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MISSION
To provide excellence in the care of patients with respiratory illnesses in our community. To continuously improve the treatment and prevention of respiratory conditions by conducting and/or supporting high quality clinical research, and by educating students and care-givers in state-of
the-art management approaches.
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SLEEP DISORDERS PROGRAM
Physicians: Sleep Laboratory: : Psychology:
Dr. Michael Fitzpatrick Dr. Michael Fitzpatrick, Medical Director Prof. Alistair.MacLean
Dr. Peter Munt Dr. Helen Driver, Co-ordinator
Dr. Donald Brunet Ms. Adrienne Leach, Administrative Director
Dr. Andre Tan
Sleep apnea patient education centre: Ms. Patti Hull, RN
The Sleep Disorders Program is multidisciplinary and consists of two board certified sleep specialists (Drs. Fitzpatrick and Driver), two respirologists (Drs. Fitzpatrick and Munt), a psychologist (Professor Alistair MacLean), a neurologist (Dr. Donald Brunet), an otolaryngologist (Dr. Andre Tan) and four full time Registered Polysomnographic Technologists.
Patients are referred to the coordinator of the Sleep Clinic and are prioritized by a physician. An Administrative Assistant then schedules the patient to the most appropriate clinic slot. Most referrals are faxed in or scheduled by phone. Typically, patients are seen at the Kingston General Hospital Fraser Armstrong Patient Centre before being scheduled for further investigations.
Contact:
Coordinator: Ms. Maureen Obreiter Phone: 613 548-2382
fax: 613 549-1459
Email: obreitem@kgh.kari.net
Sleep Laboratory: 549-6666 Extension 3347
Links:
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Pulmonary Rehabilitation Program – St. Mary’s of the Lake Hospital
This is a supervised, multidisciplinary rehabilitation program for patients with ventilatory insufficiency. Patient referrals are accepted from physicians and the COPD Education Centre. Typical patients for referral include those who remain symptomatic despite pharmacotherapy, who do not have significant co-morbid illness interfering with their ability to exercise (i.e., who do not have significant ischemic heart disease or musculoskeletal problems that limit their ability to participate), who preferably are non-smoking (although exceptions are made), and who are able to arrange transportation to this multi-modality exercise endurance training program. The 3 week inpatient program is for patients who meet entry criteria, but who are geographically displaced. The outpatient program is an 8 week program where patients attend clinic on three afternoons a week (Monday, Wednesday and Friday), and begin a customized, individualized exercise training program of various exercises including walking stair climbing, treadmill exercise, stationery bicycle, strength training, breathing exercises, stretching, etc. There is also an educational component, which comprises of eight lectures.
The aim of the program is to maximize functional capacity in patients with respiratory impairment so as to improve shortness of breath, exercise performance, and quality of life. Patients leaving the program enter a home-based program where they will continue regular exercises. Multidisciplinary services are also available for selected individuals, i.e., psychology, nutritional support, social work, pharmacy, as well as instruction from specialized COPD educators. This rehab program interfaces with the Better Breathing program, which helps people to continue home-based training, as well as avail of the exercise facilities at St. Mary’s of the Lake Hospital.
To contact Dr. O’Donnell:
Phone: 613-548-2339
Fax: 613-549-1459
Email:
To contact Physiotherapists*:
Phone: 613-548-7222, Ext. 2245
Fax: 613-544-1023
*Lorelei Samis
Linda Lefevere
Jennifer Patelli
Shelley Blackstock
Judy Baxter
Lurdes Chisamore (Secretary, SMOL)
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LUNG CANCER PROGRAM
Respirology: Thoracic Surgery: Oncology: Radiology: Coordinator:
Dr. C. D’Arsigny Dr. K. Reid Dr. C. DeMetz Dr. R. Nolan Ms. Sherry Mott
Dr. L. Forkert Dr. D. Petsikas Dr. R. Gregg Dr. K. Sutherland
Dr. D. Lougheed Dr. D. Panshwani
Dr. S. Moffatt Dr. K. Thain
Dr. D. O’Donnell
Dr. R. Wigle The Lung Cancer Program is multidisciplinary and consists of Respirologists, Thoracic Surgeons, Oncologists and Radiologists and has a coordinator and a medical advisor.
Patients are referred to the coordinator of the Lung Cancer Clinic, who then schedules the patient to the next available consultant’s clinic. Most referrals are faxed in or scheduled by phone. The coordinator contacts the referring physician and arranges for all outside investigative information to be available for the clinic visit. The Respirologists and Thoracic Surgeons see patients in the Fraser Armstrong Patient Centre, Kingston General Hospital and the Oncologists see patients at the Kingston Regional Cancer Centre, adjacent to the Kingston General Hospital.
The coordinator schedules all investigations, maintains contact with the patient and the consultant’s office and arranges the return clinic visit for discussions about the diagnosis and related issues. The coordinator arranges further staging investigations and/or referral to surgery or oncology. Thus, the coordinator’s role is to ‘navigate’ the patient through the system, while organizing all tests, investigations and referrals and documenting the time frames for each of these processes.
The group meets weekly as the Lung Tumor Board (Dr. R. Gregg, chair; Dr. K. Reid, co-chair) to discuss diagnostic and therapeutic issues. Monthly meetings focus on research issues, such as clinical trial, etc.
Contact:
Coordinator: Ms. Sherry Mott Phone: 613 544 2631 or 1 800 567 5722 ext. 4188,
fax: 613 546 8225
Email: sherry.mott@krcc.on.ca
Dr. L. Forkert Phone: 613 548 2446
fax: 613 547 2069
Email: forkert@post.queensu.caLinks:

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The Religious Hospitallers of Saint Joseph
of the Hotel Dieu of Kingston CYSTIC FIBROSIS PROGRAM
Clinic Directors: Nursing: Physiotherapy:
Dr. R. vanWylik (Pediatric Clinic) Ms. Darlene McCullogh Ms. Kristy Brundage
Dr. D. Lougheed (Adult Clinic)

Dietary Services: Social Work: Pharmacy: Pulmonary Function Lab
Ms. Julie Nedvedik Ms. Stary Stein Ms. Mary Wilson Ms. Cathy Muir

