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Parkland Center for Internal Medicine

Parkland Center for Internal Medicine (PCIM)

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Resident in PCIMThe Parkland Center for Internal Medicine is one of The University of Texas Southwestern Medical Center’s two resident continuity clinics. It is a diverse primary care continuity clinic that serves Dallas County residents via this Parkland Memorial Hospital ambulatory clinic. The clinic serves the Dallas County community and is a multidisciplinary clinic designed to cater to the underserved and uninsured populations of the County.

This resident continuity practice provides the opportunity for residents to manage a panel of primary care of internal medicine patients through their three years of training. They often will assume the care of post-discharge hospital patients and urgent care patients.

Last Updated on Tuesday, February 22 2011 15:53
 

Parkland Physical Medicine and Rehabilitation

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Date:

January 26, 2012

To:

Medical Staff
House Staff
Non-Physician Clinical Providers

From:

John Thottakara MD
Parkland Division Chief, Physical Medicine and Rehabilitation

Subject:

Effective Immediately – Change in Parkland PM & R Service

Parkland's Outpatient Rehab department has experienced a significant increase with physical and occupational therapy referrals. Due to the large number of referrals for therapy services and the inability to serve all patients due to staffing and space constraints, Parkland's Physical Medicine & Rehabilitation has created a screening process to identify those patients who would benefit most from skilled therapy services. This will unfortunately result in denying referrals for patients who may have been appropriate for therapy services. We will provide denial notification to ordering providers, so that they may offer alternative options to patients. These options may include outside rehab facilities or community resources.

Our ability to accommodate patients and their therapy needs is frequently being reassessed so that we can ensure the best care for our patients.

Community Resource List

Last Updated on Monday, February 13 2012 13:55
 

PCIM Contacts

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Last Updated on Monday, January 09 2012 14:06
 

Tools

PHHS PCP Finder

If you're discharging a patient from Parkland who doesn't currently have a primary care provider, and would like to send them to one of the satellite clinics instead of PCIM, you can use the tool below to determine their assigned clinic based on zip code.

Please note that this tool is for eligibility only; obviously, you should use your own judgement when referring patients.

 
 

PCIM PA-NP Resources

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Last Updated on Friday, July 15 2011 12:48
 

Journals

ACP

Annals of Internal Medicine current issue

Annals of Internal Medicine

NEJM

Massachusetts Medical Society: New England Journal of Medicine: Table of Contents

Massachusetts Medical Society: New England Journal of Medicine: Table of Contents

Lancet

The Lancet

The Lancet

>

BMJ

Latest headlines from BMJ

BMJ

Last Updated on Friday, November 11 2011 15:19
 

Calculators

Patient age
Barometric pressure
PaO2
PaCO2
FiO2
A-a Gradient
Normal A-a Gradient
Serum sodium
Serum glucose
Serum BUN
Calculated Osm
Bilirubin
Albumin
INR
Ascites
Encephalopathy
Child-Pugh score
Scoring:
A: 5-6
B: 7-9
C: 10-15
Patient age
Patient sex
Weight
 
Serum creatinine
eGFR
Calcium
Albumin
Corrected calcium

Sodium
Glucose
Corrected sodium


Serum sodium or BUN
Serum creatinine
Urine sodium or urea
Urine creatinine
Fractional excretion (%)


Serum sodium
Ideal sodium
Weight
 

Free water deficit (L)


For ischemic CVA the heparin dosing is as follows: no bolus, and 600-1000 units/hr drip (not weight-based). For other indications, use the calculator below.
Heparin indication

(For ACS, strongly consider LMWH instead of unfractionated heparin. Also, if using a IIb/IIIa inhibitor with unfractionated heparin, dose the unfractionated heparin as though the patient has a STEMI.)
 
Patient sex
Weight
Height
Heparin dosing weight (kg)
Bolus dose
*
Initial drip rate
*


*Maximum doses:
VTE 9000 bolus, 2000/hr gtt
NSTEMI 5000 bolus, 1000/hr gtt
STEMI 5000 bolus, 1000/hr gtt


Patient's sex
Weight
 
Height
Weight (kg)
BMI
Ideal body weight (kg)


Patient sex
Patient age
African-American?
Serum creatinine
eGFR / 1.73 m2

Bilirubin
INR
Creatinine*
*If the patient has been dialyzed at least twice within the last week, enter "4.0" for the serum creatinine.
MELD Score
Three-month mortality risk based on MELD Score:
Score
Mortality
‹10
4%
10-19
27%
20-29
76%
30-39
83%
40+
~100%

First drug
First drug dose (mg)
Second drug
Second drug dose (mg)

Note #1: Opioid analgesics have widely variable half lives, and when you switch from one form to another, you should adjust the scheduling accordingly.

Note #2: Methadone should be dosed by someone with experience using the drug. Consult palliative care or pain management.


QT (msec)
HR (bpm)
QTc (msec)


First steroid
Dose to convert (mg)
Second steroid
Second steroid dose (mg)

Age over 65
3 or more CAD risk factors
Prior coronary stenosis (50% or more)
ST segment deviation on initial ECG
2 or more anginal events in previous 24 hours
ASA use in last 7 days
Cardiac enzyme elevation
TIMI Score
TIMI Risk for cardiac event (mortality, new MI, or need for emergent revascularization) in the next 14 days:
 
Score
0-1
4.7%
 
2
8.3%
 
3
13.2%
 
4
19.9%
 
5
26.2%
 
6-7
40.9%
Serum potassium
Urine potassium
Serum osmolality
Urine osmolality
TTKG

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