Pulmonary, Critical Care Sleep Service
Pulmonary Critical Care Sleep Service (PCCSS) at VA medical center, Memphis provides care to the veteran seeking care in the field of Pulmonary medicine, Critical Care Medicine, Sleep Medicine and Respiratory therapy. These unique fields of medicine in our service are tightly inter-related but functions independent of each other.
The Pulmonary medicine team at the Memphis VA medical center is committed to providing exceptional and comprehensive inpatient and outpatient care for patients with acute and chronic pulmonary diseases. Our team consists of Board-certified Pulmonary specialists, nurse practitioners, respiratory therapists, Pulmonary fellows in training and Internal Medicine residents in training.
- Pulmonary Clinic: In person clinic appointments, telehealth and electronic consultations. The outpatient pulmonary clinic is one of the busiest at the Memphis VA. Common conditions treated in Pulmonary clinic are COPD, emphysema, chronic bronchitis, asthma, lung fibrosis, interstitial lung disease, pneumonia, tuberculosis, pulmonary hypertension, bronchiectasis, pleural effusion and more.
- Specialized pulmonary Clinics: These include:
Pulmonary Hypertension clinic: for diagnosis and treatment of patients with Pulmonary Hypertension
Advanced Lung disease clinic: management of patients with advanced lung fibrosis, advanced COPD, pre and post Lung transplant patients.
Multidisciplinary Lung Tumor Clinic: run in collaboration with Thoracic Surgery and Medical Oncology. This clinic is dedicated to the diagnosis and treatment of patients with lung cancer and lung nodules.
Asthma clinic: for the diagnosis and management of difficult to treat asthma. Joint clinic with Allergy and Immunology.
Interventional Pulmonary clinic: for patients with lung cancer or airway diseases needing advanced bronchoscopy procedures or patients with complex pleural disease needing advanced pleural procedures.
- Inpatient Pulmonary consults: Providing service to the veterans admitted to the hospital with various pulmonary diagnoses. Services includes Pulmonary consultations, diagnostic procedures, and therapeutic interventions.
- Home oxygen therapy: Our team assesses, evaluate, and arrange for home oxygen therapy for patients meeting criteria.
- Pulmonary function test (PFT): PFT includes spirometry, lung volumes, Diffusion capacity and walk tests. We are planning to add cardiopulmonary exercise testing soon.
- Pulmonary rehabilitation: We offer a comprehensive Pulmonary rehabilitation program for our veterans with chronic lung disease. Pulmonary rehabilitation has been proven to be of significant benefit for patients with COPD and other chronic lung diseases. We have a dedicated Pulmonary rehabilitation gym and therapists to supervise our patients.
- Bronchoscopy and Procedural Suite: We have a state-of-the-art bronchoscopy suite for routine and advanced diagnostic and therapeutic bronchoscopy, including endobronchial ultrasound, radial endobronchial ultrasound, electromagnetic navigational bronchoscopy, endobronchial bronchoplasty and stent placement. Our team also performs interventional procedures for simple and complex pleural effusions including routine thoracentesis or pleural tap, chest tube placement, pleur-X catheter placement and pleurodesis.
- Lung Cancer Screening program: In 2018, the Memphis VA was chosen to be one of few VA sites nationally to start a comprehensive Lung Cancer Screening Program. Our Lung cancer screening program continues to grow, and we have screened over 3000 patients to date. The Lung Cancer Screening program refers patients with concerning scans to the MTOC (Multidisciplinary Thoracic Oncology) clinic for further evaluation and treatment.
Section Chief, Pulmonary Section
Qasim Mirza, MD
Director of Pulmonary Medicine and Pulmonary diagnostic Lab
901-523-8990 Ext 6006
Critical Care Medicine:
The Critical Care Section of the PCCSS provides care for the critically ill veterans. The Memphis VA has a combined medical/surgical/cardiac intensive care unit that is staffed for and equipped with 18 critical care beds. Our monitors and other equipment are state-of-the-art and continue to be updated and upgraded to provide cutting edge state-of-the-art standard care to our patients.
Our usual patient to nurse staffing ratio is at 2: 1 at a minimum. We have intensivists who lead the multidisciplinary critical care team consisting of critical care attending physician, registered nurses, critical care fellow, critical care interns & resident(s), acute care nurse practitioners (ACNP) clinical pharmacist, nutritionist, respiratory therapist & physical therapist. Critical care team are present and available to take care of our critically ill patients 24/7, 365 days.