The Cystic Fibrosis (CF) Program is a multi-disciplinary program which provides comprehensive care to patients with CF. The team includes a pediatrician (pediatric program) and respiratory physician (adult program), nurse coordinator, physiotherapist, dietician, social worker, pharmacist, pulmonary function technologist and (for the pediatric program) a child life worker. The CF Program provides ambulatory care in separate Pediatric and Adult Clinics, provides inpatient services for hospitalized patients, and participates in CF research. The CF Clinics are accredited by the Canadian Cystic Fibrosis Foundation.
Patients with suspected cystic fibrosis may be referred directly to the appropriate physician for evaluation. Patients with confirmed CF are enrolled in the CF Program and followed regularly by all members of the team in either the Pediatric or Adult CF Clinic, in keeping with current practice guidelines. Patients typically enter the Adult Clinic at about age 18. Routine follow-up visits occur approximately every 3 months. Patients may be seen between regularly scheduled appointments for acaute illnesses. Consultative services are provided to hospitalized patients as required. Patients in the CF Program may be invited to participate in ongoing research studies. Currently, we are participating in several multi-centre CCFF-funded studies, including a genetics study (children and adults) and osteoporosis study (adults only).
Contacts:
Pediatric Clinic Director: Dr. R. vanWylik Phone: 613 544 3400 ext 3359
Fax: 613 544 3559
Email:
Adult Clinic Director: Dr. D. Lougheed Phone: 613 548-2348
Fax: 613 549 1459
Email:
Nurse Coordinator:Ms. Darlene McCullogh Phone: 613 544-3400 ext 2934
Fax: 613 544-8320
Email:
Physiotherapist: Ms. Kristy Brundage Phone: 613 544 3400 ext 3187
Fax: 613 544 8320
Email:
Dietician: Ms. Julie Nedvedik Phone: 613 544 3400 ext 2170
Fax: 613 544 1661
Email:
Social Worker: Ms. Monica Stary Stein Phone: 613 544 3400 ext 3157
Fax: 613 544 1661
Email:
Pharmacist: Ms. Mary Wilson Phone: 613 544 3400 ext 2159
Fax: 613 531 8260
Email: Pulmonary Function Lab: Ms. Cathy Muir Phone: 613 548 3232 ext 2439
Fax: 613 547 2069
Email:
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ASTHMA PROGRAM
Respirology: Nursing: Respiratory Therapy: Research:
Dr. D. Lougheed Ms. Jennifer Olajos-Clow Ms. Cathy Muir Ms. Kim Szpiro
Dr. D. O’Donnell Mr. Thomas Fisher

The Asthma Program is a comprehensive disease management program which includes diagnostic, therapeutic, educational and research components. The clinical program encompasses ambulatory, emergency and inpatient clinical care. Ambulatory services include multi-disciplinary Asthma Clinics, staffed by respirologists and a nationally certified asthma nurse educator, an Asthma Education Centre, and Pulmonary Function and Allergy Skin Testing Service. Inpatient services include a Collaborative Care Plan for the care of adult asthma patients in the Emergency Department and Inpatient settings, a spirometry service for asthma patients in the Emergency Department, Respirology consultation service for adult asthma inpatients, and Asthma Nurse Educator consultation for adults and parents of pediatric asthma inpatients. The Asthma Research Unit conducts research in asthma symptom perception and lung mechanics, asthma epidemiology, asthma management (clinical trials and asthma education), and asthma guidelines dissemination. The Asthma Research Unit is also affiliated with the hospital’s Clinical Research Centre.
Patients aged 16 years or older may be referred by a physician to the Asthma Clinic, Urgent Asthma Clinic or Asthma Education Centre for assessment. The Asthma Clinic assessments are completed by an asthma specialist (physician) and asthma nurse. Patients may require additional investigations, such as pulmonary function or allergy skin tests. Patients with confirmed asthma will be enrolled in the Asthma Education Program also. The Asthma Education Centre provides education to patients aged 16 years or older, or parents of children with asthma, referred by family physicians, emergency physicians or other specialists. Following an initial assessment by a certified asthma nurse educator, the person with asthma will receive asthma education tailored to their individual needs.Contacts:
Asthma Nurse: Ms. Jennifer Olajos-Clow Phone: 613 549 6666 ext 3779
Fax: 613 549 1459
Email:
Medical Director: Dr. D. Lougheed Phone: 613 548 2348
Fax: 613 549 1459
Email:
Asthma Research Unit
Phone: 613 549-6666 ext 2645
Pulmonary Function and Allergy Skin Testing
Phone: 613 549 6666 ext 2439
Fax: 613 547 2069
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Ronald D Wigle MD, FRCPC
102 Stuart Street,
Kingston, ON,
K7L 2V6
E-mail:
Phone: 613 548 2384
Fax: 613 549 1459
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant: Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Academic Appointments:
Professor, Department of Medicine
Secretary, Faculty of Medicine
Clinical interests:
General Respirology
Tuberculosis

Academic interests:
Teaching - Clinical Reasoning
- Clinical Skills
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Denis E O’Donnell MB, FRCPC
102 Stuart Street,
Kingston, ON,
K7L 2V6
E-mail:
Phone: 613 548 2339
Fax: 613 549 1459
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Academic Appointments:
Professor, Department of Medicine
Professor, Department of Physiology
Clinical interests:
General Respirology
COPD

Academic interests:
Supervisor, Respiratory Investigation Unit

Exercise physiology
Control of breathing in asthma and COPD
Lung mechanics in COPD
Mechanisms and management of dyspnea in cardiopulmonary disease

Selected Publications:

O’Donnell DE, D’Arsigny C, Fitzpatrick M, Webb KA. Exercise Hypercapnia in Advanced Chronic Obstructive Pulmonary Disease. The Role of Lung Hyperinflation.
O’Donnell DE, Revill SM, Webb KA. Dynamic Hyperinflation and Exercise Intolerance in Chronic Obstructive Pulmonary Disease.
O’Donnell DE, Aaron S, Bourbeau J, et al. Canadian Thoracic Society Recommendations for the Management of Chronic Obstructive Pulmonary Disease. Cdn Resp J. May-June Supplement 2003;10:11A-33A.
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Peter W Munt MD, FRCPC
76 Stuart Street,
Kingston, ON,
K7L 2V7
E-mail:
Phone: 613 548 1362
Fax: 613 548-6082
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Administrative Appointments:
Chief of Staff, Kingston General Hospital
Chair, Medical Advisory Committee KGH
Academic Appointments:
Professor, Department of Medicine, Former Head Dept of Medicine, Queen’s Kingston General Hospital, Hotel Dieu, Providence Continuing Care 1993 - 2001
Associate Dean of Health Institutions and Regional Liaison in the Faculty of Health Sciences
Clinical Interests:
General Respirology
Sleep Medicine

Academic interests:
Sleep disordered breathing
Governance and Management of Academic Hospitals
Health Service Research
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M Diane Lougheed MD, MSc, FRCPC
102 Stuart Street,
Kingston, ON,
K7L 2V6
E-mail:
Phone: 613 548 2348
Fax: 613 549 1459
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant: Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Medical Director: Asthma Program
Medical Advisor: Asthma Education Centre:

Medical Director: Adult Cystic Fibrosis Clinic Academic Appointments:
Associate Professor, Department of Medicine
Clinical interests:
General Respirology
Asthma
Cystic Fibrosis

Academic interests:
Symptom perception in asthma
Lung mechanics in asthma
Asthma epidemiology
Asthma education

Selected Publications:
MD Lougheed and DE O’Donnell. Dyspnea in Asthma. In: Dyspnea: Mechanisms, Measurement and Management, Second Edition. Ed: D Mahler, DE O’Donnell. New York: Marcel Dekker, Inc. (in press).
WM Hopman, N Garvey, J Olajos-Clow, A White-Markham, MD Lougheed. Outcomes of asthma education: Results of a mult-site evaluation. Can Respir J (in press)
MD Lougheed, J Flannery, KA Webb and DE O'Donnell. Respiratory sensation and ventilatory mechanics during induced bronchoconstriction in spontaneously breathing low cervical quadriplegia Am J Respir Crit Care Med 2002;166:370-376.
Lougheed, M D, K A Webb, and DE O'Donnell. Breathlessness during induced lung hyperinflation in asthma: the role of the inspiratory threshold load. Am J Respir Crit Care Med 1995;152:911-920.
MD Lougheed, M. Lam, L. Forkert, K. A. Webb, and D. E. O'Donnell. Breathlessness during acute bronchoconstriction in asthma: pathophysiologic mechanisms. Am Rev Respir Dis 1993;148:1452-1459.
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Susan L Moffatt MD, FRCPC
102 Stuart Street,
Kingston, ON,
K7L 2V6
E-mail:
Phone: 613 548 2332
Fax: 613 549 1459
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Medical Advisor: Asthma Program
Academic Appointments:
Associate Professor, Department of Medicine
Chair of Undergraduate Clinical Skills Education Program
Clinical interests:
General Respirology
Adult Critical Care

