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CALL OVERVIEW



FACULTY CONTACTS

For questions or concerns:

SLW ED faculty representative:
David Frager (x23-4222 or david.frager@mountsinai.org See Qgenda for availability.)

Night float or Evening Call faculty advisor:

Dairon Garcia (dairon.garcia@mountsinai.org)


BI ED liason:

Dr. Kagetsu (Nolan.Kagetsu@mountsinai.org), Dr. Somwaru (Alexander.Somwaru@mountsinai.org), and Chiefs.

SLW ED liason:

Dr. Nolan Kagetsu (Nolan.Kagetsu@mountsinai.org), Dr. Somwaru (Alexander.Somwaru@mountsinai.org), and Chiefs (mswchiefs@mountsinai.org).

BI/SLW ED follow-up:

Please call ED charge nurse if the attending changes the preliminary report with findings that affect management and the patient has already been discharged from the ED. Please email stephen.zink@mountsinai.org, Dr. Kagetsu (Nolan.Kagetsu@mountsinai.org), Dr. Somwaru (Alexander.Somwaru@mountsinai.org), and Chiefs (mswchiefs@mountsinai.org).


Interesting cases:

Please send accessions to hong.ma@mountsinai.org and Chiefs.

CALL ROTATIONS

Hours:

BI JR Call: Mon-Fri 5p-10p after daytime rotation. Sat-Sun-Holidays 1p-9p.

SL EVE: MTThF 4:15p-12a (catch 4p jitney). Wed 11:15a-10p (catch 11a jitney). Holidays 8a-7p.
W EVE: Mon-Fri 4p-12a + ED scrotal US pager call 12a-8a.
- Holidays have an AM and PM shift. [8a-4p] and [4p-12a + pager call 12a-8a]. (Holiday PM shift reserved for the rotating W Eve resident)
BI EVE: Mon-Fri 4p-12a. Holidays 8am-7pm.

SL NF: Mon-Fri 10:15p-8a (catch the 10p jitney). Sun 7p-8a. 
BI NF: Mon-Fri 10:15p-8a. Sun 7p-8a. 

SL Weekend: Sat-Sun 8a-7pm. Holidays 8a-7p
W Weekend: Sat-Sun 8a-12a + ED US pager call 12a-8a
(If you are on this shift Sunday night, you can arrive at your Monday rotation at 10 am [or] at least 10 hours after your last overnight ultrasound.)
BI Weekend: Sat-Sun 8a-7p, Holidays 8a-7p

READ ME
  • Please send an email to attendings at start of call shift.  Include hospital, contact number, and coverage period.  
  • Prioritized list by "Study time."
    • Follow up on studies that are in “Arrived” status for more than 1 hour. Open exam and investigate why it is taking so long. DO NOT LEAVE IT FOR THE NEXT RESIDENT.
  • Common list
    • Pick up studies from other sites if they are behind more than 45 mins.
    • CHECK IN with the other sites before leaving on EVE shift to make sure all sites are caught up. 
  • Time stamp
    • Weekday EVE: Dictate all ER/STAT inpatient studies VERIFIED by 11:00PM 
    • Weekday NF: Dictate all ER/STAT inpatient studies after 11:00PM till 7:45 AM
    • Weekend day/NF shifts: Dictate all ER/STAT inpatient studies Verified 15min before the end of your shift
    • Dictate inpatient cases as per list of required inpatients below 
    • Perform and dictate all US ordered 30 minutes before the end of your shift.
Common Responsibilities:
  • All ER studies
  • STAT inpatient Body/Chest CT (PE, dissection, SBO, etc.) - Prelim with a one-liner addressing emergent findings or lack thereof (with header!).  Assign to next day attendings.
  • All Inpatient MSK CT/MR - Prelim and assign to MSK attending for the following day/monday.
  • Inpatient Body MR - Prelim emergent inpatient MRCP, Pregnant r/o appendicitis, and other emergent body MRI.  One-liner prelim assigned to next day attending is acceptable (with header!).
  • Inpatient Neuro
    • 4-8PM with Neuroradiologist on call: prioritize ER cases and prelim inpatient neuro cases as time allows 
    • After 8PM: prelim ALL inpatient neuro cases - a one-liner addressing emergent findings is acceptable (with header!).
    • Do NOT dictate spine MRI level by level. Your attending will need to re-do the entire report. 
  • R1's allowed to prelim x-rays ONLY after January (draft only before this time). 
    • On a case by case basis, the R1 may be allowed to prelim additional studies after reviewing with senior resident or attending. 
    • Please be mindful that the ED may take action based on preliminary reports (including discharging patients). 

