• The resident shall gain knowledge, skills and attitudes necessary to evaluate, screen and manage patients with pulmonary problems.
• The resident will understand systems and resources available to patients, families and physicians.
  

The resident should develop attitudes that encompass the following:

• Ability to encourage patients to healthy lifestyle and behavior change
• Ability to effectively deal with patients that do not change behavior
• Knowledge of normal and abnormal pulmonary:
  • Physiology
  • COPD
  • Asthma
  • Occupational Lung Disease
  • Interstitial Lung Disease
  • Pulmonary HTN
  • ARDS
  • Respiratory Failure
  • Lung Cancer
  • Pneumonia
  • Bronchitis
  • Tuberculosis
  • Sleep Apnea
  • Pulmonary Embolism
  • Bronchoscopy Indication
• Skills in:
  • Ventilation management
  • ABG interpretation
  • PFT interpretation
  • Thoracentesis & Interpretation
  • Chest Tube Indications

• Interpretation of chest x-ray
• Indications for Chest Scan

• Acute management of asthma, COPD, Respiratory Failure, Pulmonary Embolism

• Long-term management of COPD patients, asthma patients
• Influencing Behavior change
• Assessment of patients risk of industrial lung disease

• Resources available for patients with lung disease

• Didactic material gathered from various sources

• Occupational Lung Disease

• Diagnosis & management of patients requiring hospitalization

• Influencing Behavior Change discussion
• Supporting patient with long-term illness

• Diagnosis & management of pulmonary patients requiring hospitalization
  • Appropriate measures to prevent hospitalization
  • Appropriate discharge planning
  • Understand ventilatory management & interdisciplinary team involvement
  • ABG, PFT, CXR, CT chest interpretation
  • Indications & interpretation for Thoracentesis, Chest Tube, & Bronchoscopy

• Pre-round on patients prior to 9:00 a.m.
• Attend Bronchoscopies
  • To learn to tell patient what to expect for this procedure
  • Correlate x-ray findings or lack of to bronchoscopy
• History, physical, discharge summary procedure notes on all that you perform
• Ventilation order changes only after discussion with Dr. Nassery
• Complete procedure logger

• The attending will evaluate each resident physician.
• Satisfactory rotation completion is determined by the program director in consultation with the supervising attending physician.

• Principles of Pulmonary Medicine – Weinberger
• http://www.nhlbi.nih.gov - click on Clinical Guidelines
  • http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm - Asthma Guidelines
  • http://www.goldcopd.com/ - COPC Guidelines
• http://www.chestnet.org/guidelines/
• http://www.chestnet.org/guidelines/pneumonic/ - Medical and Surgical Treatment of Parapneumonic Effusions: An Evidence-Based Guideline
• http://www.chestnet.org/guidelines/antithrombotic/ - Sixth ACCP Consensus Conference on Antithrombotic Therapy
• http://www.chestnet.org/guidelines/pneumonia/ - Evidence-Based Assessment of Diagnostic Tests for Ventilator-Associated Pneumonia
• http://www.chestnet.org/guidelines/cough/ - Managing Cough as a Defense Mechanism and as a Symptom
• http://www.chestnet.org/guidelines/pulmonary/ - Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Guidelines
• http://www.chestjournal.org/cgi/content/full/119/4/1185 - The Evidence Base for Management of Acute Exacerbations of COPD: Clinical Practice Guideline, Part 1
• http://www.chestjournal.org/cgi/content/full/119/4/1190 - Management of Acute Exacerbations of COPD: A Summary and Appraisal of Published Evidence
• http://www.chestjournal.org/content/vol123/1_suppl/ - CHEST: Volume 123/Number 1 Supplement/January 2003 “Diagnosis and Management of Lung Cancer: ACCP Evidence-Based Guidelines”