Academic interests:
TIPS Education Program for Medical Faculty.
Faculty Development
Postgraduate Education
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Lutz Forkert MD, FRCPC
Pulmonary Function Lab
Connell 2
Kingston General Hospital
Kingston, ON
K7L 4B5
Phone 613 548 2446
Fax 613 547 2069
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Director: Pulmonary Function Laboratory
Academic Appointments:
Associate Professor, Department of Medicine
Clinical interests:
General Respirology
Lung Cancer
Chronic Cough
Pulmonary Function Testing
Bronchoscopy
Academic interests:
Relationship of lung volumes and maximal flow rates.
Effects of gas tensions on lung mechanics
Wait Times for Lung Cancer
Selected Publications:
Lutz Forkert, Hiroshi .Watanaby, Kenneth Sutherland, Sandra Vincent, .and John. T. Fisher. Quantitative Video-bronchoscopy: A new technique to asses airway calibre. Am. J. Resp. and Crit. Care Med. 154: 1794-1803. 1996
McFawn P L. Forkert and J Fisher. A new method to perform quantitative measurement of bronchoscopic images. European Respiratory Journal. 18: 817-26. 2001.
O’Donnel DE, Forkert L, Webb KA. Evaluation of bronchodilator responses in patients with “irreversible” emphysema. European Respiratory Journal. 18:914-20, 2001
Newton M, DE O’Donnell and Lutz Forkert. Response of Lung Volumes to Inhaled Salbutamol in a Large Population of Patients with Severe Hyperinflation. Chest, 2002; 121: 1042 -1050
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Michael Fitzpatrick MD, FRCPC
102 Stuart Street,
Kingston, ON,
K7L 2V6
Email:
Phone: 613 548 2379
Fax: 613 549 1459
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Medical Director: Sleep Laboratory:

Academic Appointments:
Associate Professor, Department of Medicine
Program Director, Respirology
Clinical interests:
General Respirology
Sleep Medicine
Respiratory management of neuromuscular disease

Academic interests:
Pathogenesis and management of obstructive sleep apnea
Oronasal partitioning of ventilation during sleep
Effects of CPAP on the nasal airway

Selected recent publications:

Fitzpatrick MF, McLean H, Urton AM, O’Donnell DE, Tan A, Driver H. Effect of nasal or oral breathing route on upper airway resistance during sleep. Eur Respir J 2003; 22 (5): 827-32.
Noise-induced hearing loss in snorers and their bed partners. Sardesai MG, Tan AKW, Fitzpatrick MF. J Otolaryngology 2003; 32 (3): 141-5.
Fitzpatrick MF, Alloway C, Wakeford T, MacLean A, Munt P. Can patients with obstructive sleep apnea titrate their own continuous positive airway pressure (CPAP) ? Am J Respir Crit Care Med 2003; 167 (3): 716-722.

Partitioning of inhaled ventilation between the nasal and oral routes during sleep in normal subjects. Fitzpatrick MF, Driver HS, Chatha N, Voduc N, Girard A. J Appl Physiol 2003; 94 (3): 883-890.
O’Donnell DE, D’Arsigny C, Fitzpatrick MF, Webb KA. Exercise Hypercapnia in Advanced COPD: The Role of Lung Hyperinflation. Am J Respir Crit Care Med 2002; 166: 663-668.
Jokic R, Zintel T, Gallagher CG, Fitzpatrick MF. Ventilatory chemoresponsiveness in relatives of patients with obesity hypoventilation syndrome and normal subjects. Thorax 2000; 55: 940-945.
Jokic R, Bhagchandani L, Zintel T, Baetz M, Fitzpatrick MF. Effect of high versus low ambient humidity on the severity of obstructive sleep apnoea. Thorax 1999; 54: 711-713.
Jokic R, Klimaszewski A, Crossley M, Sridhar G, Fitzpatrick MF. Positional treatment versus CPAP in patients with positional obstructive sleep apnea syndrome. CHEST 1999; 115: 771-781.
Jokic R, Klimaszewski A, Mink J, Fitzpatrick MF. Surface tension forces in sleep apnea: the role of a soft tissue lubricant. Am J Respir Crit Care Med 1998; 157: 1522-1525.
Jokic R , Klimaszewski A, Sridhar G, Fitzpatrick MF. CPAP pressure requirement during the first month of treatment in patients with severe OSA. CHEST 1998; 114: 1061-9.
Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure? Michael F. Fitzpatrick, Christi E. D. Alloway, Tracy M. Wakeford, Alistair W. MacLean, Peter W. Munt and Andrew G. Day
Partitioning of inhaled ventilation between the nasal and oral routes during sleep in normal subjects Michael F. Fitzpatrick, Helen S. Driver, Neela Chatha, Nha Voduc, and Alison M. Girard
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Christine L D’Arsigny MD, FRCPC
102 Stuart Street,
Kingston, ON,
K7L 2V6
E-mail:
Phone: 613 548 2371
Fax: 613 549 1459
Clinical Appointments:
G.F.T.: Kingston General Hospital
Consultant Hotel Dieu Hospital
Providence Manor, St. Mary’s on the Lake
Academic Appointments:
Assistant Professor, Department of Medicine
Program Director, Critical Care
Clinical interests:
Intensive Care
General Respirology
Pulmonary Hypertension
Thromboembolic Disease

Academic interests:
Neuromuscular weakness in the ICU
Mechanical Ventilation
Pulmonary Hypertension
Chronic Weaning
Dyspnea in CHF

Selected Publications:
Ventilatory Assistance Improves Exercise Endurance in Stable Congestive Heart Failure DENIS E. O'DONNELL, CHRISTINE D'ARSIGNY, SATISH RAJ, HOSHIAR ABDOLLAH, and KATHERINE A. WEBB:
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Urgent Respirology Clinic
Time: Friday 9:30 – 11:30 am
Location: Fraser Armstrong Patient Centre, Level 2 south
Kingston General Hospital
76 Stuart Street
Kingston, ON
Staff: Respirologists attend on a rotational basis.
Purpose: Patients with urgent problems requiring attention within a week are seen in this clinic. Please note that the following specific clinics are also available for urgent problems: Asthma Clinic (Link) and Lung Cancer Clinic (Link).
Contact: For referrals and appointments:
Fraser Armstrong Patient Centre Booking Office
Phone: 613 548 2342
Fax: 613 549 1459
Instructions to patients:
Please bring your medication, including inhalers, and any x-rays, CT scans or breathing test results done at other institutions to your clinic appointments.
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Tuberculosis Clinic
Time: Every other Monday: 1:00 – 4:30 pm.
Location: Fraser Armstrong Patient Centre, Level 2 south
Kingston General Hospital
76 Stuart Street
Kingston, ON
Staff: R. D. Wigle, MD, FRCPC, Respirologist
G. Evans, MD, FRCPC, Infectious Disease Specialist
R. Zoutman, MD, FRCPC, Infectious Disease Specialist
Purpose: This clinic exclusively sees patients with a positive P.P.D. skin test or with either suspected or active TB.
Contact: For referrals and appointments:
Fraser Armstrong Patient Centre
Central Scheduling
Phone: 613 548-2342
Fax: 613 548-2479
Instructions to patients:
Please bring your medication, and any x-rays, CT scans or microbiology results done at other institutions to your clinic appointments.
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Pulmonary Rehabilitation Clinic
Time: Every second Monday: 1:00 – 4:30 pm
Location: St. Mary’s of the Lake Hospital
First Level

