Critical pathways project: Difference between revisions

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==How to Get Started==
==How to Get Started==
===Select a Topic===
===Select a Topic===
A topic of interest on the Resident Survival Guide column is selected and a name is assigned to it.
{| class="wikitable sortable"
{| class="wikitable sortable"
!Topic
!Topic
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!Authorship
!Authorship
|-
|-
|[[Abdominal pain]]||[[Abdominal pain critical pathways]]|| (Assign name here)
|[[Abdominal pain]]||[[Abdominal pain critical pathways]]||
|-
|-
|[[Liver function tests|Abnormal Liver function tests]]||[[Abnormal Liver function tests critical pathways]]||
|[[Liver function tests|Abnormal Liver function tests]]||[[Abnormal Liver function tests critical pathways]]||
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===Next Steps===
===Next Steps===
<div class="mw-collapsible mw-collapsed">
# Use the algorithm in the Resident Survival Guide of the selected topic as reference.
# A click on the topic of choice directs you to the algorithm in the Resident Survival Guide.
<div class="mw-collapsible-content">
{{familytree/start}}
{{familytree | | | | | | | | | A01 | | | | | |A01='''[[pH]] < 7.35'''}}
{{familytree | | | | | | | | | |!| | | | | | | | }}
{{familytree | | | | | | | | | B01 | | | | | |B01='''[[Acidosis]]'''<br>(High [H<sup>+</sup>])}}
{{familytree | | | | | | | | | |!| | | | | | | | }}
{{familytree | | | | | | | | | B02 | | | | | |B02='''Determine the primary disorder'''<br> Metabolic or respiratory?}}
{{familytree | | | | | | | | | |!| | | | | | | | }}
{{familytree | | | | | | | | | B03 | | | | | |B03=Check [HCO3<sup>-</sup>] and PaCO<sub>2</sub>}}
{{familytree | | | |,|-|-|-|-|-|^|-|-|-|-|-|-|-|.| }}
{{familytree | | | C01 | | | | | | | | | | | |C02|C01=Low [HCO3<sup>-</sup>] <br>and<br> Low to normal PaCO<sub>2</sub>|C02= High PaCO<sub>2</sub> <br>and<br>High to normal [HCO3<sup>-</sup>] }}
{{familytree | | | |!| | | | | | | | | | | | | |!| }}
{{familytree | | | C03 | | | | | | | | | | | | C04 |C03='''[[Metabolic acidosis]]'''|C04='''[[Respiratory acidosis]]'''}}
{{familytree | | | |!| | | | | | | | | | | | | |!| }}
{{familytree | | | C05 | | | | | | | | | | | | C06 |C05='''Check for respiratory compensation'''<br><br>Calculate expected PCO<sub>2</sub>|C06='''Check for renal compensation'''<br><br> Calculate expected [HCO3<sup>-</sup>] }}
{{familytree | | | |!| | | | | | | | | | | | | |!| }}
{{familytree | | | |!| | | | | | | | | |,|-|-|-|^|-|-|-|-|.|}}
{{familytree | | | D01 | | | | | | | | D02 | | | | | | D03 |D01=Decrease in PaCO<sub>2</sub>=1.25 x (24- measured HCO3<sup>-</sup>)?|D02='''Acute acidosis?'''<br><br>Increase [HCO3<sup>-</sup>]=0.1 x (measure PaCO<sub>2</sub>-40)?|D03='''Chronic acidosis?'''<br><br>Increase [HCO3<sup>-</sup>]=0.1 x (measure PaCO<sub>2</sub>-40)?}}
{{familytree | |,|-|+|-|.| | | | | |,|-|+|-|.| | | |,|-|+|-|.| | }}
{{familytree | E01 |!| E02 | | | | E03 |!| E04 | | E05 |!| E06 |E01=PaCO<sub>2</sub> too low?<br><br> '''Mixed metabolic acidosis with respiratory alkalosis'''|E02=PaCO<sub>2</sub> too high?<br><br> '''Mixed metabolic acidosis with respiratory acidosis'''|E03=[HCO3<sup>-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E04=[HCO3<sup>-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis'''|E05=[HCO3<sup>-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E06=E04=[HCO3<sup>-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis''' }}
{{familytree | |:| E07 |:| | | | | |:| E08 |:| | | |:| E09 |:|E07=Measured PaCO<sub>2</sub> is equal to expected value?<br><br> '''Compensated metabolic acidosis'''|E08=Measured [HCO3<sup>-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis'''|E09=Measured [HCO3<sup>-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis''' }}
{{familytree | |:| |:| |:| | | | | |:| |:| |:| | | |:| |:| |:| | }}
{{familytree | |L| F01 |J| | | | | |L|~|A|~|A| F02 |A|~|A|~|J| | F01=[[Metabolic acidosis resident survival guide|'''Click here for the management of metabolic acidosis''']]|F02=[[Respiratory acidosis resident survival guide|'''Click here for the management of respiratory acidosis''']] }}
{{familytree/end}}
</div></div>
 