This unit was created to ensure intensive and continuous medical and nursing care for any patient who has a current or potential life-threatening disorder and who may benefit from focused, specialized care. This facility provides a means for continuous, repetitive and anticipatory monitoring of patients. Therapeutic interventions are based on the results of this monitoring and assessment. Interventions and monitoring are provided to give each patient the maximal opportunity to survive a catastrophic illness with minimal pain and suffering. However, when death is imminent, it is the goal of these units to provide comfort, pain relief and dignity for the patients and their families.
All Veterans and active duty referral patients, both male and female, from 18 years old and geriatric patients, are served.
Rabin Shrestha, MD, D-ABSM
Director of Critical Care, VAMC, Memphis
901-523-8990 Ext. 5050
Sleep Health Center (SHC):
The Sleep Health Center section of the Pulmonary, Critical care and Sleep service is a full-service sleep center, that is accredited by the American Academy of Sleep Medicine (AASM). SHC provides evaluation, diagnosis, treatment, and monitoring for the veteran in the Mid-South, all in one place and this is unique in the Mid-South. Memphis VA sleep Health Center we provide comprehensive, competent cost-effective, and compassionate caring for veterans in the Mid-South, while training the future providers sleep medicine in our community. At Memphis VA Sleep Health Center, we can provide all the sleep disorder breathing needs of our veterans in one place including the services provided by DME companies.
Memphis VA Sleep Health Center has eight bed sleep lab for both monitored and non-monitored sleep studies that operates 7 days a week. Sleep Health Center also provides home sleep apnea test for those qualify them. Home sleep apnea test is now first diagnostic modality for those qualify. Sleep Health Center staff includes five board certified sleep medicine physicians, sleep medicine fellows, residents, nurse practitioners, sleep certified technicians, registered respiratory therapist and support staff. Memphis VA sleep Health Center his home to the only sleep medicine fellowship training the Mid-South.
Sleep disorders that SHC staff treat include:
- Sleep-Related Breathing Disordered
- Sleep-Related Movement disorders
- Circadian Rhythm Sleep-Wake Disorders
Sleep Health Center Director & Sleep Section Chief:
Ibrahim Sultan-Ali, MD
Medical Director of Sleep Health Center, VAMC Memphis
901-523-8990 Ext 6431
Respiratory Therapy Department is a division of Pulmonary Critical Care and Sleep Service (PCCSS). Services include routine Services include routine Services include routine service on all inpatient wards, specialty services to the Emergency Department, Intensive Care Unit and Spinal Cord Injury units. Also, to several outpatient clinics to include ALS, Sleep, and Home Oxygen.
The Respiratory Care Department provides 24-hour-a-day services. The Department is staffed by Nationally Credentialed, State licensed individuals that provide the following Respiratory Care services: Respiratory diagnostics, mechanical ventilation, aerosol therapy, controlled oxygen administration, pulmonary hygiene maneuvers (to include nasotracheal and endotracheal suctioning, PEP therapy, patient education, chest physiotherapy/pulmonary drainage, therapeutic/directed coughing, diaphragmatic breathing), arterial blood gas sampling/analysis, bedside ventilatory parameters, sputum induction, CPAP /BIPAP therapy, Tracheostomy care.
In addition to these services, the Respiratory Care Department also provides respiratory practitioners to respond to all cardiopulmonary resuscitation calls (Blue Alert) to perform or assist with endotracheal intubation. Services such as assessments of need/clinical indicators, suggestions to physicians regarding respiratory care modalities, on-the job didactic educational sessions to other health care professionals, consultation to any member of the nursing staff regarding respiratory care problems, feedback to pulmonary physicians regarding patients using respiratory care services, and assistance in the discharge planning are also provided.
A dedicated registered respiratory care therapist (Home Oxygen Coordinator) function as a liaison between Respiratory and the Prosthetics Departments, to assist home oxygen patients.
The Respiratory Care Department conducts regular training and lecture sessions to stay abreast of current concepts to meet the demands of the medical field. Respiratory Care Therapists are authorized by the Medical Director of Respiratory Care to perform patient procedures with potential hazards such as arterial blood gases and emergency endotracheal intubation with proper certification. All Respiratory Therapists within the Respiratory Care Department are authorized to perform arterial blood gases.
Respiratory Therapy Supervisor:
Benay Fartheree, MBAHM, RRT
Chief, Respiratory Care
901-523-8990, Ext. 6506
Pulmonary Critical Care Sleep Service
Administrative Contact person:
Marion Wilkins, MPS, BLS, GCSL, CPAS, VHA-CM
Pulmonary Critical Care Sleep Service
901-523-8990 Ext. 2052/2048