Staff: Denis O’Donnell, MB, FRCPC
Lorelei Samis, Jennifer Patelli, and Linda Lefevere
Purpose: To evaluate patients for suitability for entrance into the inpatient or outpatient pulmonary rehabilitation program at St. Mary’s of the Lake Hospital. Also, patients who have graduated from the program are followed up, and patients who develop clinical problems while in the program are often assessed at this clinic.Contact:
Dr. D.E. O’Donnell
Phone: 613-548-2339
Fax: 613-549-1459
Email:
Ms. Gail Whiteside
Phone: 613-548-2339
Fax: 613-549-1459
Email: Instructions to patients:
Wear running or walking shoes and loose clothing (track suit).
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Pulmonary Rehabilitation Clinic
Time: Every second Monday: 1:00 – 4:30 pm
Location: St. Mary’s of the Lake Hospital First Level

Staff: Denis O’Donnell, MB, FRCPC
Lorelei Samis, Jennifer Patelli, and Linda Lefevere
Purpose: To evaluate patients for suitability for entrance into the inpatient or outpatient pulmonary rehabilitation program at St. Mary’s of the Lake Hospital. Also, patients who have graduated from the program are followed up, and patients who develop clinical problems while in the program are often assessed at this clinic.
Contact:
Dr. D.E. O’Donnell
Phone: 613-548-2339
Fax: 613-549-1459
Ms. Gail Whiteside
Phone: 613-548-2339
Fax: 613-549-1459Instructions to patients: Wear running or walking shoes and loose clothing (track suit).
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Pulmonary Hypertension and Pulmonary Embolism Clinic
Time: One Friday/ month
Location: Fraser Armstrong Patient Centre, Level 4 south
Kingston General Hospital
76 Stuart Street
Kingston, ON
Staff: Christine D’Arsigny MD, FRCPC
Purpose: The following patients will be assessed and managed:
1. Diagnosed pulmonary embolism with complex diagnostic and/or therapeutic issues or with significant co-morbidities.
2. With suspected or diagnosed pulmonary hypertension requiring further assessment or management.
Contact: For referrals and appointments:
Kirsten Babcock,
Kingston General Hospital
Phone: 613 548-2371
Fax: 613 549-1459Instructions to patients:
Please bring your medication, any x-rays, CT scans, and results on electrocardiograms, echocardiograms or breathing tests done at other institutions to your clinic appointments.

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Neuromuscular Clinic
Time: Every third Tuesday: 1:00 – 4:30 pm
Location: St. Mary’s of the Lake Hospital
Staff:
Dr. Joy Wee Physiatrist 544-2143
Richard Lenart – OT 548-7222 ext 2355
Dr. Michael Fitzpatrick – Respirology 548-2379
Shari Brown – PT 548-7222 ext 2245
Dr. Michel Melanson – Neurology 549-6666 ext 2601
Teresa Whalen – Speech/Pathologist 548-7222 ext 2255
Jane Verner – Social Work 548-7222 ext 2221
Sandy Fodey – Respiratory Therapy 549-6666 ext 4228
Cathy Muir - PFT Lab 549-6666 ext 2439
Dr. Gary Burggraf – Cardiology 549-6666 ext 3722
Heather O’Meara – Clinic Nurse 548-7222 ext 2273

Purpose: This is a multidisciplinary clinic that assesses and manages patients with neuromuscular disorders. Expertise is provided by Physiatry, Neurology, Respirology, Cardiology, Occupational Therapy, Physiotherapy, Speech Pathology, Nursing, Pulmonary Function technology and Social Work.
Contact:
Mary Felix – Coordinator for Neuromuscular Clinic
Tel: 544-1894
Fax: 544-8640
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Adult Cystic Fibrosis Clinic
Time: Alternate Thursdays 9 am – 3 pm
Location:
C.O.P.C.
Hotel Dieu Hospital
Kingston, ON K7L 5G2
Staff:
Diane Lougheed, MD MSc FRCPC, Respirologist
Darlene McCullogh, RN, Nurse Co-ordinator
Kristy Brundage, BScPT, MSc, Physiotherapist
Julie Nedvedik, BASc, RD, Registered Dietician
Monica Stary Stein, MSW, RSW, Social Worker
Purpose: This is a multi-disciplinary clinic, accredited by the Canadian Cystic Fibrosis Foundation. Adults with cystic fibrosis receive comprehensive care from a team of health care professionals with expertise in CF care.
Contact: For referrals and appointments:
Darlene McCullogh at 613 544 3400 ext 2934
Instructions to Patients:
Please bring a list of your current medications to clinic. Check with the nurse coordinator at the time your appointment is made to find out if you need to go for breathing tests, an x-ray or bloodwork before your appointment.
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Adult Cystic Fibrosis Clinic
Time: Alternate Thursdays 9 am – 3 pm
Location:
C.O.P.C.
Hotel Dieu Hospital
Kingston, ON K7L 5G2
Staff:
Diane Lougheed, MD MSc FRCPC, Respirologist
Darlene McCullogh, RN, Nurse Co-ordinator
Kristy Brundage, BScPT, MSc, Physiotherapist
Julie Nedvedik, BASc, RD, Registered Dietician
Monica Stary Stein, MSW, RSW, Social Worker
Purpose: This is a multi-disciplinary clinic, accredited by the Canadian Cystic Fibrosis Foundation. Adults with cystic fibrosis receive comprehensive care from a team of health care professionals with expertise in CF care.
Contact: For referrals and appointments:
Darlene McCullogh at 613 544 3400 ext 2934
Instructions to Patients:
Please bring a list of your current medications to clinic. Check with the nurse coordinator at the time your appointment is made to find out if you need to go for breathing tests, an x-ray or bloodwork before your appointment.
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Adult Cystic Fibrosis Clinic
Time:Alternate Thursdays 9 am – 3 pm
Location:C.O.P.C.
Hotel Dieu Hospital
Kingston, ON K7L 5G2
Staff:Diane Lougheed, MD MSc FRCPC, Respirologist
Darlene McCullogh, RN, Nurse Co-ordinator
Kristy Brundage, BScPT, MSc, Physiotherapist
Julie Nedvedik, BASc, RD, Registered Dietician
Monica Stary Stein, MSW, RSW, Social Worker
Purpose: This is a multi-disciplinary clinic, accredited by the Canadian Cystic Fibrosis Foundation. Adults with cystic fibrosis receive comprehensive care from a team of health care professionals with expertise in CF care.
Contact: For referrals and appointments:
Darlene McCullogh at 613 544 3400 ext 2934
Instructions to Patients:
Please bring a list of your current medications to clinic. Check with the nurse coordinator at the time your appointment is made to find out if you need to go for breathing tests, an x-ray or bloodwork before your appointment.
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Cough Clinic
Time: Friday 1:00 – 4:00 pm
Location: Fraser Armstrong Patient Centre, Level 2 south
Kingston General Hospital
76 Stuart Street
Kingston, ON
Staff: Lutz Forkert MD, FRCPC
Purpose: Patients are investigated and managed, who have a chronic cough of more than 2 months duration.
Contact: For referrals and appointments:
Fraser Armstrong Patient Centre Booking Office
Phone: 613 548 2342
Fax: 613 549 1459
Instructions to patients:
Please bring your medication, including inhalers, and any x-rays, CT scans or breathing test results done at other institutions to your clinic appointments.
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COPD Clinic
Time: Wednesday 9:00 am – noon
Location: Fraser Armstrong Patient Centre, Level 4 south
Kingston General Hospital
76 Stuart Street
Kingston, ON
Staff: Denis O’Donnell, MB, FRCPC, Respirologist
Gail Beatty, COPD Nurse Specialist
Purpose: The evaluation and comprehensive management of patients with COPD.
The organizational structure of the clinic is as follows:
1. Clinical Management.
2. COPD Education/Self Management
3. Pulmonary Rehabilitation (i.e., 3 intersecting circles).
Patients with more advanced COPD are provided with a comprehensive management plan, which includes a series of educational sessions on self-management provided by Gail Beatty, COPD Nurse Specialist. Therapy is individualized. Bronchodilator therapy is maximized. Patients can be assessed for oxygen therapy, including simulated air travel. For patients who remain symptomatic despite optimal pharmacotherapy, referral to the Pulmonary Rehabilitation Program at St. Mary’s of the Lake Hospital usually follows.
Contact: For referrals and appointments:
Fraser Armstrong Patient Centre Booking Office
Phone: 613 548 2342
Fax: 613 549 1459

