology
    Cath Lab
    Chaplain/ Pastoral Care
    Child Life
    Critical Care/ ER
    CT/MRI scheduling
    Day Surgery
    Dietary
    ECHO
    Electroencephalography (EEG)
    Electrocardiography (ECG)
    Foster Care
    Interpreters
    Low Birth Weight
    Medical Records
    Medical Records File Room
    Nuclear Medicine
    Nutrition
    Occupational Therapy
    Operating Rooms
    Orthopedics
    Outpatient referral
    Page Operator
    Pharmacy
    Pharmacy-outpatient
    Physical Therapy
    Pulmonary Function Lab
    Radiology
    Resident Clinic
    Respiratory Therapy
    Social Work
    Urgent Care
    Weight Guidance
    Young Adult Clinic

    31

    2191
    6393/6041
    2516
    2084
    8153
    2333
    2330
    2822
    6280
    8649
    2849
    2388/2078
    2177/2182
    2327
    2740
    2326
    6134
    6272/6290
    6500
    2505
    2509
    2815
    2178
    2778
    2022
    7697
    1-800-CHILD
    0
    6209
    2879
    2778
    2763
    2305
    2844
    2762/2760
    2300
    2100
    2554
    6500

    UT SOUTHWESTERN UNIVERSITY
    HOSPITAL ZALE LIPSHY BUILDING
    5151 Harry Hines Blvd., Dallas, TX 75235

    Zale General Information


    Food:
    The cafeteria is located on the ground floor.
    M-F breakfast
    6:30am-9:00am
    M-F lunch
    11:00am-1:30pm
    Gourmet pasta buffet on Friday at noon is excellent !
    The convenience store is located on the ground floor.
    M-F
    9:00am-7:00pm
    ICU
    Psychiatry
    Neurosurgery/Ortho
    Med, Surg, Telemetry
    Oncology

    3300
    3400
    3500
    3600
    3700

    Radiology: Located in the basement. To check out films, you will need to give
    attending name and resident pager number.

    Zale: Other Essential Numbers

    ZZale Lipshy Building

    Admissions
    Anesthesia
    Angiography
    Bed Control
    Cardiac lab

    3134/3182
    3230
    3232
    3182
    8617
    (at PMH)
    Cardiovascular Lab 8395
    (at PMH)
    Day Surgery
    3200/3210
    Infection Control 3144
    Laboratory
    3350
    Medical Records
    3140
    Micro Lab
    3358
    Nutrition Services 3965
    OR Scheduling
    3251

    Pastoral Care
    3160
    Pathology (surgical) 3239
    Patient Information 3132
    Pharmacy
    3992
    Pharmacy
    648-2422 (at
    Aston)
    Physical Therapy 3823
    PACU
    3220
    Radiology
    3970
    Rehabilitation
    3800
    Respiratory Therapy 3363
    Security
    3130/3888
    Social Work
    3141
    Tumor Registry
    3545
    Volunteer Services 3192

    Note: Zale does have an automated telephone system for dictated radiology
    reports. However, individualized passwords are required (none are assigned to
    students).

    32

    3500 Gaston Ave., Dallas, TX, 75246

    214 820-0111

    General Information

    214 590-3000

    Floor Listings
    3rd Floor
    4th Floor
    5th Floor
    6th Floor
    7th Floor

    BAYLOR UNIVERSIT

    ATM Access: There is an ATM mac


    Checks can be cashed with the cash
    Food: Menu line (2-MENU)
    The cafeteria is located in the basem
    Hours:
    Daily 6:30amBake Shop is located next to the ca
    Hours:
    M-F 6:00am-7
    Atrium Cafe is located in the lobby
    Hours:
    M-F 11:00amAtrium Too is a cart just outside the
    Hours:
    M-F 9:00pm-3
    Frullati is located in the lobby of B
    Hours:
    M-F 6am-8pm
    Sat 8am-4pm
    Call Rooms: The student call room
    Hospital Lobby. Keys to the call roo
    of the rotation. Every two call room
    Phones: The prefix for all phone nu
    Fax numbers: Check on individual

    Emergency Numbers
    Police
    Code Red
    Stat 13
    Dr. Heart
    Emergency Department
    Collins Hospital Nursing Stations
    4th floor
    4C
    7th floor
    7C
    Hoblitzelle Hospital Nursing Station
    2nd floor
    2H
    3rd floor
    3H
    4th floor
    4H
    6th floor
    6H
    Jonsson Hospital Nursing Stations
    2nd floor
    2J
    3rd floor
    3J
    4th floor
    4J
    5th floor
    5J
    AM Surgery
    5J
    6th floor
    6J
    7th floor
    7J

    VETERAN AFFAIRS MEDICAL CENTER


    4500 South Lancaster Road, Dallas, TX 75216

    214 SIC-VETS (742-8387)


    VA General Information
    ATM Access: There is an ATM machine located in the basement of Bldg. 2
    near the cafeteria, and another in the Clinical Addition/Canteen Mall.
    Food: The cafeteria is located in the basement of Building 2. Hours are MF 7am-2:00 pm. Store with food on ground level. Open 7AM-4PM.
    Coffee shop across from store, 7AM-4PM (sometimes closes earlier)
    Phones: Numbers beginning with 7 may be dialed directly from outside
    the hospital. To call 7xxxx, dial 214-857-xxxx. Numbers beginning with 4
    can only be dialed from within the hospital.
    Call Rooms: Student call rooms are located on the 5th floor of the clinical
    addition near the TICU. Access codes will be given out at orientation. It is
    difficult to get scrubs when on Internal Medicine, so you may need to
    supply your own.

    VA Emergency Numbers
    Cardiac Arrest
    Emergency Room
    Med. Eval./Triage
    Security
    Security Escort

    6911
    71975 / 71976/72036
    76288/76281/76282
    70411
    40134 / 40135

    VA Building 1
    2nd Floor
    rd

    3 Floor
    4th Floor

    Mental Health
    Mental Health
    Psych
    Psych
    Mental Health
    Drug Dependence
    Psych

    71610
    70787
    71610
    70786
    70838
    70835
    70790

    VA Building 2
    3rd Floor
    4th Floor
    5th Floor
    6th Floor
    7th Floor
    8th Floor

    3C
    4C
    5B
    5C
    6B
    7A
    7B
    8A
    8B

    Day Surgery/Metabolic
    Surgery (Specialty)
    Orthopedics
    Surgery Office
    Medicine
    GEM
    Pulmonary
    Surgery/Medicine
    Medicine Office

    33

    71614/71502/71615
    71629
    71819
    71800
    71642/71643
    71709/71710
    70405/71875
    71653/71654
    70409

    Veteran Affairs Memorial Hospital

    5th Floor

    2 North
    2 South
    3 North
    3 South
    4 North
    4 South
    5 North

    VA Clinical Addition
    5th Floor

    5A

    Medicine/Telemetry
    CCU
    MICU
    SICU
    TICU

    71653 / 71654
    72181 / 72182
    71659/ 71660
    71619 / 71620
    71625

    VA Radiology Information (3rd Floor Clinical Addition; 70170)


    CT
    File Room
    MRI 1
    MRI 2
    Nuclear Medicine
    Radiology
    Radiation Oncology
    Scheduling
    Ultrasound

    76052
    76080
    70190
    77239
    70130/70137
    70170/70171/70169
    70142
    70170
    76056

    VA Laboratory Information (1st Floor Clinical Addition)


    Bacteriology
    Blood Bank
    Central Receiving Area (CRA) / Main Number
    Chemistry
    Cytology
    Hematology
    Microbiology
    Pathology
    Serology
    Special Chemistry
    TB Lab

    70672
    70720
    70666 / 70714
    70699
    70687
    70686
    70672
    70677
    70260
    70671
    70676

    Blood draws are at 5AM and 1:15PM. Lab orders need to be written and
    posted on the computer by the HUC one hour before the blood draw. If you want
    labs to be drawn at another time, you must order the labs on the computer and
    may have to draw them yourself. Labs can also be added on (if the lab has extra
    blood) by ordering them on the computer, then calling the lab and requesting an
    add-on. All blood cultures must be drawn by you or your intern/resident. ABGs
    are drawn by Respiratory Therapy. Just write an order, and the HUC will page
    them. If you are in a hurry, you can draw the ABG yourself, page Respiratory
    Therapy, and they can meet you where you are or in the ER.
    There is a car system to transport specimens to the lab. Ask the nurses for
    the door codes. In Building 2, use the track on the left. Be sure to use the
    Biohazard cars for lab samples. If youre in a hurry, walk over to the labthe
    car takes a while to get there.

    34

    VA: Other Essential Information


    Admitting Office
    Anesthesiology
    Audiology/Speech Pathology
    Canteen
    Cardiology Office
    Central Supply
    Chaplain Services
    Clothing Room
    Corrective Therapy
    Dental Services
    Dermatology
    Drug and Alcohol Counseling
    Echocardiography
    Electroencephalography (EEG)
    Electrocardiography (EKG)
    ENT
    Exercise Lab
    Eye Clinic
    GI Lab
    GU
    Holter Monitor Lab
    Housekeeping
    Inpatient Pharmacy
    Library (3rd fl Bldg. 2)
    Medical Records (old charts)
    Mental Health
    Morgue
    Nutrition Services
    Occupational Therapy
    Operating Room
    Oral Surgery
    Orthotics Lab
    Patient Transport
    Pharmacy
    Physical Therapy
    Prosthetics
    Pulmonary Function Lab
    Pulmonary Function Scheduling
    Radiation Therapy
    Rehabilitation Medicine
    Respiratory
    Social Work Service
    Speech Pathology
    Spinal Cord Injury
    Transcription
    Transitional Care Unit A
    Transitional Care Unit B
    Vascular Lab

    71449/71380/71384
    71817
    70951/70959
    77121/77123
    71556/71578
    70044
    71070/71078
    70085
    71282
    71082/71083
    71369 / 71443
    70950
    71531/71491
    70112
    71568
    71334
    71569
    71640/71441
    71590/71591
    70364/71444
    70407
    70535 / 70086
    70556/70586
    71245/71251
    70055/71364
    70806 / 70805
    70688
    70065
    71304 / 71284
    71813 / 71814
    71097
    70089
    71554/71517
    70556/70586
    71280 / 71283
    70548/76143
    70405
    71601
    70141
    71279
    70405 / 40327
    70367 / 70369
    70951/70959
    71781/71782
    71400
    71713
    71716
    71808

    35

    VA Clinic Information (Clinics 1-4 on 1st floor, 5-9 on 3rd floor)


    Clinic 1

    71382
    71441
    71640
    71641
    Eye, Neuroophthalmology, Ophthalmology Screening,
    Optometry, Retina, Visual Fields

    Clinic 2

    71348
    71393
    Alpha, Bravo, Charlie

    Clinic 3

    71372
    72025
    71378
    Prime AM/PM, Prime Brief, Prime Nurse,
    Prime Urgent, Protime

    Clinic 4

    71393
    71314
    71312
    71737
    Agent Orange, Breast, Cardiology (Thu.), Gastro, Hem/Onc,
    ID, Interferon, Delta, Persian Gulf, PCC, POW,
    Rheumatology, Surg/Onc

    Clinic 5

    71443
    71369
    71652
    71658
    Allergy, Dermatology, Diabetes, Diabetic Foot, Geriatrics,
    Gyn, Lipid, Podiatry, Pulmonary, Wound

    Clinic 6

    71366
    71371
    71381
    Cardiology (Wed & Fri), Endocrine, Epilepsy, Muscle,
    Neurology, Renal, Sleep Eval..

