PRMC Interventional Pulmonology - PeninsulaInterventional Pulmonology The First 2 Years Yashvir Singh Sangwan MBBS Director of Interventional Pulmonology . Conflicts of Interest I

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