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CALL ROTATIONS


FACULTY CONTACTS

SLW ED faculty representative:
David Frager
Any questions or concerns about the SLW ER rotation can be directed to Dr. Frager at EXT 23-4222 or david.frager@mountsinai.org. See Qgenda for availability.

Night float faculty advisor:

Dairon Garcia

Any questions or concerns about the Night Float or Evening Call rotation can be directed to Dr. Garcia at dairon.garcia@mountsinai.org.


BI ED liason:

Elina Zaretsky

Any questions or concerns related to the ED should be directed to Dr. Zaretsky at elina.zaretsky@mountsinai.org.


BI ED follow-up:

Email BIEDfollowup@mountsinai.org if the attending changes the preliminary report with findings that affect management and the patient has already been discharged from the ED. Please also cc elina.zaretsky@mountsinai.org.


SLW ED liason:

Any questions or concerns related to the ED should be directed to Dr. Kagetsu at nolan.kagetsu@mountsinai.org.  


SLW 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 also email stephen.zink@mountsinai.org.


Interesting cases:

Please send accessions to hong.ma@mountsinai.org and also cc elina.zaretsky@mountsinai.org. Dr. Ma will organize and distribute cases to residents.
    

CALL ROTATIONS

Hours: (Please note weekday vs weekend/holiday hours.) 

SLW ER: Mon-Fri 8am-4:30pm. Wed 8am-11:15a.
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. Holidays 8a-7p.
W EVE: Mon-Fri 4p-12a + ED 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 10:00 jitney). Sun 7p-8a. 
BI NF: Mon-Fri 10:15p-8a. Sun 7p-8a. 

SL Weekend: Sat-Sun 8a-7pm. 
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
  • At the start of your call shifts, please send an email to Attendings.  Include site you are at, the station phone number, and when you are covering.  
  • Your list should be prioritized by "Study time." This will allow you to see if studies are hanging around in "Arrived" status for too long.
    • Follow up on all studies that are in “Arrived” status for more than 1 hour. Open the exam and investigate why it is taking so long. DO NOT LEAVE IT FOR THE NEXT RESIDENT.
  • Dictate all studies VERIFIED 15 minutes before the end of your shift. Perform and dictate all US ordered 30 minutes before the end of your shift.
  • Please report urgent findings to the ordering provider, responding clinician (resident, NP, PA) or the ER charge nurse as a last resort. The name and time of notification, along with name of radiologist who notified the physician should be documented. Template “Notification” under MSW can be used.    
Common Responsibilities:
  • All ER studies
  • STAT inpatient Body/Chest CT (PE, dissection, abdominal pain) - Residents will prelim inpatient Chest/Body CT, a one-liner addressing emergent findings or lack thereof is acceptable.  Assign to the next day attendings.
  • All Inpatient MSK CT and MR - Residents will prelim and assign to MSK attending for the following day/monday.
  • Inpatient Body MR - Residents will prelim inpatient MRCP, Pregnant r/o appendicitis, and other emergent body MRI.  One-liner prelim assigned to next day attending is acceptable.
  • Inpatient Neuro
    • 4-8PM with Neuroradiologist on call: Residents will prioritize ER cases and prelim inpatient neuro cases as time allows 
    • After 8PM: Residents will prelim ALL inpatient neuro cases - a one-liner addressing emergent findings is acceptable.
    • Do NOT dictate spine MRI level by level. Your attending will need to re-do the entire report. 
  • R1's will be allowed to prelim x-rays only after January (draft only before this time). On a case by case basis (depending on rotation experience and complexity of case), 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 ER

Location:  
  • SL Ballroom 
Time:  
  • 8:00 am – 4:30 pm
  • Wed only: 8:00 am - 11:00 am (SLW ED resident goes to Mega)
Main Sites:
  • MSSL, MSW, Brodsky
Worklists/Pager:  
  • Create own worklist which includes x-rays from West and SL
  • Pager: 33214

Responsibilities:
  • SLWest and Brodsky ER plain films (XR) 
  • R1: Draft, prelim as comfortable second half of year. R2-4: Prelim.  
  • R1's should go with the SLW ER attending IF the ER attending starts at 8AM (not on XR 8PM shift).  
  • IF SLW ER attending starts at 12PM (late XR shift) - the resident should work with the BI Xray attending.
  • IF Dr. Dan is covering from Brooklyn, R1 should go to whichever other attending is on.  Email the attending the day before to find where they are reading from.
Other:  
  • Arrive PROMPTLY at 8:00 am to take pager from the NF resident (first priority) 
  • Cover films until 4:00 pm
  • Carry pager until 4:30 pm (answer for both hospitals)
  • Properly hand off pager to SLEve resident between 4:00-4:30 pm
Conference (mandatory): 
  • Trauma Surgery Conference on the 3rd Friday (usually) at 7:00 am at Muhlenberg 4
  • Email Deb Travis, Trauma RN coordinator (deborah.travis@mountsinai.org) to confirm date/time and cases
ER attending coverage:  
  • If no attending is assigned to ER plain films at SLW (or assigned to late shift starting at noon), the ER attending at BI is required to cross cover SLW plain films.