To contact the COPD Nurse Specialist:
Phone: 613-549-6666, ext. 2832
Fax: 613-548-2437
Email:
To contact Dr. D.E. O’Donnell:
Phone: 613-548-2339
Fax: 613-549-1459
Email:
Instructions to patients:
Please ensure the appropriate documentation, x-rays, and pulmonary function tests (when available) are sent with the patient. -------
Asthma Clinic
Time: Regular (non-urgent): Every Wednesday morning 9 am – noon
Urgent: Alternate Tuesday mornings 8:30 am – 11:30 am
Location: Fraser Armstrong Patient Centre, Level 4 south
Kingston General Hospital
76 Stuart Street
Kingston, ON
Staff: Diane Lougheed, MD, MSc, FRCPC, Respirologist
Denis O’Donnell, MB, FRCPC, Respirologist
Jennifer Olajos-Clow, BA/BPHE, BNSc, MSc, RN, CAE
Purpose: The regular clinic sees patients with asthma. This includes patients, who are being assessed for possible asthma and those with diagnosed asthma who require additional investigations or management. Assessment includes evaluation by a respiratory physician and asthma nurse. The urgent asthma clinic sees patients with known asthma who require urgent assessment of unstable asthma symptoms, such as following a hospitalization or visit to an emergency department for an asthma attack.
Contact: For referrals and appointments:
Fraser Armstrong Patient Centre Booking Office
Phone: 613 548 2342
Fax: 613 549 1459
Instructions to patients:
Please bring your medication, including inhalers, and any x-rays, CT scans or breathing test results done at other institutions to your clinic appointments.
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Queen’s University
Respiratory Medicine Training Program
RESPIRATORY MEDICINE TRAINING PROGRAM
The respiratory training program is central to the mission of the Division of Respiratory & Critical Care Medicine at Queen’s University. The program is designed to produce highly competent respiratory specialists, and is geared to meet the needs of individuals wishing to pursue a career in academic respirology as well as those who choose a career in community respirology. The program is of two years duration. The first year consists of ten months of clinical respirology training and two months of intensive care. The second year is flexible and is moulded to the unique needs of each trainee. The second year includes training in clinical respirology, research and other scholarly activity, and elective experiences related to respirology. As per Royal College guidelines, the equivalent of two months, at least, is spent in sleep medicine.
First Year Clinical Training (10 months)
The first year of the program is designed to rapidly familiarize the trainee with the full spectrum of clinical respirology. To this end, extensive experience is provided in ambulatory care (2-3 clinics per week), and in emergency and inpatient consultations (daily). The first year trainee follows the ICU in-patient population, who have been admitted under the respirology service. Extensive training is also provided in bronchoscopy and related procedures [bronchoalveolar lavage, transbronchial lung biopsy, transtracheal (Wang) needle aspiration]. The first year trainee performs on average, 150 bronchoscopies per year. The first year trainee is allowed one academic half day per week that is protected for educational development. The first year trainee also organizes and presents regularly at weekly respiratory rounds as well as bi-weekly (alternating) journal club, combined respiratory rounds (radiology, pathology, thoracic surgery and oncology), and chest radiology rounds.
First Year Critical Care Training (2 months)
The ICU component of the program is designed to provide a multi-disciplinary approach to acutely ill patients with direct input from Respirology Intensivists, Anesthetists and Surgeons. First year trainees become competent in the following procedures; endotracheal intubation, chest tube insertion, hemodynamic monitoring, parenteral nutrition, bronchoscopy via endotracheal tube, mechanical ventilation including non-invasive ventilation.
Pulmonary Function Tests
The first year trainee receives regular instruction throughout the year on pulmonary function test interpretation and is responsible for the interpretation of all pulmonary function tests on a weekly basis, under direct supervision by an experienced respirologist. A formal, four-week rotation in pulmonary function testing (including quality control and technical aspects) is mandatory in the second year of training (see below). In summary, at the end of the first year, the trainee has acquired sufficient experience in respiratory consultation to be able to practice relatively independently and therefore, can make informed choices about the components of the second year program they wish to avail of.
Bronchoscopy facility: Bronchoscopies are carried out in a dedicated bronchoscopy suite with state of the art videobronchoscopy equipment. Five trained endoscopy nurses are employed to assist with endoscopic procedures. A fluoroscopy unit with C-arm is housed in the bronchoscopy suite for use as needed.
Sleep Laboratory: A 6-bedded fully equipped computerized sleep laboratory is situated on the sixth floor of the hospital. The Medical Director of the Sleep Laboratory is a certified specialist in respirology and in sleep medicine. The laboratory runs 4-5 studies per night on 4-5 nights per week, in addition to research-related sleep studies.
Second Year Clinical Training (6 months)
The second year program is sufficiently flexible to accommodate the specific career needs of the individual. If the choice is clinical, non-academic respirology, then clinical electives are carefully chosen to further strengthen clinical competency in various domains of respirology practice. If the second year trainee wishes to choose an academic pathway, then extended training in research would be emphasized. Second year trainees attend the educational events outlined above and are responsible for organizing and participating in the bi-weekly clinical physiology rounds. Second year trainees also run a special weekly respirology clinic with respirology staff available only as resource persons if required. This graded responsibility approach is designed to foster confidence and independence in clinical respirology practice. Throughout the year, the second year trainee rotates through the following sub-speciality clinics; (1) Sleep clinic, (2) Neuromuscular clinic, (3) Asthma clinic, (4) TB and Granulomatous clinic, (5) Pulmonary Rehabilitation clinic, (6) Pulmonary Hypertension clinic.
The following electives are recommended in the second year:
 
