Resident`s Levels of Care

                        Pulmonary & Critical Care Medicine
                                              Resident Levels: PGY IV/ V/ VI

Clinical Diagnosis Management	Clinical Non-Invasive Management	Clinical Invasive (Operative Management)
Perform and document history and physical examination Formulate differential diagnosis Obtain and document informed consent Perform pulmonary artery catherization Order appropriate consults Understand the role of the pulmonary & critical care physician as a consultant to other physicians Perform arterial catheterization Interpret hemodynamic parameters in critically ill patients Perform diagnostic flexible fiberoptic bronchoscopy Interpret chest radiographs and CT images of the chest Interpret therapeutic drug levels for antibiotics and other drugs Understand the basic fundamentals of sleep polysomnography interpretation Interpret pulmonary function tests including spirometry, lung volumes, diffusing capacity, and methacholine challenge testing Interpret cardiopulmonary exercise testing	Perform orotracheal and nasotracheal intubation Perform basic and advanced cardiac life support Manage mechanical ventilation in acute and chronic respiratory failure Perform tube thoracostomy Order continuous renal replacement therapies Perform electrical cardioversion Perform transcutaneous cardiac pacing Order continuous sedative and analgesics in the critically ill Perform monitored conscious and deep sedation for invasive procedures Perform intravenous anesthetic induction for intubation Perform management of complex fluid and electrolyte disorders Perform intravenous thrombolytic therapy Order appropriate pharmacologic therapy for management of circulatory shock and related disorders Order parenteral nutirition during critical illness	Perform emergency pericardiocentesis Perform thoracentesis Perform pleural biopsy Perform tube thoracostomy Perform therapeutic bronchoscopy Perform bronchoscopy with transbronchial biopsy Insert temporary transvenous pacemakers Perform emergency cricothrotomy Perform whole lung lavage Perform endobronchial stent placement Perform endobronchial brachytherapy Perform pleurodeisis

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