# Take a moment to study this algorithm.
# Use the first branching point on the algorithm as a guide for constructing the first question.
# Use the first branching point on the algorithm as a guide for constructing the first question.
# Provide answers to the question.  There could be two or more answers to this question.
# Provide answers to the question.  There could be two or more answers to this question.
Line 281: Line 252:
# After finishing the critical pathways, add the Critical Pathways icon in the '''Main Page''' by using the following wikicode.
# After finishing the critical pathways, add the Critical Pathways icon in the '''Main Page''' by using the following wikicode.


==Critical Pathways==
==Structure of the Critical Pathways==
The structure of the critical pathways looks like this:
{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| BGCOLOR=FLORALWHITE | Topic
| BGCOLOR=FLORALWHITE | Topic from the resident survival guide
|}
|}


{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| BGCOLOR=FLORALWHITE STYLE="WIDTH:50%"| Question || BGCOLOR=LIGHTGRAY STYLE="WIDTH:25%" | Answer 1 ||BGCOLOR=LIGHTGRAY STYLE="WIDTH:25%" | Answer 2
| BGCOLOR=FLORALWHITE STYLE="WIDTH:50%"| First question || BGCOLOR=LIGHTGRAY STYLE="WIDTH:25%" | Answer 1 ||BGCOLOR=LIGHTGRAY STYLE="WIDTH:25%" | Answer 2
|}
|}


==Definition==
==Definition==
* Definitions of conditions
* The specific definitions of the answers must be provided and referenced when possible.  For example;
* [[Metabolic acidosis]] is a state in which the blood [[pH]] is less than 7.35 due to increased production of H<sup>+</sup> by the body or the inability of the body to form [[bicarbonate]] (HCO3<sup>-</sup>) in the kidney.
* [[Anion gap]] = [Na<sup>+</sup>] - [Cl<sup>-</sup>] - [HCO3<sup>-</sup>]
* Normal reference range for anion gap is between 8 and 16 meq/L.<ref name="isbn0-683-18272-2">{{cite book | author = Benjamin Abelow | authorlink = | editor =| others = | title = Understanding acid-base | edition = | language = | publisher = Williams & Wilkins | location = Baltimore | year = 1998 | origyear = |pages = | quote = | isbn = 0-683-18272-2 | oclc = | doi = | url = | accessdate = }}</ref><ref name="isbn1-4160-3105-7">{{cite book | author = Rector, Floyd C.; Brenner, Barry M. | authorlink = | editor = | others = | title = Brenner & Rector's the kidney | edition = | language = | publisher = Saunders Elsevier |location = | year = 2008 | origyear = | pages = | quote = | isbn = 1-4160-3105-7 | oclc = | doi = | url = | accessdate = }}</ref>


==Action Items==
==Action Items==
*This involves formulating a treatment plan for the patient.
*This involves formulating a treatment plan for the patient.
==References==
{{Reflist|2}}


==Resources==
==Resources==

Revision as of 00:05, 15 August 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]

Overview

The critical pathways project is focused on developing standardized treatment protocols for the management of specific medical conditions which aim at applying evidenced-based medical therapies in patient care. It is designed to provide a quick guide in a chronological manner for health practitioners in making the most rapid diagnosis and treatment of medical conditions.

Goals

  • To improve the quality of making diagnoses and treating medical conditions
  • To improve the recognition of acute conditions and how patients are triaged to the desired level of care
  • Aims at reaching a general consensus regarding the management of certain medical conditions

Who Can Contribute?

The critical pathways project is intended for interns, residents, attending physicians, nurses, and nurses practitioners to contribute their specific areas of expertise. This project is intended for editors at an Associate Editor-in-Chief level.