Elective RotationsSupervisorHospitalSleep Disorders ClinicM.F. Fitzpatrick 
P.W. MuntKingston General HospitalPulmonary Function LabL. ForkertKingston General HospitalPulmonary RehabilitationD.E. O'DonnellSt. Mary's of the LakeChest RadiologyR. Nolan
K. SutherlandKingston General HospitalInfectious DiseasesG. Evans 
D. ZoutmanKingston General HospitalThoracic SurgeryK. Reid 
D. PetsikasKingston General HospitalThoracic Oncology/RadiologyR. GreggKingston General HospitalCritical CareS. Moffatt 
C. D’Arsigny 
J. DroverKingston General HospitalAnesthesiaS. ShelleyKingston General HospitalSecond Year Training Research (6 Months)
Each trainee must complete some scholarly activity during his or her training. In particular, research participation is strongly encouraged. Six months are largely protected in the second year to accomplish this goal. Trainees are expected to present their work at an international meeting and to submit papers for publication to peer reviewed journals. Trainees can choose from a number of research programs offered at Queen's (). Second year trainees attend the regular weekly "Research in Progress Seminars" of the respiratory research group. Research ProgramsSupervisorsClinical Integrative Physiology 
Dyspnea Mechanics 
Exercise Pathophysiology 
Ventilatory MechanicsD.E. O'Donnell, M.D.* 
K. Webb, M.Sc. 
L. Forkert, M.D.*Sleep Disordered Breathing 
Upper airway physiology
Control of Ventilation
Sleep and women’s health
Sleepiness & drivingM.F. Fitzpatrick, M.D.* 
P.W. Munt,, M.D.* 
H. Driver Ph.D. 
A.MacLeanDistribution of Ventilation 
Pulmonary Function TestingL. Forkert, M.D.*Asthma: 1. Epidemiology 
2. Pathophysiology 
3. Airway Smooth Muscle PhysiologyM.D. Lougheed, M.D.* 
D.E. O'Donnell, M.D.* 
J. Fisher, Ph.D.Cardiopulmonary RehabilitationD.E. O'Donnell, M.D.* 
K. Webb, M.Sc. 
H. Abdollah, M.D.Respiratory Muscle FunctionS. Iscoe, Ph.D.Mechanical VentilationA. Froese, M.D., Ph.D. 
S. Moffatt, M.D.*
C. D’Arsigny
Pulmonary ToxicologyG. Forkert, Ph.D. 
T. Massey, Ph.D.Clinical EpidemiologyJ. Pater, M.D. 
M.D. Lougheed, M.D.*Educational Methods/EvaluationS. Moffatt, M.D.* 
R.D. Wigle, M.D.** Faculty of Adult Respiratory Program
 
  Third Year Research (12 Months)
For trainees destined for a career in academic respirology, extended training in clinical or basic research is available pending successful acquisition of funding from a variety of internal and external sources.
Combined Respirology and Critical Care Training
For trainees wishing to combine respirology training with Royal College Accredited Critical Care Training at Queen's, a separate application for a minimum of one additional year of fellowship must be made to the Critical Care Program (Director - J. Drover) as there is no formal linkage between the two programs.
Application to the Respiratory Medicine Program at Queen's
All applicants must be eligible and hold an educational licence of the College of Physicians and Surgeons of Ontario. Candidates are eligible to apply to the Queen's Respirology Program if they have completed at least three years of accredited training by the Royal College of Physicians and Surgeons of Canada in General Internal Medicine. Application forms are available on request (see below). The application deadline is August 31st (10 months in advance of the July 1st starting date for first year trainees). Interviews are held in the fall each year, and are coordinated with the other four respiratory training programs in Ontario, to facilitate prospective subspecialty residents.
For further information contact:
Dr. M. Fitzpatrick MD, FRCPI, FRCPC, Dip ABSM
Director, Respirology Training Program,
Queen’s University,
102 Stuart Street ,
Kingston, Ontario
K7L 2V6
(Phone) 613-548-2379
(Fax) 613-549-1459
(E-Mail)
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Hospital
In-PatientsOut-PatientsAdmissions Per Year
April 1 2002 – March 30 2003Consults Per Year
New ReferralsReturn VisitsGeneral Chest DiseaseAcute Respiratory FailureTumoursTbc.Kingston General Hospital3305437126815853428TOTAL3305437126815853428
Outpatient Bronchoscopy – the Division carried out 350 elective bronchoscopies April 1 2002 to March 30 2003.
There are 24 pediatric beds at Kingston General Hospital
There are 16 adult resp beds at KGH.
We had 268 respiratory inpatient consultations last year
Pulmonary Function Laboratory
Type of Measurement Available
OUTPATIENTSINPATIENTSTOTALFVL1131851216MD140916425HE/NITROGEN WASHOUT8311SB959621021VTG966611027RAW966601026POST TESTING VTG40813421POST TESTING RAW40813421GASES1323135VD/VT505MECL85186EX. 1000EX. 244044EX. 3303EIA10010O2 SAT @R42345O2 R/EX94599O2 TIT20525MVV22325MIP/MEP56864SHUNT101PEAK FLOWS29029ART. LINES303HIGH ALTITUDE TESTS202# OF PATIENTS2180872267# OF TESTS991132410235
Sleep Laboratory
Type of Study
Total Number Studies/year Diagnostic Studies – Night
283Diagnostic Studies – Day
51Therapeutic Studies – Night 546
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Address
Hit counter
Training Program
Pictures
D’Arsigny
Lettering : Stats
Loops
Local Links
Additional Links:
Chronic Obstructive Lung Disease:
- Pulmonary Rehabilitation Program St. Mary's on the Lake
- The Breathworks Plan
- The Lung Association
- On the Road..to Health & Fitness Home based exercise program
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Clinics
General Respirology
Forkert
Urgent Respirology
forkert
Urgent Asthma
lougheed
Lung Cancer
forkert
COPD
o’donnell
Sleep Disorders
fitzpatrick
TB
wigle
Pulmonary Rehabilitation
o’donnell
Cystic Fibrosis
lougheed
Pulmonary Vascular Diseases
d’arsigny
Neuromuscular Disorders
Fitzpatrick when
Faculty
D’ars
Fitz
Fork
Lough
Moff
Munt
Wigle
O’Donnell
Programs
Asthma lougheed
Rehab o’donnell
Sleep fitzpatrick
Cancer forkert
Cf lougheed
Education
Postgrad d’arsigny
Training fitzpatrick
Undergraduate moffatt--------------
DEPARTMENT OF MEDICINE
DIVISION OF RESPIROLOGY AND CRITICAL CARE MEDICINE

