ROTATIONS‎ > ‎

CALL OVERVIEW


CALL ROTATIONS

(above link only accurate until June 28 2020)

Responsibilities & Duties:
  • Only leave once touching base with handoff residents at each site
    • Ensure Combined list is caught up (both Eve-Eve, AND Eve-NF)
    • HAND OFF/re-forward the phones/pagers!!! 
  • ED studies, responsible for: 
    • All ED studies - XR, CT, MR, US, Nucs
    • Goal: Prelim within 90 minutes of QC/verified time
  • Inpatient studies, responsible for:
    • XRs: None, unless called/directly requested
    • Ultrasounds: All.  By timestamp OR if you received the phone call, you should dictate it or verbally handoff to the next resident. Make sure to check the daytime US lists, as the US techs may not call you/may just leave a note)
    • CT/MRs: Emergent findings must be reported to the team, if applicable:
    • Goal: no strict timeline (however, do keep an eye on head CTs), may vary depend on urgent request/call, or before you leave your shift.
  • Address issues with outpatient or inpatient MRI studies if asked
    • Including consents, "clearing" XRs, etc.
  • Address patient contrast extravasations
  • Perform emergent fluoro if requested, with discussion with covering attending as needed
    • Pediatric fluoro + Neonate/infant US requests: Please call the on call Pediatric Radiology attending for further instructions; further evaluation/care may require transfer to MSH.
  • If a CT cystogram is requested, make sure to ask who is coming with patient/make sure someone (i.e. patient's care team) administers the contrast into Foley. Or if you have time, you can also volunteer to do it.
If any questions, please ask Chief(s).


QC/verified timestamps:
  • ER US scanning: Perform and dictate all necessary and appropriate ER US requests up to 30 minutes prior to end of shift.  
    • DO NOT CALL for an Ultrasound to come up/to be performed, if YOU are not the one performing it!
  • 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.

MONDAY-FRIDAY
  • Weekday Eve (M, W, BI): 
    • ER: All studies verified by 11 pm, and
    • Inpatient: STAT/msk/neuro/body inpatient studies VERIFIED by 11 pm 
    • (if caught up time-stamp-wise, continue to read until 12 AM!). 
  • Weekday NF (MW, BI): 
    • ER: All studies verified after 11 pm, and 
    • Inpatient: STAT/msk/neuro/body studies verified after 11 pm - 7:45 am
SATURDAY-SUNDAY
  • Weekend day/NF shifts (M, W, BI): 
    • Both/all ER and inpatient studies, verified 15 minutes before the end of your shift


Protocols
  • Inpatient: Daytime + On-Call shared duty, all IP CT and MRI protocols for that day
  • ED: Handled by the ED technicians, using Dr. Friedman's protocol book (can forward to them if they don't have a copy). If ED technicians call requesting a protocol, you can ask them for a specific question/indication, and answer/protocol over the phone.


Common courtesy/Professionalism tips:
  • Begin dictating cases at the start of your shift to help "catch up"
  • Use the common worklist (as time allows), to keep an eye on all sites/help with volume across sites
  • Assist the junior residents with cases (even at a different site, as time allows)
  • Send an email to the assigned attending on Qgenda at the start of your weekend shift stating your hospital site, contact number, and coverage period
  • CAN dictate from resident lounges, or offices, if reading station up-to-date AND phones are forwarded properly (*This policy updated due to COVID-19 social distancing guidelines, and recent upgrades to the reading stations. May revisit policy at later date.)

Prelim's and Drafts:
  • Be mindful that the ED may take action based on preliminary reports (including discharging patients). 
  • R1s: 
    • XR, US: allowed to independently prelim, ideally after January 
    • CT, MR: draft only, EXCEPT if case reviewed with attending or senior resident, then can prelim 
  • R2-R4s:  
    • Prelim all IP, ED studies per Responsibilities & Duties above
















Pagers

M/W Pagers
  • MSW pager coverage from 8am-4:00 pm to be assigned (Pagers: 33214, 35830)
Please stop page copying the M and W pagers to your personal cell phones. If you prefer to receive pages on your cell phones, then page copy your personal pagers to your cell and then forward the M/W pagers to your personal pagers.

Follow instructions below:

Step 1: Forward your personal pager to your cell phone
Call operator at 212-523-4000 and request them "page copy” your pager to your cell. Do not undo this step.

