51. Formulae

Creatinine clearance estimation

Ideal Body Weight

Creatinine clearance from timed urine collection

Fractional excretion of sodium

Estimation of total protein from spot urine

Urine anion gapurine anion gap = UNa + UK – UCl

normal UAG negative and urine pH <5.5implied RTA: UAG positive and urine pH >5.5GI loss of bicarbonate: UAG negative and pH >5.5

Acid-base compensationsprimary metabolic acidosis: pCO2 = 1.5 × HCO3 + 8 ± 2primary metabolic alkalosis: pCO2 = 0.7 × HCO3 + 20 ± 1.5 primary respiratory acidosis: acute pH 0.008 for each pCO2 1 mm Hg

chronic pH 0.003 for each pCO2 1 mm Hgprimary respiratory alkalosis acute pH 0.008 for each pCO2 1 mm Hg

chronic pH 0.017 for each pCO2 1 mm Hg

Change in sodium based on infusate

Total body water (in liters) is calculated as a fraction of body weight; fraction is 0.6 in children; 0.6 and 0.5 in non elderly men and women; 0.5 and 0.45 in elderly men and women respectively. See N Engl J Med 2000;342:1581-1589

Sodium deficit in hyponatremiaNa deficit = 0.6 × lean weight (in men) × (140 – measured Na)

In women, the 0.6 factor becomes 0.5.

MGH Medical Housestaff Manual 121

N.B. at MGH, the urine creatinine is reported in mg/mL (as opposed to mg/dL in the serum); thus calculation with the raw numbers gives the FeNa as a percentage

ratio gives daily protein excretion in mg; based on observation that daily creatinine excretion is about 1000 mg (N Engl J Med 1983; 309:1543)

51. Formulae

Free water deficit in hypernatremia

In women, the 0.6 factor becomes 0.5.

Phenytoin serum concentration correction for hypoalbuminemia

In end stage renal disease, the 0.2 factor becomes 0.1.

Plasma osmolality

Calcium correction for hypoalbuminemiaCorrected Ca = measured calcium (mg/dL) + 0.8 (4.0 measured albumin (mg/dL))

Alveolar-arterial oxygen gradientNormal A-a gradient = 2.5 + (0.21 age)

Calculated A-a gradient = PAO2 PaO2

FiO2 = inspired fraction of O2 = 0.21 on room airPB = atmospheric pressure (mm Hg) = 760PH2O = alveolar pressure of water (mm Hg) = 47R = respiratory quotient 0.8 (N.B. R = 1 for glucose, 0.667 for saturated fat, 0.8 for protein)

Systemic vascular resistance

MGH Medical Housestaff Manual 122

52. Coronary anatomy

MGH Medical Housestaff Manual 123

53. Dermatome map

MGH Medical Housestaff Manual 124

54. Miscellaneous info (paging, dictations)

MGH Medical Housestaff Manual

Team floors, attending round locations, call room locationsAttending

roundsCall room

Team 1 (Ellison 16) Ellison 16 Ellison 16Team 2 (White 10, Phillips 20) Ellison 19 Phillips 20Team 3 (Ellison 14, Phillips 21) Ellison 14 Ellison 14Team A (White 9) White 9 White 9Team B (White 8) White 8 White 8Team C (Bigelow 11) Bigelow 11 Bigelow 11Team D (White 8) Bigelow 745 White 8Team X (White 10) Potts White 9SDU (Ellison 10) Ellison 10 Ellison 10CCU (Ellison 9) Ellison 9 Ellison 9Medical senior on call Bigelow 10Unit senior Ellison 9Bigelow teaching senior White 9Ellison teaching seniorJunior night float Ellison 9Men’s only VBK 325Women’s only White 901

Paging at MGH MGH page operator: 6-2241, 6-2066, or 6-2000 Deluxe paging: 4-5656 Quick page: 4-5700

To connect to a caller who is holding for you, check your voice mail, or change your pager status call 4-5800.Paging status may also be updated online (via Partners Telephone Directory), http://ppd.partners.org.Pager status code

2 = in hospital, available to page3 = in hospital, page emergency only4 = not available5 = in surgery6 = can be reached at telephone # XXX-XXXX7 = calls be taken by beeper # X-XXXX8 = out of hospital, available to page9 = out of hospital, page emergency only

