Allergy / Immuno / Pulmonology

Pediatric Allergy/Immunology and Pulmonology Consult Rotation 

• Please read the articles that are posted online for this rotation. We also recommend that you read your pulmonary/allergy/immunology sections in your general pediatrics textbook or read Nelson's online. Also, please make sure you are covering the A/I/Pulm sections of your content specs. 
• Choose a topic at least twice a week and meet with one of the attendings to discuss - please plan a time to meet with that attending.  
• We usually have the residents on our rotation give us a talk at the end of your rotation on an allergy, immunology, or pulmonary topic of your choosing. Please discuss this with Dr. Otsuka and she will help you determine a day and time to do this.
• Please keep up the consult lists and follow up on items that are outstanding
• BPD, CF,  HMV clinics are all at the Specialty Clinics on E. Caroline St. Suite G. CF clinics are Monday afternoons and Wednesday mornings. BPD clinics are usually on Tuesday afternoons and Thursday mornings (except for the last Tuesday of the month which is a HMV clinic and the 2nd Thursday of the month which is a CF clinic). HMV clinics are Friday mornings.
• DMD clinics are in the neurology clinic Suite A on Caroline St. These clinics are on the 1st and 3rd Friday afternoons. 
• Suite J clinics (also on Caroline) usually start by 0830 and afternoon clinics start at 1300. Specialty clinics start at 0900 or 1300 but report after your morning conferences and noon conferences. New patients usually are scheduled at 08:30-9:30 and 1300-1400 so it is imperative that you are in clinic during these times to maximize your learning experience. 
• Primarily you should attend clinics in Suite J but if you are interested you may attend one CF, BPD, HMV, and DMD clinic if you have enough time on your rotation to do so. If there is no clinic in Suite J, please attend another clinic that is available.
• Keep a list of the clinics that you have attended and send this to Dr. Otsuka at the end of your rotation. Please alert Dr. Otsuka if you are not able to attend a clinic.
• You should be able to attend noon and morning conferences so please remind us if we are keeping you late.
• PLEASE NOTIFY THE APPROPRIATE ATTENDING AS SOON AS YOU HEAR ABOUT A CONSULT to determine a meeting time. The pulmonary consult attending is in clinic on Monday-Tuesday afternoons (with the exception of Dr. Fanous who also has a clinic on Wednesday afternoon). The ward attending therefore would like to see the consult before heading out of the hospital. Also we expect that data collection, parental interview, should be performed in a timely fashion usually not more than 1 hour therefore when consults arise in clinic you should leave at an appropriate time to complete the consult in order to present to the attending managing the case.  The consult notes SHOULD NOT be a copy of the original H&P and the history should reflect the consult that you are performing and all of the appropriate information including the history, past medication history - including birth history, prior hospitalizations, medications, family and social history should be obtained (DO not use the EPIC statement that PMHX, FHX, and SHX has been reviewed insert those items into the note). If the family is not present, please call them.
• Allergy/immunology consults are done by Dr. Fanous or Dr. Ariue (Amelia will have their monthly schedule).
• New home ventilator consults are done by Dr. Ischander but the attending on call will do the consults if this is a current HMV patient or a patient that needs CPAP or BiPAP. If there is a new sleep consult that requires a sleep study then Dr. Ischander will do the consult; however, if  the patient already has a sleep study or they are trying to determine if the child should have a sleep study consult the attending on call
• For the most part, your rotation should be an outpatient rotation. You can obtain the information for consults but the write up of these can usually be done after you have attended clinic. Unless you are receiving more than 5 consults a day, we expect you to be in clinic at least for 4 hours a day.

If you have any questions about the rotation, please contact Dr. Otsuka

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