Step 2: Forward the call pager to your personal pager is as easy as forwarding phones remotely
  1. Dial “05” (in hospital) or dial 212-523-2828 (outside)
  2. Dial 2 (“to change status")
  3. Dial 33214 (M pager) or 35830 (W pager)
  4. Dial 5 (“covered by”)
  5. Dial your pager number
  6. Press “2” to confirm

W Eve resident
  • At start of shift - forward W pager to your personal pager at beginning of shift
  • At end of shift - forward W pager to M pager at the end of your shift (W NF resident covers both sites)

BI Pager
Pager 16119  
(although BI may have transitioned fully to Epic Chat at this point)

CT Perfusion Studies

Click HERE for trouble shooting CT Perfusion Studies

NF Attending Responsibilities

Night Attending Responsibilities/Signing Time Cut-off

(Otherwise, assign the studies to another attending - Evening or Daytime attending - depending on time of the shift)
  • In-patient CTs
We check all in-patient CTs for emergent findings and sign the following in-patient CTs:
    • all stroke alerts and their associated CTAs, anytime from 8p-8a (til 7a on Saturday/Sunday)
    • all pan-scan traumas (sometimes an ED patient is admitted but then they get a rescan of their trauma), anytime from 8p-8a (til 7a on Saturday/Sunday)
    • any in-patient CT by physician request, anytime from 8p-8a (til 7a on Saturday/Sunday)
    • on Friday/Saturday nights we sign all in-patient CTs til 10pm, but Neuro in particular til 2am
    • on Sunday-Thursday nights we sign all BI and KH in-patient CTs til 10pm
  • ED CTs
We sign the following ED CTs:
    • Monday-Thursday: all ED CTs from 8p-5a (from 5a-8a we sign all stroke alerts, pan-scan traumas, and any cases by physician request)
    • Friday: all ED CTs from 8p-7a 
    • Saturday: all ED CTs from 6p-7a (though neuro from 7pm onward)
    • Sunday: all ED CTs from 6p-5a (though neuro from 7pm onward); (from 5a-7a we sign all stroke alerts, pan-scan traumas, and any cases by physician request)

OVERNIGHT ATTENDING READING LIST

ULTRASOUND TECH HOURS

Beth Israel
  • Mondays & Tuesday: 17 hour coverage (12 am to 7 am is uncovered)
  • Wednesday - Friday: 24 hour coverage
  • Weekends: 22 hour coverage (7 am to 9 am is uncovered)

Morningside
  • Weekdays: 8am - 11pm
  • Weekends: 8am - 11pm, holidays will email with updates

West
  • Weekdays: 8am - 11pm (last case 10:10pm); 24h starting in March
  • Weekends: 11am - 7pm

ATTENDING COVERAGE

Check 3 pages on Radrez home page:
  • Qgenda (CT, US, XR)
  • Neuro ("Late")
  • Night attendings



FACULTY CONTACTS

Morningside-West ED FACULTY REPRESENTATIVE:
David Frager (x23-4222 or david.frager@mountsinai.org See Qgenda)

NIGHT FLOAT/EVENING CALL FACULTY ADVISOR:

Dairon Garcia (dairon.garcia@mountsinai.org)


BI or Morningside-West ED LIASON:

  • Dr. Kagetsu: Nolan.Kagetsu@mountsinai.org
  • The Chiefs: MSWChiefs@mountsinai.org


ED FOLLOW-UP:

  • Morningside-West:
    • Call ED physician or PA if the radiology attending changes the preliminary report with findings that affect management and the patient has already been discharged from the ED
    • Email Dr. Kagetsu, Dr. Somwaru and the Chiefs
  • BI specifically:
    • There is a BI ED follow up group made of ER PAs that handle callbacks at MSBI
    • BIEDFollowUp@mountsinai.org with the patient's information and reason for callback
    • Dr. Zeifer 
    • Shari Fernandez: Shari.Fernandez@mountsinai.org 


INTERESTING CASES:

Please add interesting cases to Body ICC filter to review at the Body ICC Conference.


ON-CALL PAGERS:

 Beth Israel 16119
 Morningside 33214
 West 35830


SAFE RIDES:
  • Mount Sinai Safe-ride account
  • Uber pool during 9 pm - 5 am (no solo UberX rides)
  • Out of state not covered

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

RESOURCES


Ċ
RadRez Administrator,
Jul 19, 2019, 11:02 AM
Ċ
RadRez Administrator,
Jan 28, 2017, 5:08 PM
Ċ
RadRez Administrator,
Jul 5, 2020, 9:29 PM
Ċ
RadRez Administrator,
Jan 28, 2017, 5:06 PM
ć
Christina,
Nov 9, 2019, 12:17 PM
Ċ
RadRez Administrator,
Jun 30, 2018, 8:44 PM
Ċ
Christina,
Oct 9, 2019, 6:05 PM
ĉ
Christina,
Oct 9, 2019, 6:05 PM
ĉ
Florence Doo,
Feb 28, 2020, 11:18 AM
ĉ
RadRez Administrator,
Jul 6, 2020, 10:09 AM
Ċ
RadRez Administrator,
Jan 28, 2017, 5:08 PM