RESPIRATORY SERVICE GUIDELINES
HANDOUT
RESPIRATORY SERVICE GUIDELINES

To Members of the Housestaff:
Welcome to the Respiratory Service.
The documents enclosed in this handout include goals and objectives for housestaff, guidelines for communications within the Service and other Services, timetables for clinics and educational rounds, and outlines of administrative procedures such as booking bronchoscopies.
We hope that the time you spend on this Service is educational and enjoyable. We would appreciate your feedback.Dr. Christine D’Arsigny548-2371
Dr. Michael Fitzpatrick548-2379
Dr. Lutz Forkert548-2446
Dr. Diane Lougheed548-2348
Dr. Susan Moffatt548-2332
Dr. Denis O’Donnell548-2339
Dr. Ronald Wigle548-2384
Dr. Peter MuntAdmin548-1362Clinical548-2382
Sleep Disorders Office548-2382
PFT Lab548-2439
Asthma Education CentreExt 3779
COPD Education CentreExt 2832
Sleep Education Centre
Ext 2478Lung Cancer Coordinator
Sherry Mott544-2631 ext 4188

GOALS AND OBJECTIVES FOR INTERNS AND RESIDENTS
ATTACHED TO THE RESPIRATORY SERVICE

Overall Goal
During this rotation, the resident will develop the knowledge base, skills and attitudes to provide comprehensive evaluation and care of patients with respiratory diseases in both inpatient and ambulatory settings.
Specific Learning Objectives
The objectives for a rotation on the respirology service reflect the CANMEDS 2000 essential roles and key competencies of the specialist physician. By the end of the Respirology rotation, the resident will be able to:A. Medical Expert
1. Demonstrate diagnostic and therapeutic skills for the assessment and management of (a) respiratory disorders including chronic obstructive disease, asthma, pneumonia, lung cancer, acute and chronic respiratory failure, sleep disorders, pulmonary embolism, and interstitial lung disease; (b) respiratory emergencies including upper airway obstruction, acute severe asthma, tension pneumothorax, massive hemoptysis, and respiratory arrest.
2. Interpret plain films of the chest using the principle of pattern recognition.
3. Interpret pulmonary function tests, arterial blood gases, and acid base abnormalities.
4. Understand the indications and contra-indications for respiratory procedures (thoracentesis, chest tube insertion, pleurodesis, bronchoscopy and biopsy, open lung biopsy).
5. Perform appropriate histories in patients with common respiratory problems and recognize and interpret abnormal physical findings on examination of the respiratory system.
6. Perform diagnostic and therapeutic thoracentesis, perform and interpret TB skin tests.
7. Understand the indications for, and principles of, V/Q scanning and CT scans of the chest.
B. Communicator
1. To communicate effectively with patients, families, other physicians, and allied health professionals. This includes providing concise, written and dictated consultation notes and letters.
C. Collaborator
1. Work effectively with, and enhance the interdisciplinary team involved in the delivery of medical care to respirology patients.
D. Manager
1. Utilize health care resources effectively and efficiently, demonstrating an awareness of the most cost effective way of managing patients.
E. Health Advocate
1. Recognize and respond to determinants of health which particularly affect one's respiratory health including socioeconomic status, financial resources, social supports, and public health issues.
F. Scholar
1. Recognize and correct knowledge deficiencies in the aforementioned respiratory conditions, signs and symptoms, by means of personal continuing education.
2. Critically appraise medical literature as it pertains to managing patients with respiratory diseases and disorders.
G. Professional
1. Demonstrate appropriate personal and professional behaviour in interactions with patients and colleagues.
2. Demonstrate an awareness of and appropriate response to ethical issues in the management of respiratory illnesses such as palliative care, home ventilation, cardiopulmonary resuscitation, and withholding and withdrawing life support for respiratory failure.
DIVISION OF RESPIROLOGY

There is an On-Call Schedule for Dr. Munt, Dr. Wigle, Dr. Forkert, Dr. Moffatt, Dr. O’Donnell, Dr. Lougheed, Dr. Fitzpatrick, and Dr. D’Arsigny, which is available through our secretaries and also through the KGH operator.You should check with the Service Chief (Dr. D. Lougheed, 548-2348) regarding absences from work, vacations, etc. You should always allow sufficient time prior to the absence for the Service to plan accordingly. You should notify the Divisional Office (548-2300) of any unscheduled absences.
At the start of your rotation, please call the Pulmonary Function Lab to arrange for a tour of the lab facilities (ext. 2439).
Evaluation of the Respiratory Service Rotation
All housestaff are requested to complete an evaluation of the Respirology Service and educators.
Evaluations for housestaff and the service & educators are now done online. These will be sent via an email near the end of the rotation. The “userid” and “password” will be included in the first email sent.
Prior to a housestaff being able to view his/her evaluation, an evaluation on the service AND on at least one educator MUST be completed and submitted online.
Respirology Conference (Rounds)
These will be ordinarily within the jurisdiction of the PGY4 Respiratory Training Resident. When the PGY4 is off-service (e.g. During ICU rotation) the Senior Respirology Resident Ward resident will organize these rounds. The PGY 2s, PGY3s and PGY 4s rotating through Respirology are expected to present at least one Respiratory Conference during their rotation. Other junior housestaff (clerks, PGY 1’s) may be called upon to contribute to a small or large extent.Clinics
The PGY2 on service will draw up an attendance schedule for the appropriate number of housestaff to attend Respiratory Clinics. This schedule will be submitted to the Chief of the Respiratory Service, by the 3rd working day of each month, to be posted in the clinic nursing station.
Patients are initially to be seen by a member of the housestaff and then to be reviewed with a member of the staff before the patient leaves the clinic. When seeing patients in clinic, please be sure the patient is left in a gown until seen by the staff person.
Letters are to be dictated by housestaff, and these will be typed by our secretaries, to be signed by us after we have read them. Letters should be brief and to the point, on a new patient it should not exceed 1 1⁄2 pages, and on a repeat patient where there are no new problems – not more than 1⁄2 page.
The letter should be addressed to the referring doctor and you should include his/her initials and address. If you do not know these, ask the patient for as much of this information as you can get. Letters should be dictated in a quiet room where there are no other people talking, since the background noise comes through on the tapes very clearly. Also, we would ask you to enunciate clearly, and any unusual words or medical terminology should be spelled clearly. At the beginning of each letter state the patient was seen by either Dr. Munt, Dr. Wigle, Dr. Moffatt, Dr. O’Donnell, Dr. Lougheed, Dr. Fitzpatrick, Dr. Forkert or Dr. D’Arsigny.
Consults
The Clinical Fellow and/or PGY3’s or PGY4’s assigned to the consult service are responsible for doing the Respiratory consultations. He/she should notify the consulting staff person’s secretary about each consult that has been performed on a biweekly basis. The fellow also assumes direct responsibility for all Respiratory Division patients in the ICU. He/she is responsible for the ongoing daily management, treatment decisions, and family interactions regarding these patients.
For patients seen in follow-up at FAPC after discharge from hospital a number of routine tests should be ordered at the time of discharge so that the patients can be re-evaluated in clinic. These tests are booked to be done prior to the clinic visit so that results are available at the time of visit.
1. Chest x-ray – if abnormal on admission or discharge
2. PFT (with gas exchange if Pa O2 < 60 on admission)
3. Routine blood work – if abnormal during admission or in need of monitoringRESPIROLOGY ROUNDSMONDAY
TUESDAYWEDNESDAYTHURSDAYFRIDAYFormal Ward Rounds (with x-rays)
9:00
Kidd 3 Formal Ward Rounds (with x-rays)
9:00
Kidd 3 Housestaff Teaching8:30 – 9:30
Connell 3
Respiratory Rounds
11:30 – 12:15
Kidd 4
Grand Rounds11:30 – 12:30
Etherington HallRadiology Rounds
(2nd & 4th Fridays)
12:00 – 1:00
Kidd 4Discharge Planning Rounds
2:00
Kidd 3
Journal Club
(2nd & 4th Tuesday)

