Difference between revisions of "I need a procedure"
From DukeRads
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*Relevant allergies (contrast, sedating medications) | *Relevant allergies (contrast, sedating medications) | ||
*A direct call-back number that you will be available at for 60 minutes following your page. | *A direct call-back number that you will be available at for 60 minutes following your page. | ||
| − | + | Please note that while placing an imaging-guided procedure order will be needed ('''[http://www.dukerad.radsq.com/images/9/95/IR_Ordering_Codes.pdf the most common of which are here]'''), this order alone will NOT generate a page to the appropriate radiology section; you'll need to follow the section-specific steps below to make sure they are aware of the request | |
== Who to call == | == Who to call == | ||
===VIR (Vascular and Interventional Radiology)=== | ===VIR (Vascular and Interventional Radiology)=== | ||
| − | You can either | + | You can either contact the Vascular Radiology Pager ('''970-7930''') or place a 'Consult to Interventional Radiology' order to generate a page. The pager is held 24/7 for urgent and emergent procedures. '''For non-urgent procedure requests, non-urgent questions, or FYI pages, please limit communications to the hours of 6:00 am to 9:00pm (a home-call coverage system is utilized).''' VIR procedures include: |
| − | *Tunneled central line placement | + | *Tunneled central line placement and bedside removals |
| − | + | *Arteriograms +/- intervention (e.g., arterially extravasating GI bleed requiring embolization) | |
| − | *Arteriograms +/- intervention (e.g., arterially extravasating GI bleed) | + | |
*Pulmonary arteriograms and PE suction thrombectomy | *Pulmonary arteriograms and PE suction thrombectomy | ||
| − | * | + | *IVC filter placements and removals |
| − | *Percutaneous GTube / GJ Tube / J Tube placements, replacements, and checks | + | *AVF / AVG fistulagrams +/- intervention |
| + | *Percutaneous GTube / GJ Tube / J Tube placements, replacements, and checks in adults | ||
*Percutaneous nephrostomy / biliary / cholecystostomy tube placements, replacements, and checks (PCNs, PBDs, PercCholes) | *Percutaneous nephrostomy / biliary / cholecystostomy tube placements, replacements, and checks (PCNs, PBDs, PercCholes) | ||
| − | *Solid organ tumors ablations and | + | *Solid organ tumors ablations and embolizations (e.g., hepatic Y-90 treatment, hepatic bland embolization and microwave ablation, renal cryoablation, etc) |
*Intravascular solid organ biopsies (e.g, transjugular liver biopsies, transcaval biopsies) | *Intravascular solid organ biopsies (e.g, transjugular liver biopsies, transcaval biopsies) | ||
*Vertebral kyphoplasty and sacroplasty | *Vertebral kyphoplasty and sacroplasty | ||
*Venous and arterial malformation percutaneous treatment | *Venous and arterial malformation percutaneous treatment | ||
*Additional procedures not covered below | *Additional procedures not covered below | ||
| − | + | Of note, '''VIR does not place PICC lines (contact PICC team), or inpatient non-tunneled central lines (contact medical procedure team)''' | |
| − | === | + | ===Body Interventions=== |
| − | The Body Interventions pager ('''206-2435''') is | + | The Body Interventions pager ('''206-2435''') is held from 7:30 am to 5:00 pm. If urgent or emergent intervention is required between 5:00 pm and 10:00 pm, please call the Body reading room at '''684-7224''' . If emergent intervention is required between 10:00 pm and 7:30 am, please call the Radiology Senior Call phone at '''681-4422'''. Abdominal imaging procedures include: |
*Abdominal collection drainage and aspiration | *Abdominal collection drainage and aspiration | ||
| − | *Superficial soft-tissue collection aspiration and | + | *Superficial soft-tissue collection aspiration and drains |
*Solid organ percutaneous biopsies, both targeted and random | *Solid organ percutaneous biopsies, both targeted and random | ||
| − | * | + | *See 'GI / GU Fluoroscopy' for information on Dobhoff tubes, esophograms, upper GI exams, contrast enemas, etc |
| + | |||
| + | |||
| + | ===GI / GU Fluoroscopic Studies=== | ||
