Use of Bedside Ultrasonography in Hospitalized Patients
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Steven Cocciardi, Madina Mohammadi, Hugh Black, Nicholas StollenwerkTeaser Point-of-care ultrasonography (POCUS) is an emerging and developing skill that hospitalist providers are increasingly using to improve patient care. Common applications include cardiac, pulmonary, and abdominal diagnostic evaluation at the bedside and procedural guidance. Emerging applications include the use of POCUS in triaging patients to appropriate levels of care and prompt diagnostic evaluation in rapid response and cardiac arrest scenarios. For...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Approach to Acquired Malnutrition in the Hospitalized Patient with Respiratory and Critical Illness
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Elena Kret-Sudjian, Nicholas Kenyon, Mithu MollaTeaser The significance of malnutrition in the hospitalized patient with respiratory and critical Illness cannot be overstated. It results in impaired functionality and delayed weaning from the ventilator, increased morbidity and mortality, and longer hospital stay with increased risk for readmission. To diagnose and treat malnourished patients, hospitalists must collaborate with the dietitian, pharmacist, and nurse. Delivering early nutrition to the intensive care unit patient ...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Palliative Care and Rehabilitation in Hospitalized Patients with Respiratory Failure
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Pouria Kashkouli, Kimberly Ann HardinTeaser Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. Patients with COPD have a significant need for palliative care interventions. Symptom burden in this population is as high or higher, and present for a longer period of time, as in lung cancer. There is both psychological and physical decline. Individuals with COPD have frequent hospitalizations that often result in intensive care unit admission. Compared with patient with lung canc...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Approach to Disorders of Sleep in Hospitalized Patients
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Theresa N. Duong, Jamal Mujaddid Mohammed, Kimberly Ann HardinTeaser Sleep disturbances are common in hospitalized patients and the causes are often multifactorial. The consequences of sleep disruption in hospitalized patients include worsening of the patient's cardiopulmonary status, impairment of the patient's psychiatric and cognitive health, and a negative impact on the patient's overall well-being. Therefore, the identification, evaluation, and treatment of common sleep disturbances and sleep disordered breathing are of ...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Diagnosis and Management of Pulmonary Hypertension in Hospitalized Patients
This article reviews the clinical presentation, diagnosis, classification, management principles, and specific disease-related topics, including pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension, acute right ventricular failure, perioperative considerations for PH, and when to refer to a specialized center. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Diagnosis and Management of Pulmonary Embolism in the Hospitalized Patient
This article reviews the diagnosis and management of PE in hospitalized patients. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Initiation of Mechanical Ventilation in Patients with Decompensated Respiratory Failure
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Eric D. Signoff, Jason Y. Adams, Brooks T. KuhnTeaser The role of the Hospitalist in the management of patients with acute respiratory failure is expanding. Acute respiratory failure is inherently unstable, and therefore requires frequent assessment, intervention, and reassessment. Hospitalists possess the knowledge and skills to manage heart failure, acute respiratory distress syndrome, chronic obstructive pulmonary disease, asthma, and the other causes leading to respiratory failure and can meet the dynamic needs of these p...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Noninvasive Ventilation
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): James N. Welch, Wendy Chu, Brian Morrissey, Richart HarperTeaser Noninvasive ventilation (NIV) is safe and effective for non–intensive care unit management of acute respiratory failure in carefully selected patients. Commonly used modalities (NIV) in the inpatient non–intensive care unit setting include high-flow nasal cannula, continuous positive airway pressure, and bilevel positive airway pressure. Although most frequently used for management of acute chronic obstructive pulmonary disease and heart failure exacerbatio...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Hospital Rapid Response Systems
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Christian Sebat, Voltaire Sinigayan, Timothy AlbertsonTeaser Rapid Response Systems (RRSs) have been widely implemented as a patient safety strategy to respond promptly to antecedents of clinical deterioration and avoid failure to rescue. There are many crucial roles within an RRS, although the optimal RRS team composition has yet to be determined. Numerous tools have been developed to aid in early recognition of at-risk patients, but much research is needed to define a standard. Individual examples of successful RRS have bee...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Hospitalized Patients with Acute Pneumonia
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Shaheen Najafi, Christian SandrockTeaser Pneumonia is one of the leading causes of mortality and hospitalization among US adults. The decision to admit patients from the emergency department is a major one because of its impact on patients and the hospital. The diagnosis of pneumonia is often clinical and based on symptoms and signs combined with radiographic findings. There are multiple severity assessments available that can guide treatment, prognosis, and disposition. Viruses are an important cause of pneumonia and require ...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Medical Management of Hospitalized Patients with Asthma or Chronic Obstructive Pulmonary Disease
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Theresa N. Duong, Amir A. Zeki, Samuel LouieTeaser Hospitalized patients with asthma and/or chronic obstructive pulmonary disease have a chronic inflammatory disease of the lungs that can be successfully managed with timely identification, evaluation, and medical treatment to prevent and treat exacerbations. If possible, an experienced interdisciplinary team led by hospitalists who are involved early in the hospitalization is more likely to achieve shorter hospital lengths of stay, improve regular outpatient follow-up, and re...
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Perspectives on the Management of Acute Respiratory Illness
Publication date: October 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 4 Author(s): Mithu Molla, Nicholas Kenyon (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - September 16, 2017 Category: Internal Medicine Source Type: research
Safety and Immunogenicity of Biologic Therapy in Inflammatory Bowel Disease
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Vera DenmarkTeaser Inflammatory bowel diseases, Crohn disease, and ulcerative colitis are complex multifactorial diseases that involve the interaction between innate and adaptive immunity. Tumor necrosis factor α is a potent proinflammatory cytokine with pleiotropic effects on cells of the innate and adaptive immune systems. Medical therapies that block tumor necrosis factor α have changed the clinical management of inflammatory bowel disease. This review discusses immunogenicity and safety of these agents as well as strategies ...
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Evaluation of a First Seizure and Management of Status Epilepticus
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Marcus YountzTeaser An adult presenting with a first-ever seizure needs a thorough evaluation to determine appropriate long-term management. This work-up includes a detailed history of the present event and review of the patient’s medical history and examination; laboratory evaluation, brain imaging, and electroencephalogram also are needed in most cases. The results of this evaluation are integrated into a complex decision-making process to determine whether to initiate antiepileptic drugs after a single seizure. Patients prese...
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Cardiac Pacemakers
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Eleanor Paglia, Jill CarterTeaser In a community hospital, it is important to have a basic understanding of the indications for implantation of a permanent pacemaker. Pacemaker insertion in the setting of sinus node dysfunction requires both symptoms and irreversibility. The most recent guidelines were published in 2012. It is important that patients recognize the need for longitudinal care related to their pacemaker. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
