Renal transplant patients can be very complicated to manage because of hte underlying pathology necessitating the transplant, unique post-operative problems, and because of the vast array of immunosuppressants that they must take.  Because of this, and in order to effectively communicate with their transplant surgeon, the EP must have an understanding of likely post-operative complications, such as infections that the patient is likely at risk of acquiring.  He needs awareness of how common complaints such as abdominal pain and headache may warrant a more significant evaluation in these patients.  Also, the EP will need to be aware of the complex drug interactions between the many immunosuppressants that are prescribed.

by Jose Vega

 

You’re leaving the room of a patient with uncomplicated cellulitis.  You’re just about to order blood cultures when you realize all the nurses are busy.

 

At that moment an email from your department chair concerning cutting costs and improved efficiency begins to resonate in your head.  If you order the cultures, it’s going to tie up a room for half an hour until someone can draw them.  So do you really need them?  Will they change your management?