4:00 – 5:00
Kidd 6Clerk Teaching

4:00 – 5:00Physiology Rounds (1st & 3rd Thursdays) Combined Rounds (2nd & 4th Thursdays)
4:00 – 5:00
Kidd 6 AB or
Richardson Amphitheatre
RESPIROLOGY CLINIC SCHEDULE

MONDAY
TUESDAYWEDNESDAYTHURSDAYFRIDAYDr. M. Fitzpatrick
Sleep
FAPC 4 S
Dr. L. Forkert
Respirology
FAPC 4 S

Dr. D. Lougheed
Urgent Asthma (alternate weeks)
FAPC 4 S
Dr. D. Lougheed
Resp/Asthma
FAPC 4 S

Dr. D. O’Donnell
Respirology/COPD
FAPC 4 SUrgent Respirology Clinic
FAPC 4 S
Dr. P. Munt
Sleep FAPC 4 S
Dr. D’Arsigny
Pulmonary Hypertension Clinic
TBA
Dr. Wigle-Resp or TB Clinic (alternating weeks)
FAPC 2 SDr. S. Moffatt
Respirology
FAPC 2 S
Dr. Munt
Sleep FAPC 4 S
Dr. Fitzpatrick
Sleep FAPC 4 S
Sleep/ENT Clinic
(1st Tuesday each month)
FAPC 4 S

Dr. D’Arsigny Pulmonary Embolism Clinic
TBADr. R. Wigle
Respirology
FAPC 4 SDr. C. D’Arsigny
Respirology
FAPC 4 SDr. L. Forkert
Cancer Clinic
FAPC 4 S
Dr. R. Wigle
Respirology
FAPC 4 S

Dr. L. Forkert
Cough Clinic
FAPC 4 S PLEASE SIGN UP FOR 1-2 CLINICS/WEEK *
RESPIROLOGY CLINIC SCHEDULEMONTH _________________MONDAYTUESDAYWEDNESDAYTHURSDAYFRIDAYFitzpatrick - am
X____________
X ____________Forkert - am
X____________
Urgent Asthma
X_______________Lougheed -am
X___________
O’Donnell – am
X____________Urgent Resp - am
Fitzpatrick – pm
X____________
X____________
Wigle/Moffatt pm
X____________Sleep/ENTWigle – pm
X____________
D’Arsigny – pm
X____________Cancer Clinic
X__________Wigle – pm
X_____________
Cough Clinic
X_____________Fitzpatrick - am
X____________
X ____________Forkert - am
X____________
Urgent Asthma
X_____________Lougheed -am
X___________
O’Donnell – am
X____________Urgent Resp - am
Fitzpatrick – pm
X____________
X____________
Wigle/Moffatt pm
X____________Sleep/ENTWigle – pm
X____________
D’Arsigny – pm
X____________Cancer Clinic
X__________Wigle – pm
X_____________
Cough Clinic
X_____________Fitzpatrick - am
X____________
X ____________Forkert - am
X____________
Urgent Asthma
X____________Lougheed -am
X___________
O’Donnell – am
X____________Urgent Resp - am
Fitzpatrick – pm
X____________
X____________
Wigle/Moffatt pm
X____________Sleep/ENTWigle – pm
X____________
D’Arsigny – pm
X____________Cancer Clinic
X__________Wigle – pm
X_____________
Cough Clinic
X_____________Fitzpatrick - am
X____________
X ____________Forkert - am
X____________
Urgent Asthma
X____________Lougheed -am
X___________
O’Donnell – am
X____________Urgent Resp - am
Fitzpatrick – pm
X____________
X____________
Wigle/Moffatt pm
X____________Sleep/ENTWigle – pm
X____________
D’Arsigny – pm
X____________Cancer Clinic
X__________Wigle – pm
X_____________
Cough Clinic
X_____________Fitzpatrick - am
X____________
X ____________Forkert - am
X____________
Urgent Asthma
X____________Lougheed -am
X___________
O’Donnell – am
X____________Urgent Resp - am
Fitzpatrick – pm
X____________
X____________
Wigle/Moffatt pm
X____________Sleep/ENTWigle – pm
X____________
D’Arsigny – pm
X____________Cancer Clinic
X__________Wigle – pm
X_____________
Cough Clinic
X_____________*To be returned to Service Chief (Dr. D. Lougheed) by 3rd working day of each month by SENIOR WARD RESIDENT (PGY2)OUTPATIENT BRONCHOSCOPY ROUTINE
1.____All patients must have a complete history and physical examination within 3 weeks prior to the procedure.
2____All patients must have an EKG, platelets, PT, PTT, within 72 hours of the procedure. Specifically inquire if patient is on aspirin or anticoagulants. If on aspirin, a bleeding time should be requested.
3.____Arterial blood gases – to be done within 3 weeks in any patient with moderate to severe obstructive or restrictive lung disease. Blood gases otherwise to be done at the discretion of the staff person requesting the bronchoscopy.
4.____If patient is infective, i.e. HIV, TB, hepatitis, special mention must be taken when scheduling. IV drug abusers and prison inmates should be considered in the same category.
5.____Chest x-ray – should not be more than 2 weeks old. If patients have outside x-rays they should bring them to the bronchoscopy suite.
6.____Consent – this should be obtained by physicians seeing the patient in the clinic or inpatient setting with full disclosure of the indications, risks and complications. Consent at Kingston General Hospital is good for 30 days.
7.____Scheduling – bronchoscopies are to be booked for alternate Monday’s - Gail (2339), alternate Tuesday’s - Jane (2348), Wednesday’s – Lori (2439), Thursday’s – Kirsten (2371) or Jane (2379) and Friday (urgent) Lori (2439). (other days by special arrangement only).
8.____Clinic letter – ask that a copy be sent to the attending physician performing the bronchoscopy.
9.____Follow-up clinic appointment – all patients to be seen again one week following their outpatient bronchoscopy. This should be booked while the patient is in clinic. Sherry Mott will look after all suspected cancer patients and she will book their follow-up.
10.____Patient instructions –
(a) patients are to be at the Outpatient Procedures area 1 hour prior to bronchoscopy
(b) nothing by mouth after midnight
(c) they are to bring someone to escort them home.
(d) they are to bring all known outside x-rays with them.
11.____Pre-bronchoscopy orders (responsibility of team member ordering bronchoscopy) -
(a) to ensure that x-ray films are present and blood work is on the chart
(b) to ensure an IV angiocath with normal saline to keep the vein open has been started.
(c) to prescribe the pre-medication for the bronchoscopy.
SLEEP LABORATORY
The Sleep Laboratory is located on Kidd 6. On occasion, you may be asked to evaluate a patient for medical reasons. Occasionally they may require a blood gas to be drawn. The type of patients being assessed in the Laboratory include individuals with sleep disordered breathing of various types, including sleep apnea, nocturnal desaturations from various lung and neuromuscular conditions and neurologic conditions, such as narcolepsy. Your assistance is greatly appreciated.