SLW Pager

  • MSW pager coverage from 8am-4:30 pm to be assigned (Pagers: 33214, 35830)

BI JR

Location: BI, 2 Linsky-07
Time: Weekday: 5pm-10pm after your normal day rotation; Weekend 1p-9p

Coverage: BI (Petrie), KH (BI Brooklyn), KD (BI Brooklyn MR); CityMD, ODA (urgent care), PUC (PACC/DUS Urgent care), NYEE (NY Eye & Ear)

Worklists: 
  • BISLW--> Residents--> Dwtn CALL ED

  • BISLW-->Residents--> Dtwn IP CT MR

Responsibilities:
  • Dictating/Drafting as per common responsibilities. Answer phones, protocol, if no US tech then ultrasound up to 30 minutes prior to end of shift.


SL EVE

Location:  SL Ballroom (Clark floor 3)

Time:  see hours at top of this page

Worklists/Pager: 
  • BISLW--> Residents--> SLW CALL ED
  • BISLW--> Residents--> SLW CALL IP
  • Pager: 33214
Responsibilities:  
M/T/Th/F
  • See list of common responsibilities
  • Arrive 4-4:30p and forward SL ED pager/phones (23-3799; 23-4219; p33214), hand off to NF at end of shift!
  • After 6:30 pm - perform ER ultrasounds ordered before 11:30pm (DVTs, cholecystitis, appy/intussusception, testes; donor transplant organ harvest)
  • Protocol ER CT's (and any studies called about by tech).
  • MR consents for outpatients and check on contrast extrav (if any)
Wednesdays
  • 11:15am - 4:00pm read ER xray from both SL and W (catch 11a jitney)
  • 4 - 10pm Common responsibilities and as above. 
Weekends/Holidays
  • If both RH EVE and SL EVE weekend have upper class residents, each covers their own site.
  • OPTION FOR WEEKENDS IF R1 on SL EVE:  
    • 8:00 am – 3:00 pm: R1 does all body CT’s from both sites (review with CT Attending)
    • Draft Neuro cases and review with upperclass resident at West
    • Perform and Draft all SL emergent US & review with upperclass resident at RH
    • Protocol ER CT's.
  • 3:00 pm – 7:00 pm:  
    • R1 does all plain films from both sites (review with XR Attending)
    • Draft Neuro cases and review with upperclass resident at RH 
    • Perform and Draft all SL emergent US ordered before 6:30 & review with upperclass resident at RH
    • Protocol ER CT's.



W EVE

Location:  West Ballroom, 4th floor
Time:  See hours at the top of this page

Worklists/Pager: 
  • BISLW--> Residents--> COMBINED CALL ED
  • BISLW--> Residents--> SLW CALL ED
  • BISLW--> Residents--> SLW CALL IP
  • Pager 35830
Responsibilities:      
  • Common responsibilities
  • NM on call cases from both sites until 12:00 MN
  • After 6:30p, perform ED US ordered before 11:30pm (cholecystitis, DVTs, scrotal, appy/intussusception, organ harvest); ED scrotal US 12a-8am
  • Protocol ER CT's (and any studies called by techs).
                 
OPTION FOR WEEKENDS AT WEST IF R1 IS AT ST. LUKE's: 
  • 8:00 am - 3:00 pm:  SL ER and RH ER plain films (if R1 at SL)
  • 3:00 pm - 7:00 pm:  SL ER and RH ER CTs (if R1 at SL)
  • 8:00 pm - 12:00 MN:  Split by sites (RH/SL) 
    • If there is an upperclassman on SL EVE, you can split by site throughout the whole day
  • NM on call cases from both sites until 12:00 MN

BI EVE

Location:  BI, 2-linksy 07
Time:  M-F 4:15p-12a; Weekend/Holiday 8a-7p

Main Sites: BI (Petrie), KH (BI Brooklyn), KD (BI Brooklyn MR), CityMD, ODA (urgent care), PUC (PACC/DUS urgent care), NYEE (NY Eye & Ear)

Worklists/Pager: 
  • BISLW--> Residents--> Dwtn CALL ED

  • BISLW-->Residents--> Dtwn IP CT MR

  • Tech gives residents paperwork for CityMD→ look on "Body CT South" or "US BI" (which includes outpatients).