    Clinic 7

    71439
    71368
    71380
    71665
    Amb Surgery, Back, Gen. Surg Major & Minor, Hip, Knee,
    Neurosurgery, Orthopedics, Plastic Surg, Thoracic Surg,
    Vascular Surg

    Clinic 8

    71334
    Ear, ENT

    Clinic 9

    70951
    70959
    Audiology, Speech

    5th Fl,
    Bldg 2

    71444
    Impotence, Prostate, Urology

    Clinic 8,
    Bldg 2

    71817
    Pain

    71359

    71513

    71986

    36

    71673

    BAYLOR UNIVERSITY MEDICAL CENTER


    3500 Gaston Ave., Dallas, TX, 75246

    214 820-0111
    Baylor General Information
    ATM Access: There is an ATM machine near Jonsson Lobby.
    Checks can be cashed with the cashier at the same location.
    Food: Menu line (2-MENU)
    The cafeteria is located in the basement of Truett.
    Hours:
    Daily 6:30am-8:00pm
    Bake Shop is located next to the cafeteria.
    Hours:
    M-F 6:00am-7:00pm
    Atrium Cafe is located in the lobby of Roberts Hospital.
    Hours:
    M-F 11:00am-2:30pm
    Atrium Too is a cart just outside the Atrium.
    Hours:
    M-F 9:00pm-3:00am
    Frullati is located in the lobby of Barnett Tower.
    Hours:
    M-F 6am-8pm
    Sat 8am-4pm
    Call Rooms: The student call rooms are located adjacent to Roberts
    Hospital Lobby. Keys to the call rooms will be distributed on the first day
    of the rotation. Every two call rooms share a bathroom and shower.
    Phones: The prefix for all phone numbers is 820. Dial 2 in-house.
    Fax numbers: Check on individual floors, as numbers change often.

    Baylor Emergency Numbers


    Police
    Code Red

    4444
    4444

    Stat 13
    Dr. Heart

    5000
    5555

    Emergency Department

    2505

    Collins Hospital Nursing Stations


    4C
    7C

    2744
    8304

    Hoblitzelle Hospital Nursing Stations


    2nd floor
    3rd floor
    4th floor
    6th floor

    2H
    3H
    4H
    6H

    2076
    6330
    4448
    2214

    37

    Baylor University Medical Center

    4th floor
    7th floor

    Jonsson Hospital Nursing Stations


    2nd floor
    3rd floor
    4th floor
    5th floor
    AM Surgery
    6th floor
    7th floor

    2J
    3J
    4J
    5J
    5J
    6J
    7J

    3414
    3404
    3406
    3676
    8088
    3555
    3124

    Roberts Hospital Nursing Stations


    6th floor
    7th floor
    8th floor
    9th floor
    10th floor
    11th floor
    12th floor
    13th floor
    14th floor
    15th floor
    16th floor

    6R
    7R
    8R
    9R
    10R
    11E
    12R
    13R
    14R
    15R
    16R

    2611
    3990
    3400
    4795
    3810
    3815
    3820
    3825
    3830
    3411
    3840

    Critical Care Nursing Stations


    2nd floor
    rd

    3 floor
    4th floor

    2 North ICU
    2 South ICU
    3 North ICU
    3 East ICU
    3 South ICU
    4 North ICU
    4 West ICU
    4 South ICU

    2856
    3256
    3391
    2247
    3391
    3222/3651
    7273
    3226

    Truett Hospital Nursing Stations


    2nd floor
    th

    5 floor
    6th floor
    7th floor
    OP Chemical

    2 East T
    2 West T
    OR
    6 East T
    6 West T
    7T
    Dependency

    7076
    7685
    2153
    3121
    3131
    2204
    3505

    Baylor Laboratory Information


    Lab Central (all general lab results)
    Bacteriology
    Blood Bank
    Central Collecting
    Cytochemistry
    Histology
    Immunology
    Microbiology
    Mycology
    Parasitology
    Pathology
    Pulmonary
    Special Hematology
    Virology

    3188
    3329
    3263
    3188
    3188
    2327
    3581
    3329
    2186
    3316
    2251
    2347
    3347
    2483

    38

    Baylor: Other Essential Information


    Admitting Office, room control
    Anesthesia Dept.
    Bone Marrow Unit / Bone Marrow ICU
    Breast Center
    Cancer Center
    Cardiovascular main (Heart Center)
    Cardiovascular lab (Cath Lab)
    Cardiovascular lab (TEE, Holter)
    Chaplain
    Diabetes Center
    Dietary (Therapeutic)
    Digestive Disease Center
    Electroencephalography (EEG) / Neuroscience
    Electrocardiography (EKG)
    Electrophysiology / MUGA
    Enterostomal
    ER radiology reading room
    Gastroenterology (Digestive Health Associates)
    GI Lab
    Home Care
    Internal Medicine Dept.
    Interpreters
    Labor & Delivery
    Landry Center
    Library
    Circulation Desk
    Medical Education
    Medical Records
    Nephrology
    Neurology
    Orthopedics
    Outpatient Clinic
    Page Operator
    Pharmacy
    PM&R (PT, OT, Speech therapy)
    Psychiatry
    Recovery Rooms
    Pre-op Holding
    Roberts Hospital
    Truett Hospital
    Resident Mail/TV Room
    Respiratory Therapy
    Social Services
    Speech Therapy
    Surgical Education
    Surgicare
    Transplant Services
    Urology

    39

    3327
    2165
    2744
    370-1900
    3445
    3333
    3236
    2456/4011
    2542
    2103
    3287
    3040
    3003
    2434
    2269
    2602
    3853
    2232
    3463
    4949/4663
    6202
    2833
    2126
    7800
    2372
    2377
    2361
    2135
    2350
    3003
    3434
    3275
    1600
    3611
    2683
    3505
    4926
    2720
    2237
    2330/2331
    3245
    3515
    2683
    4543
    2581
    2050
    824-0171

    Baylor: Radiology Information


    Main
    CT Scan
    File Room
    MRI
    Medical Imaging
    Nuclear Cardiology
    Nuclear Medicine
    RTAS (inpatient films)

    7440
    4067
    3207
    2310
    3216
    2187
    4057
    9729

    RTAS (for retrieval of dictated radiology reports)


    1. Call RTAS
    2. Type in the patients birthday (MM/DD/YYYY)
    3. Press 5 to get the next report, * for only the impression

    Baylor Echo Results


    1. Dial 214 828-5436
    2. Enter: #1
    3. Enter: 4 digit dictation number (your residents)
    4. Enter medical record number
    5. Stamp out disease.

    Other important numbers

    40

    UT SOUTHWESTERN UNIVERSITY
    HOSPITAL ST. PAUL BUILDING
    5909 Harry Hines Blvd., Dallas, TX 75235
    214 879-1000 (Calls to this number and calls made by dialing 0 in St. Paul
    are being answered by UTSW operators. Callers from UTSW can dial 4-digit
    extensions to St. Paul by first dialing by the access code 34. Callers from St. Paul
    UTSW 5-digit numbers can be reached after first dialing 381.

    General Information

    ATM Access: ATM is located on the 1st floor next to the POB Bldg.
    Food: The cafeteria is located on the 1st floor (Sun-Sat 6am-6:45pm)
    Call Rooms: Call rooms are located on the 2nd floor near the ER.

    Emergency Numbers
    Security/Safety

    2671
    2790

    Emergency Department
    Floor Listings
    Floor
    3rd Floor
    4th Floor

    5th Floor

    6th Floor
    7th Floor

    8th Floor

    5 East
    5 West
    5 South
    6 South
    6 East
    6 North
    7 North
    7 South
    7 East
    7 West
    8 North
    8 South
    9 North

    Service
    Med-Surg
    Oncology
    Med-Surg
    Rehab
    Day Surgery
    Section A Ortho
    Section B Surgery
    Nursery
    Labor & Delivery
    NICU
    CVICU
    Telemetry
    Telemetry
    MICU/SICU
    CICU
    CVTS

    Extension
    3031
    3030
    3037
    3041
    3040
    3047
    3447
    3051
    3156
    2150
    3051
    2154
    3060
    2160
    3061
    3071
    3060
    2170
    2175
    6318
    3080
    645-7727

    St. Paul Laboratory Information


    Admissions Department
    Blood Gases
    Breast Center, UTSW
    Histology
    Lab Results

    2770, 2062
    4241
    214-648-7010
    3670
    3695

    41

    St. Paul Building

    9th Floor

    Ward
    3 North
    3 South
    3 West
    4 North
    4 South
    4 West
    4 West
    5 North

    Outpatient Lab
    Pathology
    Pulmonary Function Lab
    Surgical Pathology
    Tumor Registry