DictationsAutomated dictation system: 4-3125

1. Type in 5 digit pin number, then pound (# sign)

2. Enter work type number If regular enter 22 and # If semi-stat, enter 44 and # If stat enter 66 and #

3. To start dictating, enter Medical Record number and then #

4. To back up during dictation, enter 3 (continue hitting 3 until you get where you want)

5. To continue forward, enter 26. To end dictation and continue onto another,

enter 87. To end all dictations and exit system, enter 5

Medical Records, clinics basement 6-2490 (to have

Bigelow visitMGH-affiliated health center Bigelow visit

is attending of record

Patient notes Billing cards Round on patients

Back Bay Yes Yes Yes YesDowntown Yes Yes Yes YesEast Boston Yes Yes Yes YesEvening Medical Group Yes Yes Yes YesNorth End Yes Yes Yes YesCharlestown No No No NoChelsea No No No NoEverett No No No NoRevere No No No No

DictationsAutomated dictation system: 4-3125 Type in 5 digit pin number, then pound (#)

sign Enter work type number

If regular enter 22 and # If semi-stat, enter 44 and # If stat enter 66 and #

To start dictating, enter Medical Record number and then #

To back up during dictation, enter 3 (continue hitting 3 until you get where you want)

To continue forward, enter 2 To end dictation and continue onto

another, enter 8 To end all dictations and exit system, enter

5

Medical Records, clinics basement 6-2490 (to

125

55. Medical housestaff

Alabiad, Chris JR 38750 CHA WAlcalay, Roy INT 34879Allen, Larry SR 38125 BMG TuAnwaruddin, Saif JR 38751 NWH TuAusiello, John INT 34883 10 WAusten, Elizabeth JR 38752 MGMG WBaeten, Jared INT 34886 7/HIV MBaggish, Aaron JR 38753 3 TuBaker, Meghan SR 38127 5 WBarbie, David JR 38754 5 MBass, Adam JR 38755 4 FBecker, Jason JR 38756 5 WBhan, Ishir SR 38129 4B WBlatt, Jacob INT 34901 7 ThBrown, Samuel SR 38130 10 MCharles, Richelle INT 34902 7 TuChen, Yi-Bin JR 38757 5 WChiappa, Victor INT 34903 5 TuChien, Amy INT 34904 3 ThCho, Tracey INT 34905Christopoulos, Katerina INT 34906 7/HIV MChun, Leslie JR 38759 4 WChyung, Yung INT 34911 MGMG TuClark, Brendan INT 34913 8 WCleary, James INT 34922 1 MCorey, Kathleen INT 34927 BMG FCrotty, Laura INT 34936 4 FCuevas, Elizabeth SR 38131 CHC WDanila, Daniel JR 38761 8 TuD'Antonio, James JR 38760 BMG WDavies, Michael SR 38132 BH WDavis, John JR 38762 1/HIV MDeFaria, Doreen INT 34950 9 ThDoctoroff, Lauren INT 34951 CTN TuDougherty, Ryan JR 38764 BMG FDurrani, Khayyam INT 34956Dygert, Paula (M/P) SR 37244 Everett WEagleson, Elizabeth JR 38765 CTN TuEgnaczyk, Gregory INT 34958 1 MEpstein, Lucy INT 34965Evans-Molina, Carmella (PC) SR 38133 4A/WHA MFaber, Tom JR 38722 Everett WFernandez, Nielsen JR 38766 CHC MFogerty, Annemarie INT 34970 CHC FFriday, Robert JR 38767 1 FGandhi, Leena JR 38768 RHC FGeyer, Alexander INT 34979 RHC WGlasofer, Sidney INT 34980 3 MGorodeski, Eiran INT 38005 MGMG W