How to Get Started

Select a Topic

Topic Resident Survival Guide Page Authorship
Abdominal pain Abdominal pain critical pathways
Abnormal Liver function tests Abnormal Liver function tests critical pathways
Acetaminophen overdose Acetaminophen overdose critical pathways
Acidosis Acidosis critical pathways
Acute coronary syndrome Acute coronary syndrome critical pathways
Acute decompensated heart failure Acute decompensated heart failure critical pathways
Acute kidney injury Acute kidney injury critical pathways
Acute liver failure Acute liver failure critical pathways
Acute meningitis and encephalitis Acute meningitis and encephalitis critical pathways
Acute pain management Acute pain management critical pathways
Acute pancreatitis Acute pancreatitis critical pathways
Acute pulmonary edema Acute pulmonary edema critical pathways
Acute respiratory distress syndrome Acute respiratory distress syndrome critical pathways
Acute vision loss Acute vision loss critical pathways
Adrenal insufficiency Adrenal insufficiency critical pathways
Agitation Agitation critical pathways
Alcohol withdrawal Alcohol withdrawal critical pathways
Alkalosis Alkalosis critical pathways
Altered mental status Altered mental status critical pathways
Anaphylaxis Anaphylaxis critical pathways
Anemia Anemia critical pathways
Arrhythmia Arrhythmia critical pathways
Arthritis Arthritis critical pathways
Ascites Ascites critical pathways
Asthma Asthma exacerbation critical pathways
Atrial fibrillation Atrial fibrillation critical pathways
Back pain Back pain critical pathways
Bleeding disorders Bleeding critical pathways
Bradycardia Bradycardia critical pathways
Brain death Brain death critical pathways
Carbon monoxide poisoning Carbon monoxide poisoning critical pathways
Cardiac arrest Cardiac arrest critical pathways
Chemotherapy toxicity Chemotherapy toxicity critical pathways
Chest pain Chest pain critical pathways
Cholelithiasis, cholecystitis, and cholangitis Cholelithiasis, cholecystitis, and cholangitis critical pathways
COPD exacerbation COPD exacerbation critical pathways
Cocaine overdose Cocaine overdose critical pathways
Congestive heart failure Congestive heart failure critical pathways
Constipation Constipation critical pathways
Contrast-induced nephropathy Contrast-induced nephropathy critical pathways
Deep vein thrombosis Deep vein thrombosis critical pathways
Diabetic ketoacidosis Diabetic ketoacidosis critical pathways
Diarrhea Diarrhea critical pathways
Dizziness Dizziness critical pathways
Dysphagia Dysphagia critical pathways
Dyspnea Dyspnea critical pathways
Endocarditis Endocarditis critical pathways
Fever Fever critical pathways
Gastrointestinal bleeding Gastrointestinal bleeding critical pathways
Headache Headache critical pathways
Hematuria Hematuria critical pathways
Hemoptysis Hemoptysis critical pathways
Heparin-induced thrombocytopenia Heparin-induced thrombocytopenia critical pathways
Hiccup Hiccup critical pathways
Hypercalcemia Hypercalcemia critical pathways
Hyperglycemia Hyperglycemia critical pathways
Hyperkalemia Hyperkalemia critical pathways
Hypernatremia Hypernatremia critical pathways
Empiric antibiotic regimen Empiric antibiotic regimen critical pathways
Hyperosmolar hyperglycemic state Hyperosmolar hyperglycemic state critical pathways
Hyperphosphatemia Hyperphosphatemia critical pathways
Hypertensive crisis Hypertension critical pathways
Hyperthermia Hyperthermia critical pathways
Hypocalcemia Hypocalcemia critical pathways
Hypoglycemia Hypoglycemia critical pathways
Hypokalemia Hypokalemia critical pathways
Hypomagnesemia Hypomagnesemia critical pathways
Hyponatremia Hyponatremia critical pathways
Hypophosphatemia Hypophosphatemia critical pathways
Hypotension Hypotension critical pathways
Hypothermia Hypothermia critical pathways
Hypoxemia Hypoxemia critical pathways
Ileus Ileus critical pathways
Infection control Infection control critical pathways
Influenza Influenza critical pathways
Insomnia Insomnia critical pathways
Low urine output Low urine output critical pathways
Metabolic acidosis Metabolic acidosis critical pathways
Metabolic alkalosis Metabolic alkalosis critical pathways
Narcotic withdrawal Narcotic withdrawal critical pathways
Nausea and vomiting Nausea and vomiting critical pathways
Neutropenic fever Neutropenic fever critical pathways
Nosocomial infection Nosocomial infection critical pathways
Oncologic emergencies Oncologic emergencies critical pathways
Overdose Overdose critical pathways
Pericarditis Pericarditis critical pathways
Pneumonia Pneumonia critical pathways
Pulmonary embolism Pulmonary embolism critical pathways
Rash Rash critical pathways
Respiratory acidosis Respiratory acidosis critical pathways
Respiratory alkalosis Respiratory alkalosis critical pathways
Respiratory failure Respiratory failure critical pathways
Seizure Seizure critical pathways
Sepsis Sepsis critical pathways
Shock Shock critical pathways
Sickle cell crisis Sickle cell crisis critical pathways
Spinal cord compression Spinal cord compression critical pathways
Stroke Stroke critical pathways
Subarachnoid hemorrhage Subarachnoid hemorrhage critical pathways
Syncope Syncope critical pathways
Tachycardia Tachycardia critical pathways
Thrombocytopenia Thrombocytopenia critical pathways
Thyroid storm Thyroid storm critical pathways
Transfusion Transfusion critical pathways
Tricyclic antidepressant overdose Tricyclic antidepressant overdose critical pathways
Urinary tract infection Urinary tract infection critical pathways
Vertigo Vertigo critical pathways
Wide complex tachycardia Wide complex tachycardia critical pathways