    3390
    3888
    2595
    3663
    2600

    St. Paul: Other Essential Information


    Administration
    Anesthesia
    Blood Bank
    Cancer Center
    Cardiology
    Cath Lab
    Central Supply/Sterile
    Chaplain Service
    Beeper
    Clinic
    Internal Medicine
    Internal medicine clinic director
    Or 972/356-0099, +17076
    Nurses Station
    Code Blue
    Diabetes Center
    Doctors Dictation
    Durable Medical Equipment
    Echocardiography (ECHO)
    Electroencephalography (EEG)
    Electrocardiography (EKG)
    Beeper
    Emergency Room Dept.
    Emergency Registration
    EMG
    Employee Health
    Environmental Services
    ET Nurse
    Family Practice (Harvest Hill)
    Gastroenterology
    Graduate Medical Education (GME)
    GME-Family Practice Center SPUH
    GME-Family Practice UTSW
    GME-General Surgery
    GME-Internal Medicine
    Guest Relations
    Health Information (Dictation)
    Health Information (Med Records)
    Help Desk
    Housekeeping
    House Staff Lounge
    Human Resources
    Infection Control
    L&D Conference Room
    Lab-Hematology
    Lab-STAT

    42

    2280
    2246
    3688
    2146
    3895
    3895
    2587
    3870
    214/590-3424
    4988,4989,2771
    2888,2889
    3639
    2888
    77
    3285
    8888
    637-7455
    3898
    2397/2595
    2396
    214/362-1203
    2790
    2800
    2397
    2758
    3587/3586/8484
    2969
    972-789-1787
    3858
    3786
    972/789-1787
    214/648-8219
    6238,3788
    3788,8866
    2345/2085
    214/879-8888
    2285
    214/648-9333
    3586
    2785, 2786
    2660
    2296
    3127
    3677
    1455

    Laundry
    Lobby Information Desk
    Medical Affairs
    Microbiology
    Neurophysiology (EEG)
    Nutrition Services
    Nutrition Svcs Dial-A-Menu
    Osteoporosis Center
    Outcomes Management Dept
    Page Operator
    Patient Information
    Patient Registration
    Pharmacy
    Physical Medicine
    Professional Office Building Lobby Info Desk
    Psychiatry/Substance Abuse
    PsychLink Chemical Dependency Recovery Service
    Public Relations
    Pulmonary Lab
    Pulmonary Services
    Radiation Oncology
    Radiation Safety
    Radiology
    CT Scan
    MRI
    Nuclear Medicine
    PICC
    Sonogram
    Special Procedure
    Radiology reports
    Radiology-Meadows MRI
    Renal Dialysis
    Respiratory Dept
    Respiratory Therapy
    Risk Management
    Security/UT police
    Social Work
    Spanish Liaison
    Stress Center
    Surgery Operating Room
    Surgery Schedule Secretary
    Surgical Pathology
    Surgery Associates Office
    Telephone Operators (CTCS)
    Transplant Services
    Transport
    Womens Center

    43

    8484
    2103
    3753
    3684
    2397/2595
    2482
    3282
    3975
    3850
    7979
    2100
    2062/2770
    2690/2691
    3873
    8634
    7318/3080
    630-7285
    3056/3201
    2595
    2590
    2696
    2688
    2750, 2745
    4165
    2879
    2580
    6775
    4163
    4169
    214/879-8888
    214/590-4525
    3075
    1738
    2590
    3880
    214/648-8311
    3850
    3088
    3898
    2231
    2251
    3663
    3787, 3797
    214/648-8299
    6210
    3584
    3887

    PRESBYTERIAN HOSPITAL OF DALLAS


    8200 Walnut Hill Lane, Dallas, TX, 75231

    214 345-6789
    General Information
    ATM Access: There is an ATM machine on the first floor of the main
    hospital, near the lobby.
    Checks can be cashed with the cashier located next to the ATM.
    Food:
    Caf Presby is on the first floor of the main building.
    Menu Line
    Hours: Daily

    (Caf Presby only)


    x4237
    7:00am-10:00am
    11:00am-3:30pm
    4:00pm-12:30am

    Doctors Dining Room is on the first floor of the main building and has free
    drinks, yogurt, cookies, and string cheese. Code to enter the door is 214.
    French Garden Deli is located on the first floor of the Perot Center.
    Hours:

    M-F
    Sat

    7:00am-7:00pm
    8:00am-3:00pm

    Jackson Cafeteria is on the ground floor of the Jackson Building.


    Hours:

    M-F

    11:30am-1:30pm

    Wall Street Deli is on the first floor of Professional Building 3.


    Hours:

    M-F

    7:00am-4:00pm

    Taco Bell is on the first floor of Professional Building 3


    Hours:

    M-F

    11:00am-2:00pm

    Residents Lounge: The residents lounge is on the 9th floor of the main
    building. It has computer access, cable TV, and a pool table. To get in the
    door, turn the handle to reset the keypad, then enter 997722.
    Phones: The prefix for all phone numbers is 345. For in-house dialing, simply
    enter the four digit phone extension.

    Emergency Numbers
    8888
    6666
    7753

    Page Operator

    8480

    Emergency Room
    Main
    Triage
    Meadows

    7885
    5657
    5658

    44

    Presbyterian Hospital of Dallas

    Medical Emergency
    Fire/Emergency
    Security Dispatch

    Presby Main Hospital Nursing Stations


    1 ICU
    Main 2W
    Main 2E
    2 ICU
    Main 3W
    Main 3E
    3 ICU/CCU
    Main 4W
    Main 4E
    4 ICU
    Main 5W
    Main 5E
    Main 6W
    Main 6E
    Main 7W
    Main 7E
    Main 8W
    Main 8E
    9 ICU

    101-109
    201-226
    230-248
    280-288
    301-326
    332-351
    381-390
    401-426
    427-451
    480-490
    501-526
    527-551
    601-626
    627-651
    701-726
    727-751
    801-826
    827-851
    981-984

    7956
    7200
    7290
    7992
    7300
    7390
    7682
    7400
    7490
    7692
    7500
    7590
    7600
    7690
    7700
    7790
    7800
    7890
    7068

    Jackson Hospital Nursing Stations


    Jackson 2W
    Jackson 2E
    Jackson 3W
    Jackson 3E
    Playroom
    Jackson 4W
    Jackson 4E
    Jackson 5W
    Jackson 5E
    Jackson 6W
    Jackson 6E

    201-227
    228-253
    301-327
    329-353
    401-424
    425-444
    524-544
    550-572
    624-634
    644-663

    5200
    5290
    5300
    5390
    5333
    5400
    5490
    5500
    5590
    5600
    5690

    Perot Center Nursing Stations


    Perot 4W
    Perot 4E
    Perot 5W
    Perot 5E
    Newborn Nursery
    NICU
    Labor and Delivery
    Special Care Nursery

    401-421
    427-451
    501-526
    527-551

    2400
    2490
    2500
    2590
    2562
    2647
    2652
    2820

    Presby: Other Essential Information


    Admitting
    Emergency Department
    Jackson
    Labor and Delivery
    Main
    Meadows
    Perot
    Short Stay Nursery
    Bed Control
    Blood Bank
    Case Management
    Chaplain

    8309
    7997
    2642
    7872
    5658
    2491
    2581
    7871
    7763
    4350
    7158

    45

    Community Mental Health Center (CMHC)


    Doctors Dining Room
    Echo
    EEG
    EKG
    Facilities Management
    Geriatrics
    Home Health
    Hotel Presby
    Infection Control
    Information Systems
    Main
    Help Desk
    Insurance Verification
    Laboratories
    Chemistry/Results/Misc
    Cytology
    Histology
    Microbiology
    Nuclear Medicine
    Phlebotomy
    Special Procedures
    Menu Line (Caf Presby only)
    Medical Records
    Nuclear Medicine
    Occupational Therapy: Main
    Jackson
    Operating Rooms
    Main
    Perot
    PACU
    Main
    Perot
    Pharmacy
    Physical Therapy
    Main
    Jackson
    Psychiatry
    Adult Day Hospital (Jackson 5W)
    Adult Inpatient Unit (Jackson 5E)
    Community Mental Health Center (CMHC)
    Consult & Emergency Services
    Eating Disorders Program
    Psychiatric Intake
    Pulmonary Diagnostic Lab
    Radiology
    CT Scan
    File Room
    Main
    MRI
    Perot File Room
    Special Procedures
    Ultrasound
    Residents Lounge

    46

    7355
    6904
    2630
    7980
    7782
    8515
    8787
    4663
    4030
    8123/6307
    8516
    4357
    4397
    7760
    4910
    7552
    6350
    2632
    7760
    6350
    4237
    7670
    2556
    7483
    7387
    7470
    2661
    7176
    2670
    7180
    7480
    7680
    5500
    5590
    7355
    7355
    8752
    8747
    7884
    8476
    6956
    7770
    6905
    2394
    6934
    7694
    4714/ 4711/ 4701

    FOOD
    One of the essential tasks of the 3rd year medical student is to organize food when
    on call. Taking food orders and then making a take-out run offers the advantage
    of getting out of the hospital for a while! Be sure to ask other on-call teams or
    services if theyd like to get in on your food order, and try to collect cash
    (including tax!) when you take the order, instead of trying to page everyone and
    collect money later.
    If you are in the medical center with no time to leave, you have several options:
    Parkland Cafeteria: located on the 1st floor (South). Open every day.
    Hours:
    Breakfast 7:00am-9:30 am
    Lunch
    11:30am-1:30pm
    Dinner
    5:00pm-6:30pm
    Menu available daily on the Parkland website
    McDonald's:
    Hours:

    located on the 1st floor of Parkland.


    M-F 5:00am--4:00am
    Sa-Su 7:00am-11:00pm only

    Childrens Cafeteria: located in front of G Elevators, lower level.