Grable, Phyllis INT 34984Graham, Garth SR 38135 4 TuGross, Rebekah JR 38769 CTN TuGutierrez, Orlando JR 38770 5 ThHiggins, James SR 38138 4B WHo, Ivan SR 38139 10 FHo, Wendy JR 38771 3/WHA MIsakova, Tamara INT 34991 4 TuIyasere, Christiana JR 38772 1/HIV MJacobs, Ramon JR 38724 CHC TuJean-Jacques, Muriel INT 34992 10/WHA MJordan, Jamie INT 34995 7 FKao, Ann (M/P) SR 37242 RHC WKathpalia, Paru INT 34996 BH WKeebler, Mary JR 38774 BH FKelley, Alyson INT 35008 BH WKent, Sarah INT 35009 10/WHA MKind, Amy Haavisto (PC) SR 38143 4A/WHA MKing, Jennifer INT 35014 1 FKiryluk, Krzysztof JR 38775 BH FKorngold, Ethan SR 38144 9 TuKrauser, Daniel SR 38145 MGMG WKuo, Alexander SR 38146 1A MKwon, Annette JR 38776 2 TuLarvie, Mykol INT 35033Lee, Percy INT 35032Lin, Jeffrey INT 35046Linden, Erica JR 38777 RHC WLiu, Catherine JR 38778 9 MLiu, Yu SR 38149 8 WLui, George JR 38725 Everett WLynch, John JR 38780 MGMG TuMagnani, Jared JR 38781 CHC WMannstadt, Michael SR 38150 BMG FMcCall, Jennifer JR 38783 3/WHA MMcCants, Rotonya SR 38151 6 WMcGarvey, Scott JR 38015 RHC ThMehrotra, Ateev (M/P) SR 34795 RHC MMerchant, Faisal INT 35051 9 WMills, Lisa JR 38804 7 WMoore, Allan INT 35053 BMG WMorrill, James SR 38152 RHC FMorss, Alex SR 37281 CHA WMoss, Joshua INT 35055 2 MMurray, Lorne INT 35060 10 WMyers, Julie INT 35061 CHC WNgo, Duyen SR 38153 BH WNguyen, Deanna SR 38154 MGMG Tu

MGH Medical Housestaff Manual 126

55. Medical housestaff

Nguyen, Duy JR 38785 BH/SH FNozari, Ala INT 35063O'Donoghue, Michelle JR 38786 BMG TuO'Halloran, David SR 38155 6 FOlsen, Josalyn INT 35065 NEHC WOwens, Robert INT 35066 8 WPardee, Timothy INT 36067 6 FPeck, Robert INT 34669 RHC WPekow, Joel INT 35071 1 FPerez, Marco SR 38158 4C MPerri, Patrick SR 38159 CTN TuPoppers, David SR 38160 8 ThPowis, Kathleen INT 34670 CHC TuPride, David INT 35075 4 TuPugliese, Douglas INT 35083Ragar, Brent INT 34673 Everett WRanjan, Ravi JR 38788 4 TuRhee, Eugene INT 35084 10 ThRhee, Ina JR 38789 8 ThRiccio, Christopher (M/P) SR 37239 RHC WRogers, Karen INT 34685 MBB MRothenberg, S. Michael JR 38791 RHC WRuddy, Kathryn INT 35088 5 TuSakhuja, Rahul INT 35089 1 FSarraf, Pasha JR 38792 9 WSavir, Asaf INT 35090 4 MSchwartz, Brian JR 38013 RHC WSharman, Jeff SR 38162 3 MShaywitz, Adam JR 38794 2 ThShifrin, Seth (M/P) SR 37243 MIT W

Shih, Alvin INT 35093 BMG TuSmith, Akaya INT 35104 4 ThSolomon, Margaret JR 38012 CHC TuSood, Suman SR 38163 9/WHA ThSosa, Lynn JR 38795 9 TuSpeliotes, Elizabeth JR 38796 4 ThThakore, Avni SR 38164 BH FThomas, Karen JR 38798 10 FTodd, Derrick INT 35127 9 FTolle, James SR 38165 5 FTrice, Elizabeth INT 35133 CTN WTsai, Andy INT 35134Tsai, Kenneth INT 35147Tung, Roderick SR 38166 3 FWan, Emily JR 38800 3 FWeiner, Rory INT 35155 5 ThWeiss, Matthew SR 38167 6 FWelch, Julie JR 38011 RHC WWexler, Tamara INT 35157 DT MWright, Douglas JR 38801 BH/SH FWykrzykowska, Joanna JR 38802 6 MYachimski, Patrick JR 38803 8 ThYassa, David JR 38727 MBB MYeckes, Heather SR 38168 10/WHA ThYeh, Robert INT 35162 2 ThYu, Channing INT 35164 7 ThYu, Timothy INT 38001Yusuf, Rushdia INT 38003 RHC FZacks, Eran SR 38169 6 ThZeglis, Mark SR 38170 8 MZhu, Tong SR 38171 2 W