Next Steps

  1. Use the algorithm in the Resident Survival Guide of the selected topic as reference.
  2. Use the first branching point on the algorithm as a guide for constructing the first question.
  3. Provide answers to the question. There could be two or more answers to this question.
  4. Link provided answers to corresponding pages on WikiDoc.
  5. Give Definitions and Action Items for the first question. Please add references when necessary.
  6. Use the second branching point after each answer as a reference for the second question.
  7. Repeat steps 3, 4, and 5.
  8. After finishing the critical pathways, add the Critical Pathways icon in the Main Page by using the following wikicode.

Structure of the Critical Pathways

The structure of the critical pathways looks like this:

Topic from the resident survival guide
First question Answer 1 Answer 2

Definition

  • The specific definitions of the answers must be provided and referenced when possible. For example;
  • Metabolic acidosis is a state in which the blood pH is less than 7.35 due to increased production of H+ by the body or the inability of the body to form bicarbonate (HCO3-) in the kidney.
  • Anion gap = [Na+] - [Cl-] - [HCO3-]
  • Normal reference range for anion gap is between 8 and 16 meq/L.[1][2]

Action Items

  • This involves formulating a treatment plan for the patient.

References

  1. Benjamin Abelow (1998). Understanding acid-base. Baltimore: Williams & Wilkins. ISBN 0-683-18272-2.
  2. Rector, Floyd C.; Brenner, Barry M. (2008). Brenner & Rector's the kidney. Saunders Elsevier. ISBN 1-4160-3105-7.

Resources

  • Wikicode for Icons
__NOTOC__
{| class="infobox" style="float:right;"
|-
| [[File:Siren.gif|30px|link={{PAGENAME}} resident survival guide]]|| <br> || <br>
| [[{{PAGENAME}} resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
|}
{| class="infobox" style="float:right;"
|-
| [[File:Critical_Pathways.gif|88px|link={{PAGENAME}} critical pathways]]|| <br> || <br>
|}

  • Wikicode for Critical Pathways
__NOTOC__
{{CMG}}

==Critical Pathways==
{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| BGCOLOR=FLORALWHITE | {{Smallcaps|[[{{PAGENAME}} critical pathways|{{PAGENAME}} critical pathways]]}}
|}

{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| BGCOLOR=FLORALWHITE STYLE="WIDTH:50%"| Critical Point 1 || BGCOLOR=MEDIUMAQUAMARINE STYLE="WIDTH:25%" | [[{{PAGENAME}} A critical pathways|A]] ||BGCOLOR=LIGHTGRAY STYLE="WIDTH:25%" | [[{{PAGENAMEE}} B critical pathways|B]]
|}

{|CELLPADDING=20 STYLE="WIDTH:50%; HEIGHT:50px" BORDER="1"
| BGCOLOR=FLORALWHITE STYLE="WIDTH:50%" | Critical Point 2 || BGCOLOR=MEDIUMAQUAMARINE STYLE="WIDTH:25%" | [[{{PAGENAME}} A1 critical pathways|A1]] ||BGCOLOR=LIGHTGRAY STYLE="WIDTH:25%" | [[{{PAGENAMEE}} A2 critical pathways|A2]]
|}

==Definition==

==Action Items==

==References==
{{Reflist|2}}

[[Category:Critical pathways]]
[[Category:Disease]]
[[Category:Emergency medicine]]
[[Category:Medicine]]
[[Category:Primary care]]
[[Category:Signs and symptoms]]

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