    Menu:
    4237
    Main Cafeteria Hours: 6:30am-10:30am, 11am- 2pm, 5pm-2:30am.
    Jackson Cafeteria Hours: 11:30am- 2:30pm
    Margot Perrot Deli Hours: 7am- 7pm
    Zale Lipshy:
    Cafeteria: ground floor, 6:30am-9:00am, 11:00am-1:30pm
    Convenience Store: ground floor, open 9:00am-7:00pm

    Local Restaurants: (menus in OR Lounge or Biotel, across from Psych ER)


    Anderson's BBQ
    Bangkok City
    Chipotle Mexican Grill
    Eatzis
    Gloria's
    Lover's Eggroll
    Miami Subs
    Panda's
    Parkland Subs
    Pizza Inn
    Qdoba Mexican Grill
    Quiznos Subs
    Sal's Pizza and Restaurant
    Sonny Bryans BBQ
    Starbucks

    214-630-0735
    214-824-6200
    214-871-3100
    214-526-1515
    214-521-7576
    214-358-1318
    214-521-9570
    214-528-3818
    214-634-3330
    214-526-2560
    214-352-2277
    214-231-7827
    214-522-1828
    214-357-7120
    214-522-3531

    47

    5410 Harry Hines Blvd


    4301 Bryan St
    2705 McKinney Ave
    3403 Oak Lawn Ave,
    4140 Lemmon Ave,
    5360 W Lovers Ln,
    3826 Lemmon Ave
    3917 Cedar Springs Rd
    2115 Butler St
    5460 Lemmon Ave
    5600 W Lovers Ln,
    2626 Howell St
    2525 Wycliff Ave
    2202 Inwood Rd
    4101 Lemmon Ave

    Starbucks
    Taj Express
    Thai Lotus
    Thai Nipa
    Tom Tom Noodle House

    214-219-0369
    214-528-0200
    214-520-9385
    214-526-6179
    214-522-1694

    3330 Oak Lawn Ave


    4436 Lemmon Ave,
    3851 Cedar Springs Rd
    4315 Lemmon Ave
    3699 McKinney Ave

    VA: The cafeteria is located in the basement of VAMC. Check with the
    medicine or surgery offices for on-call meal vouchers (good mostly for
    breakfast or lunch). There are restaurants located near VAMC around
    Marvin D. Love Freeway. You can call most of the restaurants to order
    take-out, but they typically do not deliver to the VA. Its about a 15-minute
    drive to these restaurants.
    Glorias
    Olive Garden
    Chilis
    Outback Steakhouse

    214-948-3672
    972-298-8871
    214-330-4829
    972-228-8748

    600 West Davis Street Dallas


    639 N Cockrell Hill Rd (Duncanville)
    7035 Marvin D Love Fwy
    (Desoto)

    In addition to the above restaurants, there are many fast food restaurants in the
    immediate vicinity of the VA along Lancaster Rd. and the adjacent streets. Be
    careful, especially at night.
    Churchs
    Long John Silvers
    Dominos Pizza
    Lubys
    Pizza King
    KFC/ Taco Bell
    Sweet Georgia Brown
    Wingstop
    Subway
    Long John Silvers
    Long John Silver's
    Mcdonald's
    William's Fried Chicken
    Taco Bell

    214-374-8700
    214-374-1199
    214-375-3030
    214-371-8080
    214-371-5464
    214-371-9028
    214-375-2020
    214-374-9464
    214-623-0528
    214-374-1199
    214-371-2741
    972-224-4021
    972-228-0668
    214-339-9640

    48

    3605 S Lancaster Rd
    2828 E Ledbetter Dr
    1111 W Ledbetter Dr
    4155 S R L Thornton Fwy
    3410 S Lancaster Rd
    2802 E Ledbetter Dr
    2840 E Ledbetter Dr
    2207 E Ledbetter Dr
    2231 W Ledbetter Dr
    2828 East Ledbetter Drive
    3606 South Polk Street
    8333 South Lancaster Road
    8502 South Lancaster Road
    2332 West Ledbetter Drive

    REFERENCE AND RANDOM USEFUL INFO


    LAB INFO

    (note: normal lab values vary by hospital)


    Shorthand for Laboratory Values
    MCV/MCH/MCHC
    CBC:

    Hgb
    WBC

    Platelets
    Hct
    Segs/ Bands/ Lymphs/ Monos/ Basos/ Eos

    Chem 7 or 10:
    Na

    Cl

    BUN

    Ca
    Glucose

    HCO3

    Cr

    Phos

    Mg

    Coags: PT / INR / PTT


    Blood Gases: pH / PCO2 / HCO3 / PO2 / % O 2 sat
    Normal Blood Gas Values
    Measurement
    Arterial Blood
    Venous Blood
    PH
    7.40
    7.36
    pO2
    80-100 mm Hg
    30-50
    PCO2
    35-45 mm Hg
    40-52
    O2 Saturation
    > 95%
    60-85%
    HCO3
    22-26 mEq/L
    22-28 mEq/L
    Base Difference (deficit/excess)
    -2 to +2
    -2 to +2
    Simple Acid Base Disturbances
    Acid Base Disorder
    Primary
    HCO3
    Metabolic Acidosis
    HCO3
    Metabolic Alkalosis
    pCO2
    Respiratory Acidosis
    pCO2
    Respiratory Alkalosis

    Secondary
    pCO2
    pCO2
    HCO3
    HCO3

    Expected Compensation

    pCO2 = (1.5 x HCO3 ) + 8


    pCO2 = (0.9 x HCO3 ) + 9
    HCO 3 = 0.35 x pCO2
    HCO 3 = 0.50 x pCO2

    Common Hematologic Studies


    PT (extrinsic pathway)
    PTT (intrinsic pathway)
    Hemoglobin
    Male
    Female
    Hematocrit
    Male
    Female
    Mean corpuscular volume
    Leukocyte profile
    Total
    Lymphocytes
    Mononuclear cells
    Granulocytes
    Platelet count
    Erythrocyte Sedimentation Rate

    11-13 sec
    22-31 sec
    14-18 g/dL
    12-16 g/dL
    40-52%
    37-46%
    82-105 um3
    4.8-10.8 X 103/ul
    0.8-3.1 X 103/ul
    0.1-0.8 X 103/ul
    2.3-7.7 X 103/ ul
    140-450 X 103/ ul
    0-15 mm/ hr

    49

    Common Serum Chemistries


    Albumin
    Ammonia (plasma)
    Bilirubin: Total
    Direct
    Calcium, Total
    Chloride
    Cholesterol (Desirable)
    Creatinine
    Glucose, Fasting
    Magnesium
    Osmolality
    Phosphate
    Potassium (plasma)
    Protein, Total
    Sodium
    Urea Nitrogen
    Uric Acid

    3.5 5.0 gm/ dl


    28 80 ug/ dl
    < 1.5 mg/ dl
    < 0.4 mg/ dl
    8.5 10.5 mg/ dl
    95 105 mmol/L
    < 200 mg/ dl
    0.7 1.3 mg/ dl
    70 110 mg/ dl
    1.4 2.0 mEq/ L
    270 300 mOsm/ kg
    2.5 4.5 mg/ dl
    3.2 4.5 mmol/ L
    6.0 8.0 gm/ dl
    135 145 mmol/ L
    8 22 mg/ dl
    3.2 7.2 mg/ dl

    Common Serum Enzymatic Activities


    Amylase
    Alkaline phosphatase
    ALT, SGPT
    AST, SGOT
    Creatine Kinase
    CK-MB (heart)
    CK-MM (skeletal muscle)
    CK-BB (brain)
    GGT (-glutamyl transferase
    LDH
    Lipase

    <200 IU/ L
    <115 IU/ L
    <38
    <40
    <195 IU/ L
    <6% (heart)
    94-100%
    0%
    <70 IU/L
    <242 IU/ L
    0-160 IU/ L

    Common Phlebotomy Tubes


    Labs
    Amylase/Lipase
    Cardiac Enzymes
    Electrolytes
    Hemogram/ Platelet/ Differential (CBC)
    Hepatitis Serologies
    LFTs
    EtOH
    Lactate
    PT/PTT

    Phlebotomy Tube
    Gost Top
    Gost Top
    Gost Top
    Lavender Top
    Gost Top
    Gost Top
    Red Top
    Gray top (on ice)
    Blue Top

    Note: Gost (pronounced ghost) = yellow


    Common Conversions:
    1 pound = 2.2 kg
    1 inch = 2.54 cm
    98.6 o F = 37 o C
    100.4 o F = 38 o C

    101.3 o F = 38.5 o C
    Convert anything at
    www.onlineconversion.com

    50

    NUTRITION
    A quick way to consider nutrition for a patient with chronic diseases such as
    diabetes, hypertension, and coronary artery disease is to think of WAVEthe
    patients Weight, Activity and diet in terms of Variety and Excess. Guidance
    for WAVE can be found at www.utsouthwestern.edu/naa/wave/wave_info.htm
    Weight can be quickly assessed using Body Mass Index (BMI).
    The calculation for Body Mass Index is:
    BMI = [weight (pounds) / height (inches)2] x 704.5
    Underweight
    <18.5
    Normal
    18.5 24.9
    Overweight
    25- 29.9
    Obese
    30-39.9
    Extreme Obesity
    > 40
    Ordering Hospital Diets
    Each patient upon admission to the hospital should have a diet order (even if it is
    NPO indicating that nothing is permitted orally). Write diet orders in
    terminology consistent with the options available on the computer for the unit
    clerk to enter. If you have questions, the clinical dietitian assigned to your floor
    is available to advise you and will, as patient load permits, assess nutritional
    status and diet orders of each patient. Listed below are common diet orders for
    Parkland. (If needed, several different orders can be combined.) For a more
    complete listing of diets and nutritional products you can consult:
    The DFWHC Manual of Nutrition Therapy (large red binder located at nursing
    stations)
    Dietary Rx booklet- PHHS Physicians Nutrition Therapy Guide (a thin pocket
    guide distributed to Parkland house staff)
    Children Medical Centers Nutrition Formulary
    For diet changes: remember to rewrite the entire diet order. If the patient was
    on a 4 gm sodium diet and now you want it to become a diabetic diet, you need to
    include the 4 gm sodium descriptive again (ie 1800 cal ADA, 4 gm sodium diet).
    Diet Progression (Commonly used after surgery)
    NPO
    Clear Liquid (CL)
    Full Liquid (FL)
    Mechanical Soft (for chewing difficulties)
    Soft (can use in transition from FL to General, limits fried foods and gassy
    vegetables)
    General (2500 kcalories)
    And theres a Hispanic and Oriental General Diet to meet cultural requests.
    Diet Modified by Texture
    Mechanical Soft (ground meat, soft vegetables)
    Pureed Diet (like baby food)
    With Thick Liquids for Dysphagia (for swallowing difficulties, used with other
    diets)
    Wired Jaw Diet

    51

    Medical Nutrition Therapy for Diseases


    Low Saturated Fat-Low Cholesterol Diet (or TLCTherapeutic Lifestyle
    Change)
    Sodium Restriction (For some patients a fluid restriction may also be
    included.)
    4 gm/No Added Salt (for hypertension)
    2 gm/Low Salt Low Sodium (used with heart failure or ascites)
    GI Dietsa number are possible, including
    Low Fiber/Low Residue
    Low Fat (40-50 gms fat on a 2000 kcal diet)
    High Fiber
    Renalvarious levels of protein from 40-100 gm protein often with
    accompanying
    potassium and sodium restrictions
    Liverif encephalopathy cannot be corrected with meds, protein is restricted,
    usually .6-.8 gm/kg dry weight
    Diabetic, for inpatients specify ADA with a kcal level
    1200-1400; 1500-1600; 1600-1800; 2000; 1800-2000; 2200, 2400
    Obesityselect a kcal level from 1000, 1200, 1400, 1500, 1600, 1800, 2000
    (Adapted from Physicians Guide to Ordering Diets, PHHS, 2002-2003.)

