Ward Resources
Pharmacy Resources
These are some resources put together by the VGH Pharmacy, which can be very helpful in your day-to-day ward management
Medical Procedures and Blood Thinners
These are the VCH guidelines for medical procedures and how long blood thinners (antithrombotics and anticoagulation) need to be held before and after the procedure. We generally go by the old guidelines where LP is considered "standard risk". 2022 guidelines are also attached for reference.
Bloodthinners and Medical Procedure Guidelines (Old).pdfLP and antithrombotics (New).pdfImmunotherapy Resources
We often use a variety of immunotherapies in the course of treating inflammatory diseases. These have unique side effect profiles that are important to discuss with our patients. These are some resources that can be helpful with counselling patients and determining appropriate treatment.Â
RheumInfo has excellent info sheets on most of the immunotherapy medications we use (e.g. IVIg, rituximab, MMF, azathioprine, cyclophosphamide, etc.). Search for the relevant drug and scroll to the bottom of the page to find the "Quick Reference Guide"
BrainWorks is an initiative of SickKids Hospital in Toronto, which provides useful treatment algorithms and tapering schedules for patients with inflammatory CNS disorders (CNS vasculitis in particular, but also antibody-mediated disorders)
VGH General Neurology - Who to review with?
Daytime, Consult attending (typically arrives around 1pm)
Consults admitted to other services (except ICU)
Consults in ICU patients not likely targeted to neurology (eg. neurosurgical patient)
Consults in ER not likely to be admitted (can wait until afternoon)
Daytime, Ward attending
Patients admitted to Neurology and ICU
Consults in ICU likely targeted to neurology (eg. status epilepticus)
Consults in ER to be admitted or urgent (cannot wait until afternoon)
Urgent issues or concerns about patients admitted under Neurology
Weekend, One attending
All new consultations
All new admissions
All ward issues
Overnight, On-call
ANY urgent issues, review with overnight attending
BEFORE 11pm
Review with overnight attending
Overnight, AFTER 11pm (2 or fewer)
Urgent: review with overnight attending
Non-urgent: review with daytime ward attending
Overnight, AFTER 11pm (>2*)
Notify overnight attending around 6 to 630am to come in to start reviewing BEFORE 8am
*An objective threshold of more than 2 overnight consults for general neurology has been set (staff are aware) to eliminate any ambiguity around who to review with and when, and to prevent things piling up for the morning team.