| + | GI / GU fluoroscopic studies are available from 7:30 am to 5:00 pm and can be scheduled by calling '''684-7257'''. If emergent evaluation is required between 5:00 pm and 10:00 pm, please call the Body reading room at '''684-7224''' . If emergent intervention is required between 10:00 pm and 7:30 am, please call the Radiology Junior Call phone at '''681-4422'''. GI / GU fluoroscopic evaluations include: | ||
| + | *Imaging-guided Dobhoff tube placements (we ask that an attempt is first made on the floor) | ||
| + | *Esophagrams, Upper GI studies (evaluate through the ligament of Trietz), and small bowel follow throughs (for intestinal motility) | ||
| + | *Contrast enemas (water-soluble contrast for leaks, barium for pre G-tube placement) | ||
| + | *Fluoroscopic cystograms and retrograde urethragrams (RUGs) | ||
| + | *For similar exams but in the pediatric patients, please see 'Pediatric Fluoroscopic Studies' for more information | ||
| + | |||
| + | |||
| + | ===Pediatric Fluoroscopic Studies=== | ||
| + | Pediatric fluoroscopic studies are typically available from 7:30 am to 5:00 pm and can be scheduled by calling '''684-7288'''. If urgent / emergent evaluation is required between 5:00 pm and 7:30 am, please call the Radiology Junior Call phone at '''681-4422'''. Pediatric fluoroscopic evaluations include: | ||
| + | *Fluorscopic upper GI exams (evaluate for malrotation, upper GI pathology) | ||
| + | *Fluoroscopic GTube / GJ tube checks | ||
| + | *Intussusception reductions | ||
===Neuroradiology Interventions=== | ===Neuroradiology Interventions=== | ||
| − | The Neuroradiology Interventions pager ('''206-9959''') is | + | The Neuroradiology Interventions pager ('''206-9959''') is held from 7:30 am to 5:00 pm. If emergent intervention is required between 5:00 pm and 10:00 pm, please call the Neuroradiology reading room at '''684-7213''' . If emergent intervention is required between 10:00 pm and 7:30 am, please call the Radiology Senior Call phone at '''681-4475'''. Neuroradiology procedures include: |
*Fluoroscopic guided lumbar punctures (following failed bedside LP attempts) | *Fluoroscopic guided lumbar punctures (following failed bedside LP attempts) | ||
*Myelograms | *Myelograms | ||
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===Musculoskeletal Interventions=== | ===Musculoskeletal Interventions=== | ||
| − | MSK interventions can be requested between 7:30 am to 5:00 pm by calling the MSK reading room at 684-7465. If | + | MSK interventions can be requested between 7:30 am to 5:00 pm by calling the MSK reading room at '''684-7465'''. If emergent intervention is required between 5:00 pm and 7:30 am, please call the Radiology Senior Call phone at '''681-4475'''. MSK procedures include: |
*Fluoroscopic guided bone biopsies, marrow aspiration | *Fluoroscopic guided bone biopsies, marrow aspiration | ||
*Shoulder and hip arthrograms and aspirations | *Shoulder and hip arthrograms and aspirations | ||
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| − | === | + | ===Thoracic Interventions=== |
| + | Chest interventions can be requested between 7:30 am to 5:00 pm by calling the CTI reading room at '''684-7419'''. If emergent intervention is required between 5:00 pm and 7:30 am, please call the Radiology Senior Call phone at '''681-4475'''. Chest procedures include: | ||
| + | *Lung / mediastinal / pleural biopsy not accessible by interventional pulmonology | ||
| + | *CT guided thoracentesis / chest tube placement if not successful by ultrasound approach with interventional pulmonology | ||
Revision as of 08:53, 23 July 2022
Contents
Procedure Request Checklist
Imaging-guided interventions are provided by several sections in radiology, the details and appropriate contacts for which are below (and also on this spreadsheet). For all procedures, however, please have the following information readily available:
- Patient last name and MRN (room number is not terribly helpful)
- Consentability, NPO, and anticoagulation status
- Relevant allergies (contrast, sedating medications)
- A direct call-back number that you will be available at for 60 minutes following your page.