    GENERAL HEALTH MAINTENANCE


    American Cancer Society Recommendations
    For early detection of cancer in average-risk, asymptomatic people

    Breast (F, age 20+)


    Breast self-exam
    Clinical breast exam
    Mammography

    Monthly, starting at age 20


    Every 3 yrs, ages 20-39
    Annual, starting at age 40*
    Annual, starting at age 40

    Colorectal (M/F, age 50+)


    FOBT and flex sig
    DCBE
    Colonoscopy

    Annual FOBT and flex sig every 5 yrs, starting


    at age 50
    Every 5 yrs, starting at age 50
    Every 10 yrs, starting at age 50

    Prostate (M, age 50+)


    DRE and PSA test

    Offer annually starting at age 50 for men who


    have a life expectancy of at least 10 yrs**

    Pap Smear/Cervical Screening(F, age 18+)


    Pap test and pelvic exam: Begin 3 yrs after onset of vaginal intercourse, but
    no later than 21 yrs of age. Screen annually with conventional Pap tests or
    every 2 yrs using liquid-based Pap tests. Screen every 2-3 yrs for age 30
    after 3 consecutive normal test results. May stop screening if >70 with 3
    normal tests and no abnormal tests in last 10 yrs, or after total hysterectomy.

    52

    ATP III Cholesterol Guidelines


    LDL-C
    Risk Category
    Goal
    CHD or Equiv
    <100 mg/dL
    2+ Risk Factors
    <130 mg/dL
    0-1 Risk Factor
    <160 mg/dL

    LDL for Lifestyle


    Changes

    100 mg/dL
    130 mg/dL
    160 mg/dL

    LDL for drugs


    130 mg/dL
    130 mg/dL
    190 mg/dL

    CHD equivalents: DM, AAA, carotid or peripheral artery disease.


    Major Risk factors: (1) HTN or on BP meds, (2) Age >45 male or > 55 women, (3)
    Smoking, (4) HDL <40, (5) Family history (1st degree relative with CAD <55 y/o male or
    <65 y/o female)

    USEFUL PATIENT CARE GUIDELINES


    Diagnostic Criteria for Diabetes
    Fasting blood glucose > 126 on 2 occasions.OR
    Random blood glucose > 200 on 2 occasions
    * requires symptoms (polyphagia, polydipsia, or polyuria)
    HbA1C is currently not an option. Criteria differ in pregnancy.
    Insulin Sliding Scale
    Use SSI to cover the patient while you adjust the basal NPH or 70/30 doses.
    Check Blood Glucose qid (before meals and at bedtime), then convert to bid
    dosing when possible. You can calculate the total Regular Insulin requirement
    from the total used in SSI, then distribute it for the day as follows:
    AM: 66% Total (1/3 Regular, 2/3 NPH)
    PM: 33% Total (1/2 Regular, 1/2 NPH)
    Sample Sliding Scale (Units of regular insulin)
    CBG
    BB
    BL
    BS
    0-60
    Give orange juice and call house officer
    61-200
    No Insulin
    201-250
    2U
    2U
    2U
    251-300
    4U
    4U
    4U
    >300
    6U
    6U
    6U
    Glascow Coma Scale
    Eye Opening
    4. Spontaneous
    3. To command
    2. To pain
    1. None

    Verbal Activity
    5. Oriented
    4. Confused
    3. Inappropriate
    2. Incomprehensible
    1. None

    HS

    0U
    2U
    4U

    Motor Activity
    6. Obeys commands
    5. Localizes pain
    4. Withdraws to pain
    3. Flexion to pain
    2. Extension to pain
    1. None
    Degree of brain injury: 13 mild, 9-12 moderate, 8 severe, 3=death

    53

    Apgar Score
    Signs/points

    Heart rate
    Respirations
    Muscle tone
    Reflex
    Color

    Absent
    Absent
    Limp
    No response
    Blue

    <100
    Slow/irreg, weak cry
    Some flexion
    Grimace
    Blue extremities

    >100
    Vigorous cry
    Arms, legs flexed
    Cry, withdrawal
    Pink all over

    IV Solutions (ions in mEq/L)


    Solution
    D (g/L) Cal/l
    0.9 NS
    0
    0
    LR
    0
    9
    D5W
    50
    170
    D5 0.45 NS
    50
    170
    D5 LR
    50
    179
    D=Dextrose, Lac=Lactate

    Na
    154
    130
    0
    77
    130

    K
    0
    4
    0
    0
    4

    Ca
    0
    3
    0
    0
    2.7

    Cl
    154
    109
    0
    77
    109

    Lac
    0
    28
    0
    0
    28

    Osm
    310
    273
    253
    405
    527

    DOMESTIC VIOLENCE ASSESSMENT


    Domestic violence is the number one cause of injury to women.
    Healthcare workers have a crucial role in identification and referral!

    SCREEN PATIENTS FOR DV: H-I-T-S


    How often does your partner:

    Physically Hurt you?

    Insult you or talk down to you?

    Threaten you with harm?

    Scream or curse at you?

    Points for each answer:


    Never =
    1
    Rarely =
    2
    Sometimes =
    3
    Fairly often = 4

    Frequently = 5

    Total scores 10 indicate the patient is in a dangerous relationship


    and should be offered help.
    Exercise caution when asking domestic violence screening questions. For
    example, a victim is not likely to give reliable answers if you ask the questions
    while her partner is in the exam room. Create an excuse for the woman to be
    interviewed alone (gyn exam privacy, paperwork that needs to be filled out)
    before asking the questions.
    The VIP Center at Parkland Hospital (214-786-1110) provides multidisciplinary
    health-care intervention for victims and survivors of violence, with caseworkers
    available round the clock.
    Counseling and Intervention Resources for Victims
    Parkland Rape Counseling Center: 214-590-0430
    Violence Intervention Prevention Center: 214-590-2926
    Genesis Womens Shelter: 214-942-2998 (answered 24/7)
    Genesis Womens Outreach (counseling): 214-559-2050

    National Hotline: 1-800-799-SAFE


    54

    USEFUL SPANISH PHRASES


    Caution: The phrases presented in this section are not complete enough to take a
    full H&P, but should help you in the ER or on your daily morning rounds. Note
    that, unlike English, Spanish has a formal and informal tense when referring to
    the 2nd person (i.e: you, your, etc.).
    Suggested references for medical Spanish: Que Paso (by Kantrowitz), Medical
    Spanish Pocket, also check out www.freetranslation.com
    Basic Spanish
    You need
    You must
    I want
    Would you
    Can you
    When?
    How much/how many?
    Where?
    Please try

    Necesita
    Tiene que
    Quiero
    Podria
    Puede
    Cuando
    Cuanto
    Donde
    Trata por favor

    Common Phrases
    Where are you going?
    Goodbye
    Welcome
    Good luck
    Good evening/good night
    Sure. Of course.
    How do you say in Spanish?
    Slower
    Excuse me
    Be careful
    Wait
    Im sorry
    Why not?
    Do you have
    Get lost
    Beat it
    Ill be back
    I speak very little Spanish
    Im learning to speak Spanish
    Please answer yes or no to my
    questions
    Huh?

    A donde va
    Adios
    Beinvenido
    Buena suerte
    Buenas noches
    Claro
    Come se dice en Espanol
    Mas despacio
    Con permiso
    Con cuidado
    Espera
    Lo siento
    Por que no?
    Tiene usted
    Vayase
    Vete
    Voy y vengo
    Hablo muy poco espanol
    Estoy aprndiendo hablar espanol
    Por favor contesta si o no a mis
    preguntas
    Mande?

    55

    Body Parts
    Head
    Back
    Abdomen
    Breasts
    Face
    Belly
    Chest
    Extremity
    HEENT
    Eyes
    Cheek
    Ears
    Freckles
    Lips
    Mouth
    Nose
    Sinus
    Teeth
    Neck
    Throat
    Adams apple
    Specific Anatomy
    Heart
    Liver
    Spleen
    Lungs
    Kidneys
    Skin
    Anus
    Appendix
    Bladder
    Bronchi
    Brain
    Buttocks
    Gallbladder
    Hair
    Intestines
    Nerves
    Pancreas
    Penis
    Rectum
    Stomach
    Vagina
    Womb

    Cabeza
    Espalda
    Vientre
    Senos
    Cara/Rostro
    Panza/barriga
    Pecho
    Extremidad
    Ojos
    Cachete
    Oidos/orejoas
    Pecas
    Labios
    Boca
    Nariz
    Seno
    Dientes
    Cuello
    Garganta
    La nuez de adan
    Corazon
    Higado
    Bazo
    Pulmones
    Rinones
    Piel
    Ano
    Apendice
    Vejiga
    Bronquios
    Cerebro
    Cadera
    Vesicula biliar
    Pelo
    Intestino
    Nervios
    Pancreas
    Pene, Miembro viril
    Recto
    Estomago
    Vagina
    Matriz

    56

    Extremities
    Bones
    Joints
    Arms
    Shoulder
    Muscles
    Hands
    Thumb
    Wrists
    Legs
    Feet

    Huesos
    Articulacion
    Brazos
    Hombro
    Musculos
    Manos
    Pulgar
    Munecas
    Piernas
    Pies

    Introduction
    Good morning.
    Good afternoon/evening.
    My name is I am the medical
    student helping the doctors here.
    How are you?
    better
    so so
    good

    Buenos dias.
    Buenas tardes/noches.
    Me llamo Soy el/la estudiante
    medico(a) ayudando a los doctores aqui.
    Como esta?
    mejor
    mas o menos
    bien

    Patient Information
    What is your name?
    How old are you?
    Do you live with your...
    ...parents / spouse ?
    ...son/daughter?
    ...mother / father?
    ...grandmother/grandfather?
    ...a friend?
    Have you been here before? When?

