The Washington Manual® Internship Survival Guide

KEYS TO SURVIVAL

ACLS ALGORITHMS: ILCOR Universal/International ACLS Algorithm / Comprehensive ECC Algorithm / Ventricular Fibrillation/Pulseless VT Algorithm / Pulseless Electrical Activity Algorithm / Asystole: The Silent Heart Algorithm / Bradycardia Algorithm / The Tachycardia Overview Algorithm / Narrow-Complex Supraventricular Tachycardia Algorithm / Stable Ventricular Tachycardia (Monomorphic or Polymorphic) Algorithm

ACCUMULATING YOUR WAR CHEST: Books and Tools to Carry With You / Handheld Computer Resources / Internet Resources / Internet Resources for Evidence-Based Medicine

USEFUL FORMULAS: A-a O2 Gradient / Anion Gap (Serum) / Anion Gap (Urine) / Body Mass Index / Creatinine Clearance (Estimated, Measured) / Corrected Serum Calcium / Corrected Serum Sodium / Fractional Excretion of Sodium / Fractional Excretion of Urea / Mean Arterial Pressure / Osmolality (Serum, Estimated) / Osmolal Gap / Reticulocyte Count (Corrected) / Reticulocyte Production Index / Medical Epidemiology

TRIAGE: Before Accepting Admissions / Other Important Questions to Consider

CROSS COVERAGE: General Points / Reasons You Must Go See a Patient / Things to Consider Asking Before Arrival at Bedside / Things That Can Wait / Appropriate Transfer of Patients to the Intensive Care Unit

PATIENT AND STAFF RELATIONS: Working with Ancillary Staff / Referring a Patient / Working with Difficult Patients / Addressing End-of-Life Issues

ADMISSIONS: General Points / Admission Orders / DVT Prophylaxis / GI Prophylaxis / Assessment/Plan / Laboratory Results and Orders / Patient Safety Issues

DAILY ASSESSMENTS: Rounds / Daily Notes and Evaluation / Discharge Planning / Signouts

OTHER NOTES OF IMPORTANCE: Off-Service Notes / Procedure Notes / Death/Expirations

DISCHARGES: Discharge Process/Pearls / Discharge Summary

TOP TEN WORKUPS: Chest Pain / Abdominal Pain / Acute Altered Mental Status / Acute Renal Failure / Headache / Hypotension and Hypertension / Common Arrhythmias / Fever / Shortness of Breath / Gastrointestinal Bleeding

COMMON CALLS AND COMPLAINTS: Alcohol Withdrawal / Bleeding at Line Sites and After Procedures / Constipation / Cough / Diarrhea / Falls / Hyperglycemia and Hypoglycemia / Holding Medications for Morning Tests / Insomnia / Lack of Intravenous Access / Nausea and Vomiting / Pruritus / Rash / Sundowning / Transfusion Reactions

PAIN CONTROL: General Points / Selected Agents in the Three Step Analgesic Ladder

THERAPEUTIC CONSIDERATIONS: Antibiotics / Anticoagulation

TOOLS OF THE TRADE (FLUIDS, ELECTROLYTES, VITAL SIGNS, ELECTROCARDIOGRAPHY, RADIOLOGY): Fluids and Base Electrolytes / Electrolyte Abnormalities / Vital Signs / Electrocardiographic Interpretation / Acid-Base Disorders / Radiograph Interpretation / Preparation for Procedures

APPROACH TO CONSULTATION: The Medicine Consult / Dermatology / Neurology / Obstetrics and Gynecology / Ophthalmology / Orthopedic Surgery / Otolaryngology / Psychiatry / General Surgery

GUIDE TO PROCEDURES: All You Really Need to Know About Vascular Access / Venipuncture / Femoral Vein Phlebotomy / Peripheral IV / Blood Cultures / Arterial Blood Gas Sampling / Central Venous Access / Lumbar Puncture / Thoracentesis / Paracentesis / Guidelines for Occupational Exposures

CRITICAL CARE NOTES: Keys to Intensive Care Unit Survival / Ventilators / ICU Sedation / Cardiac Parameters / Shock / Drips / Suggestions for Prophylaxis / Total Parenteral Nutrition (TPN)

FINAL TOUCHES: Feedback / Patient Data Tracking Form