Please note that while placing an imaging-guided procedure order will be needed (the most common of which are here), this order alone will NOT generate a page to the appropriate radiology section; you'll need to follow the section-specific steps below to make sure they are aware of the request
Who to call
VIR (Vascular and Interventional Radiology)
You can either contact the Vascular Radiology Pager (970-7930) or place a 'Consult to Interventional Radiology' order to generate a page. The pager is held 24/7 for urgent and emergent procedures. For non-urgent procedure requests, non-urgent questions, or FYI pages, please limit communications to the hours of 6:00 am to 9:00pm (a home-call coverage system is utilized). VIR procedures include:
- Tunneled central line placement and bedside removals
- Arteriograms +/- intervention (e.g., arterially extravasating GI bleed requiring embolization)
- Pulmonary arteriograms and PE suction thrombectomy
- IVC filter placements and removals
- AVF / AVG fistulagrams +/- intervention
- Percutaneous GTube / GJ Tube / J Tube placements, replacements, and checks in adults
- Percutaneous nephrostomy / biliary / cholecystostomy tube placements, replacements, and checks (PCNs, PBDs, PercCholes)
- Solid organ tumors ablations and embolizations (e.g., hepatic Y-90 treatment, hepatic bland embolization and microwave ablation, renal cryoablation, etc)
- Intravascular solid organ biopsies (e.g, transjugular liver biopsies, transcaval biopsies)
- Vertebral kyphoplasty and sacroplasty
- Venous and arterial malformation percutaneous treatment
- Additional procedures not covered below
Of note, VIR does not place PICC lines (contact PICC team), or inpatient non-tunneled central lines (contact medical procedure team)
Body Interventions
The Body Interventions pager (206-2435) is held from 7:30 am to 5:00 pm. If urgent or emergent intervention is required between 5:00 pm and 10:00 pm, please call the Body reading room at 684-7224 . If emergent intervention is required between 10:00 pm and 7:30 am, please call the Radiology Senior Call phone at 681-4422. Abdominal imaging procedures include:
- Abdominal collection drainage and aspiration
- Superficial soft-tissue collection aspiration and drains
- Solid organ percutaneous biopsies, both targeted and random
- See 'GI / GU Fluoroscopy' for information on Dobhoff tubes, esophograms, upper GI exams, contrast enemas, etc
GI / GU Fluoroscopic Studies
GI / GU fluoroscopic studies are available from 7:30 am to 5:00 pm and can be scheduled by calling 684-7257. If emergent evaluation is required between 5:00 pm and 10:00 pm, please call the Body reading room at 684-7224 . If emergent intervention is required between 10:00 pm and 7:30 am, please call the Radiology Junior Call phone at 681-4422. GI / GU fluoroscopic evaluations include:
- Imaging-guided Dobhoff tube placements (we ask that an attempt is first made on the floor)
- Esophagrams, Upper GI studies (evaluate through the ligament of Trietz), and small bowel follow throughs (for intestinal motility)
- Contrast enemas (water-soluble contrast for leaks, barium for pre G-tube placement)
- Fluoroscopic cystograms and retrograde urethragrams (RUGs)
- For similar exams but in the pediatric patients, please see 'Pediatric Fluoroscopic Studies' for more information
Pediatric Fluoroscopic Studies
Pediatric fluoroscopic studies are typically available from 7:30 am to 5:00 pm and can be scheduled by calling 684-7288. If urgent / emergent evaluation is required between 5:00 pm and 7:30 am, please call the Radiology Junior Call phone at 681-4422. Pediatric fluoroscopic evaluations include:
- Fluorscopic upper GI exams (evaluate for malrotation, upper GI pathology)
- Fluoroscopic GTube / GJ tube checks
- Intussusception reductions
Neuroradiology Interventions
The Neuroradiology Interventions pager (206-9959) is held from 7:30 am to 5:00 pm. If emergent intervention is required between 5:00 pm and 10:00 pm, please call the Neuroradiology reading room at 684-7213 . If emergent intervention is required between 10:00 pm and 7:30 am, please call the Radiology Senior Call phone at 681-4475. Neuroradiology procedures include:
- Fluoroscopic guided lumbar punctures (following failed bedside LP attempts)
- Myelograms
- Vertebral body / disc aspiration for evaluation of osteomyelitis
- CSF-leak related interventions
Musculoskeletal Interventions
MSK interventions can be requested between 7:30 am to 5:00 pm by calling the MSK reading room at 684-7465. If emergent intervention is required between 5:00 pm and 7:30 am, please call the Radiology Senior Call phone at 681-4475. MSK procedures include:
- Fluoroscopic guided bone biopsies, marrow aspiration
- Shoulder and hip arthrograms and aspirations
Thoracic Interventions
Chest interventions can be requested between 7:30 am to 5:00 pm by calling the CTI reading room at 684-7419. If emergent intervention is required between 5:00 pm and 7:30 am, please call the Radiology Senior Call phone at 681-4475. Chest procedures include:
- Lung / mediastinal / pleural biopsy not accessible by interventional pulmonology
- CT guided thoracentesis / chest tube placement if not successful by ultrasound approach with interventional pulmonology
