Respiratory Consult 🫁

πŸ“‹ 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, SpOβ‚‚ on air/Oβ‚‚, 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

πŸ”Ž Investigations to Know

  • CXR β€” always have the latest one reviewed
  • ABG β€” especially if hypoxic or deteriorating
  • Bloods: FBC, CRP, D-dimer, cultures
  • CT thorax β€” if done or pending
  • Sputum culture, blood cultures if febrile

πŸ“ž 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 [Oβ‚‚ 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.

πŸ“ Tips

  • Clearly state if the patient is hypoxic or deteriorating
  • Know the Oβ‚‚ 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)