  • Pager 16119

Responsiblities:      
  • Common responsibilities.
  • If a full report is requested for any inpatient study, the resident should dictate a full report. 
  • ALL CITYMD studies must be called in. The secretary and tech manager can help you reach the clinician if necessary. 
  • ODA critical findings can be reported to their tech manager. 
  • Inpatient ultrasounds are sometimes requested during call shifts. Please discuss the immediate necessity of the case with the ordering physician. If they insist it is emergent and you do not agree, please discuss the case with your attending. 
  • ER and inpatient fluoro examinations will be performed on a case by case basis.

SLW NF

Location: St. Luke's Ballroom, Clark floor 3
Time: M-F 10:15p-8am; Weekend/Holiday 7p-8am (*NF week is Sun-Fri)

Main Sites: MSSL, MSW

Worklists/Pager: 
  • BISLW--> Residents--> SLW CALL ED
  • BISLW--> Residents--> SLW CALL IP
  • Pager 33214
Responsibilities: 
  • SL: 
    • 10:00 pm - 8:00 am:  Prelim all SL ER studies
    • 12:00 mn - 8:00 am:  Prelim all RH ER studies 
  • Inpatients:  
    • Neuro: All ER Head CT and MRI. Inpatient's from 4-8PM: Dictate as time permits.  Inpatient after 8PM: Prelim all CT and MRI (both STAT and nonSTAT cases).  MRI examinations can be abbreviated to a one-liner w/ pertinent findings (add header).
    • Abbreviated report for the following cases as time allows: STAT CT cases (PE chest, dissection, fall out of bed), plain radiographs if asked by team
    • Provide wet read for critical findings on all inpatient MSK CT/MRI
Other:
  • Perform and dictate emergent ultrasounds ordered before 7:30am (cholecystitis, scrotal, dvt, appy, intussuception, organ harvesting).
  • NM on call cases from both sites after midnight                   
  • If at West, contact RH Eve person for emergency testicular US at RH
  • Carry pager (answering for both sites after MN) 
  • Protocol ER CT/MR studies and inpatient CT/MR studies as needed

BI NF

Location:  BI, 2 linksy - 07
Time: M-F 10:15p-8am; Weekends/Holiday 7p-8a (NF week shift is Sun-Fri)

Main Sites: BI (Petrie), KH, KD, CityMD, ODA, PUC, NYEE

Worklists/Pager: 
  • BISLW--> Residents--> Dwtn CALL ED

  • BISLW-->Residents--> Dtwn IP CT MR

  • Tech gives residents paperwork for CityMD→ look on "Body CT South" or "US BI" (which includes outpatients).

  • Pager 16119

Responsibilities:      
  • Prelim all ER and urgent care XR/CT/US/NM
  • Neuro: All ER Head CT and MRI. Inpatient's from 4-8PM: Dictate as time permits.  Inpatient after 8PM: Prelim all CT and MRI (including both STAT and nonSTAT cases).  MRI examinations can be abbreviated to a one-liner focusing on acute/pertinent findings (or their absence).
  • Dictate BRIEF prelim report emergent inpatient MRI’s and inpatient chest CTA’s. 
  • Whenever possible, residents should also put in a BRIEF prelim report on other inpatient cross-sectional studies. 
  • If a full report is requested, the resident should dictate a full report. Inpatient XR’s should be dictated with a full report when requested. 
  • Nuclear medicine sentinel node and lymphoscintigraphy injections until 8 AM
  • For ER US, the ED physician must discuss the patient with you to approve the study and confirm if/when it will be performed.
  • Inpatient ultrasounds are sometimes requested during call shifts. Please discuss the immediate necessity of the case with the ordering physician. If they insist it is emergent and you do not agree, please discuss the case with your attending. 
  • ER and inpatient fluoro examinations will be performed on a case by case basis.

ATTENDING COVERAGE

See Qgenda schedule for on call and late shift attendings.

ATTENDINGS *intranet*
BI Nuclear Medicine
Neuroradiology (please refer to monthly email also)

BODY ON CALL ATTENDING
-Please follow Qgenda schedule and call next day's attending. (On weekends, contact Monday attending.)
MSK ON-CALL ATTENDING

-Please see document "+ MSK CALL MSHS" below.


*For overnight MR and NM studies, the overnight attending can look over studies and discuss findings with ED if requested. If a final read is requested immediately, please refer to the above on call schedule. Otherwise, the study will be finalized the next morning by the appropriate attending. 


*For pediatric fluoro cases, please call the on call Pediatric Radiology attending for further instructions.



RESOURCES



RADIOLOGY SUPERVISORS

  • Supervisors are on site until 11 pm if you need help 
  • Transferring images to PACS from an US machine
  • Getting in touch with RIS for system wide problems or if you can’t dictate

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