    Como se llama?
    Cuantos aos tiene?
    Con quien vive? Con su (s):
    ...padres / esposo (a)?
    ...hijo(a)?
    ...madre / padre?
    ...abuela(o)?
    ...amigo (a)?
    Ha estado aqui antes? Cuando?

    Common Complaints
    Doctor, I have
    Abscess
    Backache
    Bellyache
    Headache
    Heartache
    Stomacache
    Addiction
    Allergies
    Anemia
    Andina
    Anxiety

    Doctor, yo tengo
    Absceso
    Dolor de espalda
    Dolor de barriga
    Dolor de cabeza
    Angusita
    Dolor de estomago, colicos
    Adicion
    Alergia
    Anemia
    Andina
    Anseidad

    57

    Asthma
    Bleeding
    Bump/lump
    Burn
    Chills
    Chest pain
    Cancer
    Cirrhosis
    Cough
    Constipation
    Crazy
    Cramps
    Edema
    Fart
    Fear
    Fevers
    Gallstones
    Gunshot wound
    Heart attack
    Heart failure
    Hematochezia
    Hematemesis
    Hemorrhoids
    High blood pressure
    High blood sugar
    Insanity
    Itch
    Jaundice
    Kidney stone
    Lame
    Liver disease
    Loss of consciousness
    Mental illness
    Night sweats
    Numbness
    Obstruction
    Pain
    Pain-boring
    Pain-continuous
    Pain-burning
    Pain-cramping
    Pain-deep
    Pain-dull
    Pain-gripping
    Pain-heavy

    Asma
    Sangrado
    Bulto, protuberancia
    Quemadura
    Escalofrios
    Dolor en el pecho
    Cancer
    Cirrosis
    Toz
    Estrenimiento
    Loco
    Calambres
    Hinchazon
    Pedo
    Miedo
    Fiebre, calenture
    Piedras de la hiel
    Escopetazo
    Ataque de Corazon
    Falla cardiaca
    Desposiones con sangre
    Vomito con sangre
    Almorranas
    Alta presion
    Alta azucar en la sangre
    Locura
    Comezon, picazon
    Peil amarilla
    Calculo en el rinon
    Cojo
    Enfermedad del higado
    Perdida del conocimiento
    Enfermedades mentales
    Sudores por la noche
    adormecimiento
    Obstruccion
    Dolor
    Dolor penetrante
    Dolor continuo
    Dolor que quema
    Dolor calambre
    Dolor hondo
    Dolor sordo
    Dolor resgante
    Dolor pesado

    58

    Pain-intense
    Pain-pressure
    Pain-referred
    Pain-ripping
    Pain-severe
    Pain-sharp
    Pain-shooting
    Pain-tearing
    Pain that moves
    Pain-throbbing
    Pain-tightness
    Pneumonia
    Rabies
    Rash
    Ringing in ears
    Runny nose
    Scabies
    Stroke
    Sweating
    Swelling
    Thyroid problems
    Tuberculosis
    Venereal disease
    Blurred vision
    Weight change
    Worms
    HPI
    Why did you come to the
    hospital/clinic?
    What happened / Whats the
    matter?
    Are you in pain now?
    Where does it hurt?
    Show me with one finger.
    Does anything else hurt?
    How long have you had this pain?
    for hours / days / weeks
    since this am/pm
    When did this pain occur / start?
    regularly/irregularly
    before/after eating
    when walking/laying down
    after physical exertion
    Did the pain come on suddenly?
    Does the pain occur repeatedly?

    Dolor intensivo
    Dolor con presion
    Dolor referido
    Dolor rasgante
    Dolor severo/fuerte
    Dolor agudo
    Dolor punzante
    Dolor desgarrante
    Dolor que se mueva
    Dolor pulsante
    Dolor tirantez
    Pulmonia
    Rabia
    Salpullido, erupcion
    Zumbido
    Catarro, moquean
    Sarnas
    Apoplejia
    Sudor
    Hinchazon
    Problemas de las tiroides
    Te-Be
    Enfermedad venereal
    Vista nublada
    Cambiado de peso
    Lombrices
    Por que vino a el hospital / la clinica?
    Que occurrio / Que le ocurre?
    Tiene dolor ahora?
    Donde le duele?
    Muestreme/Enseeme con un dedo.
    Le duele algo mas?
    Cuando hace que padece ese dolor?
    desde hace horas / dias / semanas
    desde esta maana / noche
    Cuando occurio / empiezo el dolor?
    regularmente/esporadicamente
    antes de / despues de comer
    al andar / estando echado(a)
    despues de un esfuerzo
    El dolor se presenta de repente?
    El dolor se presenta con cierta

    59

    Is the pain constant?


    How long does the pain last?
    Have you have this kind of pain
    before? How often?
    What kind of pain do you have?
    wrenching / throbbing / crampy
    burning / stabbing
    Does the pain radiate?
    What helps the pain?
    What makes it better / worse?
    change of position
    heat / cold / rest
    nothing / medication

    frecuencia?
    Permanece el dolor o las molestias?
    Cuanto tiempo dura el dolor?
    Habia padecido a alguna vez ese dolor?
    Con que frecuencia?
    Que tipo de dolor tiene?
    tirones / palpitaciones / calambres
    escozor / punzadas
    Nota si el dolor se expande?
    Con que se alivia el dolor?
    Que hace que el dolor sea mejor / peor?
    cambio de posicion
    calor / frio / descanso
    de ningun modo / algun medicamentos

    ROS
    Do you have chest pain / difficulty
    breathing?
    while exercising?
    at rest?
    when you are upset?
    Have you had a fever?
    Have you noticed a change in your
    bowel habits?
    Do you have a good appetite?
    Are you hungry?
    Has your weight incrsd/ dcrsd?
    Do you feel nauseated?
    Do you vomit?
    Do you have
    constipation / diarrhea?
    black stools (melena)?
    bloody stools?
    Do you have problems with
    headache?
    having low energy?
    sleeping / thinking?
    feeling sad?
    thinking about suicide?
    losing/gaining weight?
    eating?
    your strength?
    urinating?
    defecating?
    muscle/bone pain?
    your skin?
    When was your last period?
    How long did it last?

    Tiene dolor en su pecho / dificultades


    para respirar?
    durante ejercicio?
    al descansar?
    cuando es que se molesta?
    Ha tenido fiebre?
    Ha notado un cambio en su
    popo/excremento?
    Tiene bueno apetito?
    Tiene hambre?
    Su peso ha subido / bajado?
    Tiene nausea?
    Ha vomitado?
    Tiene
    estreimiento / diarrea?
    popo/excremento negra?
    sangre en su popo/excremento?
    Tiene problemas
    de dolores de cabeza?
    de tener bastante energia?
    al dormir / pensar?
    de sentirse triste?
    de pensaminetos de suicidarse?
    de perder/aumentar de peso?
    al comer?
    de las fuerzs?
    de orinar?
    al hacer del bao?
    de dolores de los musculos/huesos?
    de la piel?
    Cuando fue su ultima regla?
    Cuanto tiempo duro?

    60

    Heavy/light flow?
    Was it normal/abnormal?
    PMH / Soc Hx
    Do you have asthma / DM / HTN?
    ...heart disease
    AIDS?
    ...other medical problems
    Have you ever had surgery?
    Are you taking any medications?
    Do you have any allergy to meds?
    Do you smoke (regularly)?
    Do you drink?
    Do you use any drugs?
    Do you have tattoos?
    Have you ever received a blood
    transfusion?
    PE
    I am going to examine your
    I am going to inspect your
    ...head / mouth
    ...heart / lungs / abdomen

    Mucha/poca sangre?
    Fue normal/anormal?
    Tiene asma / diabetes / presion alta?
    ...problemas/enfermedades del corazon?
    SIDA?
    ...otros problemas medicos?
    Ha tenido alguna operacion/cirugia en el
    pasado?
    Toma actualmente algun medicamento?
    Tiene alergias a algun medicamento?
    Fuma (habitualmente/regularmente)?
    Bebe / Toma alcohol?
    Toma alguna droga?
    Tiene algun tatuaje?
    Ha recibido trasfusiones de sangre?

    ...breasts / rectum / cervix


    Relax.
    Breathe deep / normally.
    Do not breathe / hold your breath.
    Breathe through your mouth.
    Open your mouth.
    Show me your tongue.
    Open / close your eyes.
    Cough. Again. Swallow.
    Sit up. Lie down. Stand up.
    Please lift up / move your
    arm / hand / leg / foot
    head / shoulders / buttocks
    Follow my finger (the light).
    Make a fist.
    Do like this... (then show them)

    Le voy a examinar su(s) ...


    Le voy a inspeccionar su(s)
    ...la cabeza / la boca
    ...el Corazon / los pulmones / el
    estomago
    ...los pechos / el recto / la boca de matriz
    Relajase/Calmase.
    Respire profundo / normalmente.
    No respire / aguante la respiracion.
    Respire por la boca.
    Abra la boca.
    Saque la lengua.
    Abra / cierre los ojos.
    Tose. Otra vez. Trague / Pase la saliva.
    Sientase. Acuestese. Levantese.
    Por favor, levante / mueva su(s)
    brazo / mano / pierna / pie
    cabeza / hombros / pompis
    Siga mi dedo (la luz).
    Haga un puo.
    Haga esto

    Surgery / Ob-Gyn Postop Checks


    How are you feeling today?
    How is your pain?
    Is your pain getting better?
    Are you eating / walking / voiding
    ok?

    Como se siente hoy?


    Le duele mucho o poco?
    Su dolor esta mejorando?
    Esta comiendo / caminando / orinando
    bien?

