Respiratory Consult 🫁
Guide for respiratory/pulmonology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: full name, date of birth, location and MRN; note that admission may not be for a respiratory reason
- Reason for respiratory consult (e.g. hypoxia, pleural effusion, haemoptysis, possible PE, pneumonia not improving)
- Past Medical History: asthma, COPD, interstitial lung disease, TB, lung cancer, immunocompromise
- Medications: including steroids, inhalers, immunosuppressants
- Observations: respiratory rate, SpO₂ on air/O₂, trends
- Investigations: recent CXR, CT thorax (if done), ABG results
- Bloods: FBC, CRP, D-dimer, cultures if infection suspected
- Microbiology: sputum culture, viral PCR, blood cultures
- COVID-19 status if relevant
🔎 Investigations to Know
- CXR — always have the latest one reviewed
- ABG — especially if hypoxic or deteriorating
- Bloods: FBC, CRP, D-dimer, cultures
- CT thorax — if done or pending
- Sputum culture, blood cultures if febrile
📞 Example Script
- Hi, this is [Your Name], the intern from the [Team Name]. I'm calling to request a respiratory consult for a [Age] year-old [M/F] patient, admitted for [reason for admission], but with a respiratory concern of [e.g. hypoxia, consolidation not improving, large pleural effusion].
- They have a history of [e.g. COPD, asthma]. They are currently on [O₂ requirements], with saturations of [value]% and RR of [rate]. CXR shows [finding], and we are concerned about [e.g. evolving pneumonia, possible empyema].
- We’re hoping for your input regarding [e.g. pleural tap, escalation, imaging]. Please let us know if any further investigations are needed before review.
📝 Tips
- Clearly state if the patient is hypoxic or deteriorating
- Know the O₂ delivery method and response
- Have the most recent imaging and bloods to hand
- Clarify what your team is hoping for (e.g. pleural intervention, diagnosis, escalation advice)