# At the VA, How Do I Order [item]? ====Infusion therapies==== * NF consult for approval * Clinic orders * Clinic Medication Quick Order > Pulmonary Service Clinic Orders Menu * Infusion clinic consult * Consult > Additional Services > Infusion Clinic ====Radiology==== === Sniff Test === - Radiograph - abdominal radiograph - in comments, write sniff test ## Lab Tests ===Myositis Panel=== - Misc order - in comments, write sent out myositis panel, code 10257 ===Cystic Fibrosis Genetic Test=== - Misc order - in Comments, write send out CFTR gene, code 10458 ===Body Fluid Samples=== __Cytology__ * collect sample into sample cup * paper lab order form __Micro, chemistries__ * collect samples into purple- and red-top tubes * place orders * attach patient label to samples * walk to lab on 4F near MICU ## Diagnostic Tests ===Pulmonary Function Tests=== - ''Orders'' - ''Consult Menu'' - ''Pulmonary, Respiratory & HOME O2'' - ''Pulmonary Function Test Outpt - BT'' ===EKG, outpatient=== - ''Admission order'' - ''pre op'' - ''ekg now'' - Personally walk the patient to EKG area ## Medications ===Ordering tPA and dornase=== - send Teams message to [[mailto:faryal.qureshi@va.gov|Faryal Qureshi]] - Orders, High-alert medication ===Non-Formulary Medication=== - ''Orders'' - ''Meds Outpatient Quick Orders'' - ''#12 Controlled Substances (non formulary)'' - ''(CLICK HERE FOR CONSULT)'' - ''Attention: Faryal Qureshi'' ===Asthma Biologics=== At Baltimore VA, Fasenra (benralizumab) is the only on-formulary biologic for severe asthma. * Order EpiPens x2 * Place order for Infusion clinic * Place [[#Non-Formulary Medication|Non-Formulary Order]] for Fasenra ## DME ===Inhaler Adjuncts=== Includes: incentive spirometer, PEP device (Acapella), pulse oximeter For more significant support equipment (oxygen, nebulizers, suction equipment, ventilators, etc.) see [[#Home O2 Consult|Home O2 Consult]]. For ordering flutter valves, spacers, peak flow meters, incentive spirometry, etc. - ''Orders'' - ''Consult'' - ''Additional Services → Prosthetics'' - ''Prosthetics Request Non-Implant- Baltimore'' ===Home O2 Consult=== Below is how to order a 6MWT (to qualify for home oxygen), qualify for nebulizers, obtain suction equipment, obtain ventilators. - Orders Tab - Consult - Pulmonary, Respiratory & Home O2 - Home Oxygen Request - VAMHCS To expedite home O2, contact [[mailto:richard.farr@va.gov | Richard Farr]] or Kimberley. ## Referrals ===Refer for Lung Transplant=== * Write a VACO note - Shared Template > Medical Care > Transplant > VACO ===Refer to Subspecialty Clinics=== For lung cancer screening, lung mass clinic, pulmonary hypertension, pulmonary rehab, 6MWT, home oxygen assessment, qualify for nebulizers, suction equipment, ventilators. - Orders - Consult - Pulmonary, Respiratory & Home O2 ===Sleep Disordered Breathing=== * Refer to Sleep Clinic - ''Orders'' - ''Consult'' - ''Neurology'' - ''Sleep'' - ''Neurology Sleep Disorders Clinic Outpt'' * NIPPV Equipment (CPAP, BIPAP) - ''Orders'' - ''Consult'' - ''Neurology'' - ''Sleep'' - ''Sleep therapy outpt''