    61

    Any CP / SOB / f/n/v?


    Are you passing gas?
    Have you had a bowel movement?
    You need to ambulate today.
    You need to use this (IS) 10 times
    every hour.
    Today take only clear liquids.
    Nothing by mouth.
    Home today (tomorrow)!

    Ha tenido dolor en su pecho /


    difficultades para respirar / fiebre /
    nausea / vomito
    Ha pasado gas de abajo? Ha heco
    popo/excremento (numero dos)?
    Necesita caminar mucho hoy.
    Necesita usar esto diez veces cada hora.
    Hoy tome solamente liquidos.
    Hoy no puede tomar nada por la boca.
    Se va a la casa hoy (maana)!

    Obstetrics
    Is the baby moving well?
    Are you having contractions?
    Your water has not broken?
    Push! Stronger!
    Its a boy/girl
    Good work!
    Keep pushing like that!
    He (she) weighs __ lbs and __ oz

    Su bebe esta moviendo bien?


    Tiene contraciones ahora?
    Su bolsa de agua esta intacta?
    Empuje! Mas fuerte!
    Es un nio / una nia.
    Muy bien!
    Siga empujando asi!
    Pesa __ libras y __ onzas.

    Miscellaneous
    Is there anyone here who speaks
    Spanish/English?
    Do you understand?
    Sorry, I didnt understand you.
    Speak slower, please.
    Please, repeat it slowly.
    We need an interpreter!
    Do you have any questions?
    Ive never done this before.
    I dont know what Im doing.
    Im not a doctor, but I play one on
    TV.
    Take care. Be careful.
    I hope you get better soon!

    Hay alguien aqui que hable


    Espanol/Ingles?
    Entiende usted?
    Lo siento, no le he entendido.
    Hable mas despacio, por favor.
    Repita lentamente, por favor.
    Necesitamos un traductor!
    Tiene algunas preguntas?
    Nunca he hecho esto antes.
    No se lo que estoy haciendo.
    No soy doctor, pero actuo como
    uno en la television.
    Que le vaya bien. Cuidese.
    Que se mejore!

    CALL ROOM INFO


    Locations: Please refer to the respective sections describing each rotation
    (pp. 8-13).

    Etiquette: Use common sense, eg. do not waltz in at 2am and


    turn on the lights - be respectful of your classmates (and
    residents) who may already be sleeping!
    62

    ABBREVIATIONS
    AAA
    AAO
    Ab
    ABG
    ABI
    Abx
    a.c.
    AD
    ad lib
    AEA
    AF
    AFB
    AFP
    AFSF
    AG
    AKA
    AMA
    AOCD
    AODM
    AP
    ARDS
    ARF
    AROM
    AS
    ASA
    ASB
    ASHD
    AT
    ATN
    AU
    AVF
    AVM
    AWOL
    BBB
    BCP
    BE
    BEA
    bid
    BKA
    BM
    BOM
    BOWI
    BOWR
    BPM
    BRBPR
    BRP
    BS
    BSO
    BTL
    Bx
    C

    Abdominal aortic aneurysm


    Awake, alert, and oriented
    Abortion
    Arterial blood gas
    Ankle-brachial index
    Antibiotics
    Before meals
    Right ear
    As desired, freely
    Above elbow amputation
    Atrial fibrillation, afebrile
    Acid-fast bacilli
    Alpha fetoprotein
    Anterior fontanel soft/flat
    Anion gap
    Above knee amputation
    Against medical advice/ advanced
    maternal age
    Anemia of Chronic Disease
    Adult-onset diabetes mellitus
    Anteroposterior
    Acute respiratory distress
    syndrome
    Acute renal failure
    Artificial rupture of membranes
    Left ear
    Aspirin
    Asymptomatic bacteriuria
    Arteriosclerotic heart disease
    Atrial tachycardia
    Acute tubular necrosis
    Both ears
    Arteriovenous fistula
    Arteriovenous malformation
    Absent without official leave
    Bundle branch block
    Birth control pill
    Barium enema
    Below elbow amputation
    Twice a day
    Below knee amputation
    Bowel movement
    Bilateral otitis media
    Bag of water intact
    Bag of water rupture
    Beats per minute
    Bright red blood per rectum
    Bathroom privileges
    Bowel sounds, breath sounds
    Bilateral salpingo-oophorectomy
    Bilateral tubal ligation
    Biopsy
    With

    63

    CA
    CABG
    CAD
    CBC
    CBD
    CBG
    C/C/E
    CCU
    c/d/i
    CEA
    CHF
    CHI
    Circ
    CM
    CMT
    CMV
    CO
    c/o
    COPD
    CPAP
    CPD
    CRF
    C&S
    C/S
    C/T
    CTA
    CVA
    CVP
    C/W
    Cx
    CXR
    D&C
    D&E
    D/C
    DCBE
    DDx
    DGI
    DIC
    DJD
    DKA
    DM
    d/o
    DOA
    DP
    DPL
    DPT

    Carcinoma/Cancer
    Coronary artery bypass graft
    Coronary artery disease
    Complete blood count
    Common bile duct
    Capillary blood glucose
    Clubbing/cyanosis/edema
    Coronary care unit
    Clean, dry, and intact
    Carcinoembryonic antigen
    Carotid endarterectomy
    Congestive heart failure
    Closed head injury
    Circumcision
    Costal margin
    Cervical motion tenderness
    Cytomegalovirus
    Cardiac output, carbon monoxide
    Complains of
    Chronic obstructive pulmonary
    disease
    Continuous positive airway
    pressure
    Cephalopelvic disproportion
    Chronic renal failure
    Culture & sensitivity
    Caesarian section
    Chest tube
    Clear to auscultation
    Costovertebral angle/
    cerebrovascular accident
    Central venous pressure
    Consistent with
    Cervix, culture
    Chest x ray
    Dilation and curettage
    Dilation and evacuation
    Discontinue, discharge
    Double-contrast barium enema
    Differential diagnosis
    Disseminated gonococcal
    infection
    Disseminated intravascular
    coagulation
    Degenerative joint disease
    Diabetic ketoacidosis
    Diabetes mellitus
    disorder
    Dead on arrival
    Dorsalis pedis
    Direct peritoneal lavage
    Diphtheria, pertussis, tetanus
    Digital rectal examination

    DRE
    DTR
    DT
    DTs
    D5W
    D10W
    DUB
    D/W
    Dx
    EBL
    EBV
    ECT
    EDC
    EF
    EFW
    EOMI
    EP
    ERCP
    ESR
    ESRD
    ET
    EtOH
    EUA
    Ext
    FBS
    FFP
    FHR
    FHT
    FM
    FNA
    FOBT
    FROM
    F/U
    FUO
    Fx
    Fxn
    GB
    gc
    GERD
    GETA
    GHM
    GSW
    gtt
    GTT
    GU
    GVHD
    H/A
    HAV
    Hb, Hg
    HbA1C
    HbcAg
    HbsAg
    HBV

    Hct
    HD
    HDV
    H/H
    HIT

    Deep tendon reflex


    Diphtheria tetanus
    Delirium tremens
    5 % dextrose in water
    10% dextrose in water
    Dysfunctional uterine bleeding
    Discussed with
    Diagnosis
    Estimated blood loss
    Epstein-Barr virus
    Electroconvulsive therapy
    Estimated date of confinement
    Ejection fraction
    Estimated fetal weight
    Extraocular movements intact
    Electrophysiology
    Endoscopic retrograde
    cholangiopancreatography
    Erythrocyte sedimentation rate
    End stage renal disease
    Endotracheal
    Ethanol
    Exam under anesthesia
    Extremities, extract
    Fasting blood sugar
    Fresh frozen plasma
    Fetal heart rate
    Fetal heart tones
    Fetal movements
    Fine needle aspirate
    Fecal occult blood test
    Full range of motion
    Follow-up
    Fever of unknown origin
    Fracture
    Function
    Gall bladder
    gonococcus
    Gastroesophageal reflux disease
    General endotracheal anesthesia
    General health maintenance
    Gun shot wound
    Drop
    Glucose tolerance test
    Genitourinary
    Graft vs. host disease
    Headache
    Hepatitis A virus
    Hemoglobin
    Hemoglobin A1C
    Hepatitis B core antigen
    Hepatitis B surface antigen
    Hepatitis B virus

    HLIV
    HO
    HOCM
    HPI
    HRS
    hs
    HSG
    HSM
    HSV
    HTN
    Hx
    IBD
    IBS
    ICP
    Ifxn
    IDDM
    IHSS
    IM
    INR
    I&D
    I&O
    IOC
    ITP
    IUD
    IUFD
    IUGR
    IUPC
    IV
    IVDA
    IVF
    IVP
    JP
    JVD
    JVP
    K.O.
    KUB
    LAD
    LAO
    Lap
    LE
    LES
    LGA
    LLL

    64

    Hematocrit
    Hospital day
    Hepatitis D virus
    Hemoglobin / hematocrit
    Heparin-induced
    thrombocytopenia
    Heparin locked intravenous line
    House officer
    Hypertrophic obstructive
    cardiomyopathy
    History of present illness
    Hepatorenal syndrome
    Hora somni (bed time)
    Hysterosalpingogram
    Hepatosplenomegaly
    Herpes simplex virus
    Hypertension
    History
    Inflammatory bowel disease
    Irritable bowel syndrome
    Intracranial pressure
    Infection
    Insulin dependent diabetes
    mellitus
    Idiopathic hypertrophic subaortic
    stenosis
    Intramuscular
    International Normalized Ratio
    Incision and drainage
    Intake and output
    Intraoperative cholangiogram
    Idiopathic thrombocytopenic
    purpura
    Intrauterine device
    Intrauterine fetal demise
    Intrauterine growth retardation
    Intrauterine pressure catheter
    Intravenous
    Intravenous drug abuse
    Intravenous fluids
    Intravenous pyelogram
    Jackson-Pratt drain
    Jugular venous distention
    Jugular venous pulse
    Keep open
    Kidney, ureter, bladder
    Left axis deviation/ left anterior
    descending/ lymphadenopathy
    Left anterior oblique
    Laparotomy
    Lower extremity
    Lower esophageal sphincter
    Large for gestational age
    Left lower lobe