BI JR

Location: 
  • Beth Israel, 2 Linsky-07
Time: 
  • Weekday: 5pm-10pm after your normal day rotation
  • Weekend: 1pm-9pm 
Main Sites:
  • BI (Petrie), KH - Kings Highway (BI Brooklyn), KD - Kingsway Diagnostic (BI Brooklyn MR)
  • CityMD, ODA: ODA Urgent Care, PUC: PACC/DUS Urgent Care, NYEE: New York Eye & Ear Infirmary
Worklists: 
  • BISLW--> Residents--> Dwtn CALL ED

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

Responsibilities:
  • Common responsibilities.
  • BI JR will primarily be responsible for phone calls, with help from seniors as needed. 
  • If there is no US technician, BI JR will also primarily be responsible for US ordered 30 minutes prior to the end of their shift. Seniors will help as needed. 


SL EVE

Location:  
  • SL Ballroom 
Time:  
  • M/T/Th/F: 4:15 pm - 12:00 midnight (catch 4p/12:30a jitney)
  • W: 11am-10:00pm (SLW ED resident leaves for Mega)
  • Sat/Sun/Holidays: 8:00am - 7:00pm
Main Sites:
  • MSSL
Worklists/Pager: 
  • BISLW--> Residents--> SLW CALL ED
  • BISLW--> Residents--> SLW CALL IP
  • Pager: 33214
Responsibilities:  
M/T/Th/F

  • Common responsibilities (ER/inpatient)
  • Arrive between 4:00-4:30 pm to receiver pager from SLW ER resident (catch the 4:00 jitney for residents residing in the housing)
  • After 6:30 pm - perform all ER ultrasounds ordered before 11:30pm 
  • Protocol ER and inpatient CT's.
  • Carry pager (33214) after 4:00 pm, hand off to Night Float resident
Wednesdays
  • 11:00am - 4:00pm read ER xray from both SL and W
  • 4 - 10pm Common responsibilities
  • Protocol ER CT's.
Saturdays, Sundays, and Holidays
  • If both RH EVE and SL EVE weekend have upper class residents, each covers their own site
  • With 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.

Other: 
  • MR consents for outpatients
  • US abdominal survey for organ harvesting (note: portal vein flow)

W EVE

Location:  
  • West Ballroom, 4th floor
Time:          
  • Monday-Friday: 4:00 pm - 12:00 MN; hold pager 12:00 MN - 8am for scrotal US
  • Saturday/Sunday: 8:00 am - 12:00 MN; hold pager 12:00 MN - 8am for scrotal US
  • Holiday hours
    • AM shift 8:00am - 4:00pm 
    • PM shift 4:00pm - 12:00 MN shift; hold pager from 12:00 MN - 8am for scrotal US
Main Sites:
  • MSW
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
  • Perform US ordered before 11:30pm
  • Protocol ER and inpatient CT's.
  • US abdominal survey for organ harvesting (note: portal vein flow)
                 
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: Beth Israel, 2 Linsky-07
Time:          
  • Monday - Friday: 4:00pm - 12:00 MN
  • Saturday/Sunday/Holiday: 8:00am - 7:00pm
Main Sites:
  • BI (Petrie), KH - Kings Highway (BI Brooklyn), KD - Kingsway Diagnostic (BI Brooklyn MR)
  • CityMD, ODA: ODA Urgent Care, PUC: PACC/DUS Urgent Care, NYEE: New York Eye & Ear Infirmary
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:  
  • MSSL St. Luke's Ballroom 
Time:
  • Monday - Friday: 10:00pm - 8:00am 
  • Saturday/Sunday/Holiday: 7:00pm - 8:00am (NF Sun- Fri. Sat NF covered by assigned resident.)
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 (including both STAT and nonSTAT cases).  MRI examinations can be abbreviated to a one-liner focusing on acute/pertinent findings (or their absence).
    • 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 (fell out of bed, change in condition) 
    • Look at all inpatient MSK CT or MRI and also provide wet read for critical findings
Other:
  • Perform and dictate emergent ultrasounds ordered before 7:30am.
  • 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) 
  • At West, PHYSICALLY hand-off pager to incoming ER day shift resident
  • Protocol ER CT/MR studies and inpatient CT/MR studies as needed
  • US abdominal survey for organ harvesting (note: portal vein flow)

BI NF

Location:  
  • MSBI: Beth Israel, 2 Linsky-07
Time:
  • Monday - Friday: 10:00pm - 8:00am 
  • Saturday/Sunday/Holiday: 7:00pm - 8:00am (NF Sun- Fri. Sat NF covered by assigned resident. 
Main Sites:
  • BI (Petrie), KH - Kings Highway (BI Brooklyn), KD - Kingsway Diagnostic (BI Brooklyn MR)
  • CityMD, ODA: ODA Urgent Care, PUC: PACC/DUS Urgent Care, NYEE: New York Eye & Ear Infirmary
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.


REFERENCES



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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