Clinic abbreviationsBH = Beacon HillBMG = Bulfinch Medical GroupCHA = Cambridge Health AllianceCHC = Chelsea Health CenterCTN = Charlestown Health CenterEverett = Everett Family CareHIV = HIV Clinic MBB = MGH Back BayMGMG = Mass General Medical GroupRHC = Revere Health CenterSR = MGH Senior HealthWHA = Women's Health Associates

MGH Medical Housestaff Manual 127

56. Area hospitals and health centers

Addison Gilbert Hospital 978-283-4000Anna Jacques Hospital 978-463-1000Beth Israel Deaconess Medical Center 617-667-7000Beverly Hospital 978-922-3000Boston Medical Center 617.638.8000Brigham & Women’s Hospital 617-732-5500Brockton Hospital 508-941-7000Bulfinch Medical Group (BMG) 617-724-6620Bunker Hill Health Center 617-724-8160Cambridge Hospital 617-498-1000Cape Cod Hospital 508-771-1800Carney Hospital 617-296-4000Charlestown Health Center 617-724-8160Chelsea Health Center 617-884-8300Chelsea Soldiers Home 617-884-5660Children’s Hospital 617-355-6000East Boston Health Center 617-569-5800East Boston Health Center Urgent Care 617-568-4470Emerson Hospital 508-369-1400Everett Family Care 617-394-7500Falmouth Hospital 508-548-5300Faulkner Hospital 617-983-7000Framingham Union, MetroWest 508-383-1000Good Samaritan Hospital 508-588-4000Holy Family Hospital 978-687-0151Holyoke Hospital 413-534-2500Jewish Memorial Hospital (Boston) 617-442-8760Jordan Hospital 508-746-2000Joslin Diabetes Center 617-732-2400Lahey Clinic, Main Burlington 781-744-5100Lahey Clinic, North 978-538-4000Lawrence General Hospital 978-683-4000Lawrence Memorial Hospital 781-306-6000Leonard Morse, Metrowest 508-650-7000Lowell General Hospital 978-937-6000Malden Hospital 781-322-7560Martha’s Vineyard Hospital 508-693-7900Mass General Medical Group (MGMG) 617-724-3346McLean Hospital 617-855-2000MEEI 617-523-7900Melrose-Wakefield Hospital 781-979-3000MetroWest Hospital 508-383-1000MGH West – Waltham 781-522-9000Milton Hospital 617-696-4600Morton Hospital 508 828-7000Mount Auburn Hospital 617-492-3500Nantucket Cottage Hospital 508-228-1200New England Baptist Hospital 617-754-5800New England Medical Center 617-636-5000Newton-Wellesley Hospital 617-243-6000

North End Health Clinic 617-742-9570North Shore Medical Center 978-741-1215Portsmouth Regional Hospital 603-436-5110Quigley Memorial Hospital (Chelsea) 617-884-5660Quincy Hospital 617-773-6100Revere Health Center 781-485-6000Rhode Island Hospital 401-444-4000Saints Memorial Medical Center, Lowell 978-458-1411Shattuck Hospital 617-522-8110Somerville Hospital 617-591-4500South Shore Hospital 781-340-8000Spaulding Rehab Hospital 617-573-7000Spaulding, Downtown Crossing 617-724-5044Spaulding, Framingham 508-872-2200Spaulding, Medford 781-391-7518Speare Memorial Hospital, Portsmouth, NH 603-536-1120St. Anne’s Hospital 508-674-5741St. Elizabeth’s Hospital 617-789-3000St. Joseph’s Hospital (Nashua) 603-882-3000St. Luke’s Hospital (New Bedford) 508-997-1515St. Vincent Hospital (Worcester) 508-363-5000Sturdy Memorial Hospital (Attleboro) 508-222-5200UMass Memorial Medical Center 508-334-1000Union Hospital (Lynn) 781-581-9200VA – Brockton 508-583-4500VA – Jamaica Plain 617-232-9500VA – West Roxbury 617-323-7700Whidden Memorial Hospital 617-389-6270Winchester Hospital 781-729-9000Worcester Medical Center 508-363-5000Youville Rehabilitation Hospital 617-876-4344