    LLQ
    LMP
    LNMP
    LOA
    LOC
    LP
    LR
    LSB
    LTCS
    LUL
    LUQ
    LVEDP
    LVEF
    LVH
    MAC
    MAP
    MCV
    MEG
    Mets
    MI
    MMM
    MMSE
    MN
    MRN
    MRSA
    MTC
    MUGA
    MVA
    MVC
    MVP
    NABS
    NAD
    NB
    NBN
    NCAT
    ND
    NG
    NHL
    HNP
    NIDDM
    NIL
    NKDA
    Nl
    NOS
    NPH
    NPO
    NS
    NSAID
    NSR

    Left lower quadrant


    Last menstrual period
    Last normal menstrual period
    Lysis of adhesions
    Level/ loss of consciousness
    Lumbar puncture
    Lactated Ringers
    Left sternal border
    Low transverse cesarean section
    Left upper lobe
    Left upper quadrant
    Left ventricular end diastolic
    pressure
    Left ventricular ejection fraction
    Left ventricular hypertrophy
    Mycobacterium avium complex
    Mean arterial pressure
    Mean cell volume
    Mid-epigastric area
    Metastases
    Myocardial infarction
    Moist mucous membranes
    Mini mental status exam
    Midnight
    Medical Record Number
    Methicillin resistant staph. Aureus
    Medullary thyroid carcinoma
    Multiple gated image analysis
    Motor vehicle accident
    Motor vehicle collision
    Mitral valve prolapse
    Normal active bowel sounds
    No acute distress
    Newborn
    Newborn nursery
    Normocephalic, atraumatic
    Non-distended
    Nasogastric
    Non-Hodgkins lymphoma
    Nursing home placement
    Non-insulin dependent diabetes
    mellitus
    Not in labor
    No known drug allergies
    Normal
    Not otherwise specified
    Normal pressure hydrocephalus,
    neutral protamine Hagedorn
    (insulin)
    Nothing by mouth
    Normal saline, night sweats
    Nonsteroidal anti-inflammatory
    drug
    Normal sinus rhythm

    65

    NT
    NTG
    OA
    OCP
    OD
    OM
    OME
    O/N
    OOB
    OP
    OR
    ORIF
    OS
    OSA
    OU
    p
    PA
    PAC
    para
    PAT
    PBC
    PCA
    p.c.
    PCN
    PCP
    PCWP
    PEA
    PEEP
    PERRLA
    PFT
    PID
    PIH
    PMI
    PM&R
    PMR
    PND
    PNH
    PO
    POD
    ppd
    PPD
    PPH
    PRBC
    PPROM
    PROM
    prn
    PSA

    Non-tender
    Nitroglycerin
    Osteoarthritis
    Oral contraceptive pill
    Overdose/right eye
    Otitis media
    Otitis media externa
    Overnight
    Out of bed
    Oropharynx
    Operating room
    Open reduction & internal fixation
    Left eye
    Obstructive sleep apnea
    Both eyes
    After
    Posterio-anterior
    Premature atrial contraction
    Number of pregnancies
    Paroxysmal atrial tachycardia
    Primary biliary cirrhosis
    Patient controlled analgesia
    After meals
    Penicillin
    Pneumocystis carinii pneumonia,
    phenylcyclidine , primary care
    provider
    Pulmonary capillary wedge
    pressure
    Pulseless electrical activity
    Positive end expiratory pressure
    Pupils, round, reactive to light and
    accommodation
    Pulmonary function test
    Pelvic inflammatory disease
    Pregnancy induced hypertension
    Point of maximal impulse
    Physical medicine and
    rehabilitation
    Polymyalgia rheumatica
    Paroxysmal nocturnal dyspnea
    Paroxysmal nocturnal
    hemoglobinuria
    By mouth
    Post-operative day
    Pack per day (cigarettes)
    Post-partum day
    Postpartum hemorrhage
    Packed red blood cells
    Preterm premature rupture of
    membranes
    Premature rupture of membranes
    As needed
    Prostate specific antigen

    PSC
    PSGN
    PTCA
    PTL
    PTRA
    PUD
    PVC
    PVD
    q
    qAC
    QD
    qHS
    QID
    QOD
    RA
    RAO
    RBBB
    RDS
    RDW
    RF
    RL
    RIND
    RLL
    RLQ
    RML
    R/O
    ROM
    ROS
    RPP
    RR
    RRR s
    m/r/g
    RTA
    RTC
    RTXN
    RUL
    RUQ
    RVH
    s
    SAH
    SB
    SBE
    SBP
    SCC
    SCLC
    SGA
    sig

    Primary sclerosing cholangitis


    Post-streptococcal
    glomerulonephritis
    Percutaneous transluminal
    coronary angioplasty
    Preterm labor
    Percutaneous transluminal renal
    angioplasty
    Peptic ulcer disease
    Premature ventricular contraction
    Peripheral vascular disease
    Every
    Before every meal
    Every day
    Every night
    Four times a day
    Every other day
    Rheumatoid arthritis/ right atrium
    Right anterior oblique
    Right bundle branch block
    Respiratory distress syndrome
    Red cell distribution width
    Rheumatoid factor
    Ringers lactate
    Reversible ischemic neurological
    deficit
    Right lower lobe
    Right lower quadrant
    Right middle lobe
    Rule out
    Range of motion, Rupture of
    membranes
    Review of systems
    Rate-pressure product
    Recovery room
    Regular rhythm and rate without
    murmurs, rubs, or gallops
    Renal tubular acidosis
    Return to clinic
    Retraction
    Right upper lobe
    Right upper quadrant
    Right ventricular hypertrophy/
    renovascular hypertension
    Without
    Subarachnoid hemorrhage
    Still birth
    Subacute bacterial endocarditis
    Spontaneous bacterial peritonitis
    Squamous cell carcinoma
    Small cell lung carcinoma
    Small for gestational age
    Let it be labeled/ signify

    SL
    SOB
    SOOL
    S/P
    SQ
    SROM
    S/S
    SSS
    SVD
    SVR
    SVT
    Sx
    TAH
    TB
    TEE
    TIA
    tid
    TIPS
    TM
    TNM
    TO
    TOA
    TPN
    TTE
    TTP
    TURP
    TVH
    UA
    U/A
    UE
    UOP
    UPPP/
    UP3
    URI
    UTI
    VF
    VO
    VRE
    VS
    VSS
    VT
    WD
    WN
    WNL
    WPW

    66

    Sublingual
    Shortness of breath
    Spontaneous onset of labor
    Status post
    Subcutaneous
    Spontaneous rupture of
    membranes
    Signs and symptoms
    Sick sinus syndrome
    Spontaneous vaginal delivery
    Systemic vascular resistance
    Supraventricular tachycardia
    Symptoms
    Total abdominal hysterectomy
    Tuberculosis
    Transesophageal echo
    Transient ischemic attack
    Three times a day
    Transjugular intrahepatic
    portosystemic shunt
    Thyromegaly
    Tumor-nodes-metastases
    Telephone order
    Tubo-ovarian abscess
    Total parenteral nutrition
    Transthoracic echo
    Thrombotic thrombocytopenic
    purpura
    Transurethral resection of the
    prostate
    Total vaginal hysterectomy
    Umbilical artery
    Urinalysis
    Upper extremity
    Urine output
    Uvulopharyngopalatoplasty
    Upper respiratory infection
    Urinary tract infection
    Ventricular fibrillation
    Verbal order
    Vancomycin resistant
    Enterococcus
    Vital signs
    Vital signs stable
    Ventricular tachycardia
    Well developed
    Well nourished
    Within normal limits
    Wolff-Parkinson White syndrome

    BLOOD AND BODY FLUID EXPOSURE


    1.

    Wash or rinse all exposed skin areas IMMEDIATELY with antimicrobial


    soap and/or water. Flush all mucous membranes with COPIOUS amounts of
    water or normal saline.
    2. Notify Zale Lipshy Health Referral Center Nurse by paging 214-588-6263
    (i.e. Nursing Supervisor). Pager answered 24 h per day, 7 d per week. The
    nurse will return your call and ask you specific questions concerning your
    possible exposure. Information needed: date and time of exposure, details of
    procedure being performed, exposure type and severity (volume of fluid,
    type of needle, depth of injury, condition of skin), information about source
    patient.
    3. Notify your supervisor and/or the areas supervisor (charge nurse) where you
    were exposed.
    4. Health care worker or on-duty supervisor is responsible for determining if
    the patients antigen/antibody status is documented in the pt record.
    5. Complete a Zale Lipshy Occurrence Report or UTSWMC Incident Report
    (depending where you were exposed). Include the patients name, medical
    record number, and room number or location of exposure
    6. Obtain two tiger top tubes of blood drawn from the source patient. The
    supervisor or his/her designee of the area is responsible for obtaining the
    source patients blood or beginning the process to obtain the patients test
    results after you notify them. Tubes are sent to Zale Lipshy lab or Parkland
    lab depending on where incident occurs for serology tests per facility
    protocols.
    7. Report to Zale Lipshy Health Center (located on 1st floor). Bring Occurrence
    Report or Incident Report with you.
    8. Assessment of your exposure potential and subsequent recommended
    treatment optimally should be started within ONE HOUR post-exposure at
    the Zale Lipshy Health Center by the Employee Health Manager or referral
    nurse (UTSWMC physicians exposed at PMH have the option of initial care
    at PMH emergency room, but may take longer than Zale Lipshy).
    9. Antiretroviral therapy may be recommended (and provided if your consent is
    obtained) if the exposure was to an HIV+ patient, a patient at high risk for
    HIV+, or you had significant exposure to an unknown source. HBIg may be
    recommended if source patient is HBV seropositive. There is no
    recommended prophylaxis for HepC.
    10. Your blood should be drawn the day of exposure for baseline testing, and
    again at 6 weeks, 3 months, 6 months, and 9 months if the source patients
    lab results return positive or are unknown.
    11. If you are offered and accept to take prophylaxis, it optimally should be
    started within ONE HOUR after exposure.
    You will receive post-exposure counseling through the Zale Lipshy Health
    Center. If exposure occurs at the VA or another center, report to the
    Emergency Department, Employee Health during business hours, or other
    specified location for that medical center. Report incident to Southwestern
    Exposure Control Program for follow-up care.

    67

    NOTES

    68

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