prmc interventional pulmonology - peninsulainterventional pulmonology the first 2 years yashvir...
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PRMCInterventional Pulmonology
The First 2 Years
Yashvir Singh Sangwan MBBS
Director of Interventional Pulmonology
Conflicts of Interest
I get a RVU based salary
I have never received a RVU bonus
I have had salary cuts for not making enough RVUs
I have no other Conflict of Interest as a Physician
Bronchoscopy
Pleural Procedures
Quantity
Vs.
Quality
A World-Class Service?
Pleural Outcomes
Clinicians can correctly distinguish 84% of effusions astransudate / exudate and identify 94% of exudates beforethoracentesis – So…why not go straightaway todefinitive treatment of the most likely cause?
Romero et al. Chest 2002; 122 : 1524 - 29
LOS down 3 days, Readmission down 60%
Repeat Procedures =0
Complications =0
# of Procedures / Effusion = 1.28
Both our volume & our
outcomes have
improved
Publications
➢Sangwan YS, Chasse R. A modified technique for percutaneousdilatational tracheostomy: A retrospective review of 60 cases.J Crit Care.2016 Feb;31(1):144-9.
➢Sangwan YS. Are New Airway Devices for Percutaneous DilatationalTracheostomy Really Needed? Respir Care. 2015 Jul;60(7):e132.
➢Sangwan YS. Double-lumen endotracheal tube device for percutaneousdilatational tracheostomy: an inventor's perspective. Chest. 2015May;147(5):e192.
➢Sangwan YS. Defining an ideal technique for percutaneous dilatationaltracheostomy--is real-time ultrasound guidance the final piece of thepuzzle? J Crit Care. 2015 Apr;30(2):429.
➢Sangwan YS, Palomino J et al. Critical airway management: a suggestedmodification to rigid fiber-optic stylet based on 301 novice intubations. JBronchology Interv Pulmonol. 2012 Oct;19(4):349-57.
➢Sangwan YS, Palomino J et al. A new endotracheal tube designed toenable a single operator to perform percutaneous dilatationaltracheostomy while maintaining the airway, providing continuousbronchoscopic guidance, and minimizing procedural complications:demonstration of feasibility on a mannequin and a cadaver. JBronchology Interv Pulmonol. 2011 Oct;18(4):368-73.
Abstracts➢ Amariei E, Sangwan YS et al. Successful Use of Intrapleural
Alteplase and Dornase in a Pregnant Woman with ComplicatedParapneumonic Effusion (ID 10168). ATS 2017.➢ Kalchiem-Dekel O, Sangwan YS et al. Fiberoptic Bronchoscopy for
ARDS Patients in Prone Position: Feasibility, Safety, Diagnostic &Therapeutic Utility (ID 8369). ATS 2017.➢ Sangwan YS et al. A Young Man with Severe Bronchial Stenosis: To
Stent or Not To Stent ? - That Is the Question (ID 7007). ATS 2017.➢ Leiter N, Sangwan YS et al. Administration of Intrapleural Therapy for
Thoracic Empyema in the Setting of a Bronchopleural Fistula: A NovelUse of the Intrabronchial Valve (ID 7880). ATS 2017.➢ Pickering EM, Sangwan YS, Sachdeva A et al. Tissue Acquisition
During EBUS: Comparison of a 19G vs 21G Needle (ID 11382). ATS2017.➢ Hersi K, Sangwan YS et al. 10082 - Multi-Modality Management of a
Lone Mediastinal Silicosis Presenting as an Extremely Rare Case ofChylothorax. ATS 2018.➢ Hersi K, Sangwan YS et al. 10165 - A Double Whammy-When
Pulmonary Toxin Join Forces. ATS 2018.➢ Hersi K, Sangwan YS et al. 10190 - Occam’s Razor: An Extremely
Rare Presentation of a Very Rare Pulmonary Manifestation of Lupus.ATS 2018.➢ Hersi K, Sangwan YS et al. 15459 - Flu Vaccine Associated ANCA
Vasculitis: A Rare Entity. ATS 2018.
ATS 2019
➢J Crossan et al. How empowering endoscopy staffdecreased our EBUS Scope damages
➢J Crossan et al. Outcomes of outpatient povidoneiodine pleurodesis via IPC
➢S Kalluri et al. A Chest Tube preferred approach toinpatient pleural effusions
➢J Crossan et al. Intra-pleural lytics- how low can wego?
➢S Kalluri et al. A rare case of Bronchiectasis
Even our patients are
Innovative
The Future - Robots ?
Asthma & COPD
Thanks