57. Useful NWH phone numbers

Main number 617-243-6000

CCU 65874 Usen 6459Tanger 4 West 64005 Usen 68955 West 63406 Usen 63076 West 6323Chemistry 6093Hematology 6595Bacteriology 6096Blood bank 6091Labs at night 6107EEG 6624EKG 6629Echo 6231Pathology 6104GI clinic 6151Psychiatry 6434Radiology 6075CT 6724MRI 6217Ultrasound 6050Nuclear medicine 6050RTAS 6757OR 6289Pharmacy 6012Scheduling 6800Williams, Marie 6467

58. Useful MGH phone numbers

LABORATORIESGeneral lab info 4-LABSChemistry 6-3636Hematology 6-3601Blood gas (stat lab) 6-3856Blood bank 6-3623Special coag 6-3900Thyroid lab 6-8642Microbiology 6-3613Blood Cultures 6-7919Parasitology 6-3861Virology 6-3820Serology 4-7645Pathology (main) 6-2967Cytology 6-3980Immunopath (ANCA, flow, EM) 6-8493Immunology 6-3743CARDIAC STUDIESCath lab 6-7400Echo (inpt, TEE, dobut echo) 6-8871Echo (outpt) 6-1840EP Lab 6-5036Pacer Interrogation 4-2820Holter lab 6-7737Stress lab (ETT) 4-3600NEURO STUDIESEEG 6-3640EMG/NCS 6-3644CNI/TCD (clin vasc lab) 6-2034Sleep study (inpatient) 4-7419Sleep study (outpatient) 4-7426PULMONARY STUDIESInduced sputum page RTPFT 6-1200UROLOGY STUDIESUrodynamics 4-5101

RADIOLOGYRoutine scheduling 4-XRAYEW/White 1 radiology 6-3050EW CT Room 6-6760Film Library (Dodd Ell 2) 4-4212Chest (IR lung biopsy) 4-4254Chest x-ray (Ellison 2) 4-4201CT main desk (Blake 2) 4-1036GI fluoroscopy 4-4221GI reading room 4-4210Chest reading 4-4213Bone 6-7717MRI main desk 4-4226MRI scanner (inpatient) 4-9521Nuclear med (V/Q, bone) 6-8350Neurorad 6-8320Neurorad emerg pager 39991PET scheduling 6-8367PET scanner 6-9548Portable CT Tech for ICU 34147Ultrasound 6-3074GI/GU interventional(thora, para, liver bx)

6-8396

Vascular (LENI, angio), interventional

6-8314

Vascular (arterial, carotid) 6-2034

58. Useful MGH phone numbers

Main number 617-243-6000

CCU 65874 Usen 6459Tanger 4 West 64005 Usen 68955 West 63406 Usen 63076 West 6323Chemistry 6093Hematology 6595Bacteriology 6096Blood bank 6091Labs at night 6107EEG 6624EKG 6629Echo 6231Pathology 6104GI clinic 6151Psychiatry 6434Radiology 6075CT 6724MRI 6217Ultrasound 6050Nuclear medicine 6050RTAS 6757OR 6289Pharmacy 6012Scheduling 6800Williams, Marie 6467

PHARMACYInpatient pharmacy 6-3572Outpatient pharmacy 4-3100Outpatient pharmacy fax 6-3789

MISCELLANEOUSAdmitting 6-3390Admitting fax 4-8409MD Connect 6-3384Bauer library (housestaff) 6-8054/4-6585Infection control 6-2036Interpreter Services 6-6966Medical Services 6-2862Occupational health 6-2217Poison center 617-232-2120Physician referral 6-5800Registrar’s office 6-2119Security 6-2121Treadwell library 6-8600White front desk 6-2281

FREQUENTLY USED NUMBERSPage operator 6-2241ETT (stress test) 4-3600Echo (TTE) 6-8871Stat portable X-ray 6-3050LENI 6-8314Neurorad emerg pager 39991Routine rads sched 4-XRAYLabs 4-LABSMedical senior on beeper 22337

