Difference between revisions of "I need a procedure"

Revision as of 09:32, 1 October 2022

Who and How to Call

Image-Guided Procedure Who to Call Spreadsheet

Who to Call Spreadsheet & Procedure Orders Spreadsheet

• Imaging-guided interventions are provided by several radiology sections, the details and appropriate contacts for which are in the above spreadsheet and text below (consider using the search function for quick navigation).
• Placing an imaging-guided procedure order will be needed (the most common of which are here), but this order alone will NOT generate a page to the appropriate section; you'll need to follow the section-specific steps below to make sure the appropriate team is aware of the request

VIR (Vascular & Interventional Radiology)

CONTACT: Vascular IR pager (970-7930)

HOURS: Routinely in-house from 6:30am - 6:30pm, and available overnight for urgent and emergent consults (home call system)

PROCEDURES

• Tunneled central lines (placements and bedside removals)
• Visceral and pulmonary arteriograms and intervention
• Percutaneous GTube / GJ Tube / J Tubes
• Percutaneous nephrostomy / biliary / cholecystostomy tubes (PCNs, PBDs, PercCholes)
• IVC filter placements and removals
• AVF / AVG fistulagrams and interventions
• Solid organ tumor ablations and embolizations
• Vertebral kyphoplasty and sacroplasty
• Venous and arterial malformation percutaneous treatment

Of note, VIR does not place PICC lines (contact PICC team), and generally does not place or pull inpatient non-tunneled central lines (contact medical procedure team).

Body IR

CONTACT: Body IR pager 206-3465

HOURS: 7:30 am to 5:00 pm Monday-Friday. If emergent procedure is required between 5:00 pm and 10:00 pm Monday-Friday, or 7:30 am to 12:00 pm on weekends/holidays, please call the Body reading room (684-7224). If emergent intervention is required overnight, please call the Radiology Senior Call phone (681-4422).

PROCEDURES:

• Intraabdominal and superficial soft tissue drain placement and aspiration (U/S and CT-guided)
• Percutaneous solid organ and other intraabdominal biopsies, both targeted and random (U/S and CT-guided)
• See 'GI / GU Fluoroscopy' for information on Dobhoff tubes, esophograms, upper GI exams, contrast enemas, etc

GI / GU Fluoro Studies

CONTACT: Monday-Friday 7:30am-5:00pm 684-7257; urgent procedures 7:30am - 12:00 pm on the weekend 684-7224 (body reading room); emergent procedure after 5pm Monday-Friday 681-4475 (Jr Cal phone)

HOURS: 7:30 am to 5:00 pm Monday-Friday; urgent and emergent procedures available after hours.

PROCEDURES:

• Imaging-guided Dobhoff tube placements (after failed attempt on 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 available from 7:30 am to 5:00 pm Monday-Friday, and urgent studies available from 7:30 am to 12:00 pm on the weekend. These can be scheduled by calling the Peds reading room (684-7288). If emergent evaluation is required outside of these hours (overnight), please call the Radiology Junior Call phone (681-4475). Pediatric fluoroscopic evaluations include:

• Fluorscopic upper GI exams (evaluate for malrotation, upper GI pathology) and contrasted enemas
• Fluoroscopic Dobhoff tube placement
• Fluoroscopic percutaneous GTube / GJ tube checks
• Intussusception reductions

Neuroradiology Interventions

The Neuroradiology Interventions pager (206-9959) is held from 7:30 am to 5:00 pm Monday - Friday. If emergent intervention is required between 5:00 pm and 10:00 pm Monday-Friday, or 7:30 am - 12:00 pm on the weekend, please call the Neuroradiology reading room (684-7213). If emergent intervention is required outside of these hours (overnight), please call the Radiology Senior Call phone (681-4422). 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

Neurovascular Interventional Radiology

Neurovascular IR is staffed by neurosurgery, and can be reached at the functional pager 970-2671. Neurovascular interventions include:

• Intracranial vasculature occlusion suction thrombectomy
• Intracranial aneurysm embolization

Musculoskeletal Interventions

MSK interventions can be requested between 7:30 am to 5:00 pm Monday-Friday by calling the MSK reading room (684-7465). If emergent intervention is required between 5:00 pm and 7:30 am or on the weekend, please call the Radiology Senior Call phone (681-4422). 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 10:00 pm Monday-Friday by calling the CTI reading room (684-7419). If emergent intervention is required outside of these hours, please call the Radiology Senior Call phone (681-4422). 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

Procedure Request Checklist

For all procedures,, 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.