MEDICAL RECORDSRecord requests 6-2470Dictations (to pull charts) 6-2490To dictate 4-3125

MGH CAFETERIABreakfast: 6:30-10:30 am M-F (7-10 WE)Lunch: 10:45-3 pm M-F (11-2 WE)Dinner: 4:15-8 pm M-F (Until 7 WE)Housestaff dinner: 9-10 pm M-F

58. Useful MGH phone numbersFLOOR PHONE FAXBigelow 7 6-3496 4-2862Bigelow 9 (RACU) 4-9000 4-9999Bigelow 10 (Dialysis) 6-3700 6-5876Bigelow 11 4-1500 6-4202Bigelow 13 (Burn) 6-3354 6-7561Bigelow 14 6-6100 6-7562Blake 6 (Transplant) 4-8610 4-8650Blake 7 (MICU) 6-8048 4-0102Blake 8 (Cardiac SICU) 4-4410 4-4450Blake 11 (Psychiatry) 4-9110 4-9150Blake 12 (Neuro ICU) 6-8071 6-7560Ellison 4 (SICU) 4-5100 6-7566Ellison 6 4-4610 4-4650Ellison 7 4-4710 4-4750Ellison 8 4-4810 4-4850Ellison 9 (CCU) 4-4910 4-4950Ellison 10 (SDU) 4-5010 4-5050Ellison 11 (Cards access) 4-5110 4-5150Ellison 12 4-5210 4-5250Ellison 14 4-5410 4-5450Ellison 16 4-5610 4-5650Ellison 19 4-5910 4-5950Phillips 20 4-6010 4-6050Phillips 21 4-6110 4-6150Phillips 22 4-6210 6-4228White 6 6-6106 6-7555White 7 6-3336 6-7550White 8 6-3339 6-7551White 9 6-3342 6-7557White 10 6-3345 6-7564White 11 6-3348 6-7558White 12 6-3351 6-8272PACU 6-2835 4-8422OR front desk 6-8910Surgical day care 6-8593

SPECIALTY CLINICS (OUTPT)Allergy/Immunology 6-3850Anticoagulation 6-2768Arthritis/Rheumatology 6-7938Breast Center 4-4800Cardiology 4-6750Dental 6-1076Dermatology 6-2745Endocrine 6-8720Epilepsy 6-3311GI clinic 4-6113GID/STD 6-2748Gynecology 6-2756Hematology 4-6193In vitro fertilization 4-3500Infectious disease 6-3906Medical Walk-In 6-2707Neurology 6-2777Neurosurgery 6-3776Neuropsychiatry 6-3647Obstetrics 4-BABYOncology 4-4000Oral surgery 6-2740Ortho brace clinic 6-3248Orthopedics 6-2784Pain Center 6-8810Physical therapy 6-2961Podiatry 6-3487Psychiatry 4-5600Pulmonary 6-1721Radiation oncology 6-8653Renal 4-0329Surgery (general) 6-2760Travel 4-1934Urology 6-2797

EMERGENCY DEPARTMENTMain 4-4100 6-7415APS 6-2994 4-3727MAMP 4-4190MIMP 4-4134RDU 4-4149Trauma/Acute 4-4170Medical Walk In Unit 6-2707

INPATIENT CONSULTSIf not listed or after hours call MGH page operator.Acute stroke service pager 34282Addictions (West End) 6-2984Allergy 6-3850Cardiology (ward) 6-9292Dental (pager 31062) 6-1076Dermatology pager 28008Endocrine 6-3966Hematology/Oncology 4-5559Infectious disease 6-3812Homeless team 4-3729Nutrition (TPN) 6-3373Pain Service pager 2PAINPalliative Care 4-9197Pathology (FNA Service) 6-3980Psychiatry 6-2984Pulmonary 6-3735Radiation oncology 6-8650

MASSACHUSETTS EYE AND EAR INFIRMARYOperator 617-523-7900Emergency Department 617-573-343111th floor 617-523-7900 x2480PACU 617-523-7900 x2392ENT clinic 617-573-4101ENT consult 617-573-3431Ophthalmology clinic 617-573-3202Ophthalmology consult 617-573-3412