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FLUOROSCOPY


FLUORO ROTATION

Faculty representative: Dr. Benjamin Bashist

Hours: 8am – until attending dismissal

Location: 
BI: Main reading room
W: Resident lounge (close to fluoro suite)
SL: Resident lounge on 3rd floor Clark building (next to fluoro suite)
PACC: 4th floor RR in 6-seat suite, and X-ray Core

Technicians:
BI: 38-6191
W: 23-7499 / 36-3382
SL: 23-4272 / 23-4275

Rotation Schedule:
On the prior day, please:
- Provide technicians with your pager number. (EVERY day, as technicians change daily)
- Check IDX to make sure you are aware of scheduled patients.

 MONDAY TUESDAY WEDNESDAY THURSDAYFRIDAY 
MS West
(Bashist)


 Float*

MS St. Luke's
(Bashist)

11:30 jitney to West for conference
MS St. Luke's is priority. Expect post-op leak studies every 4th thursday of the month

If no SL cases, Float* applies based on volume.

If low cases at all sites, go to PACC for JMP cases
 MS St. Luke's is priority

If no SL cases, Float* applies based on volume. 

If low cases at all sites, go to PACC for JMP cases

*Float = Coordinate with techs the previous day at all 3 sites to prep for next day.  If there are no scheduled cases, the default site should be MS West, as there can be frequent MBS add-ons during the day. If an inpatient case gets added on at ANY site, your priority and duty should be to travel immediately to that site.
AND ALSO, while waiting for Fluoro studies:
Backup Body CT / Chest CT - While waiting for fluoro studies, the resident should check the lists, and help with Body CT or Chest CT, including protocolling, and touch base with the relevant attending at whichever site they are currently located.

Note: Inpatient fluoro always takes priority!!! Outpatients and MBS may be scheduled as time allows, otherwise may coordinate with on-site residents for coverage.


Scheduling Outpatients:

Outpatient add-ons for Tuesdays, Thursdays, and  Fridays must be approved first by Attendings covering fluoroscopy at their respective sites. 

At Beth Israel, outpatients should only be scheduled on Mondays and Wednesdays. 
At Roosevelt, outpatients should only be scheduled on Mondays. 
At St Luke's, outpatients should only be scheduled on Wednesdays.

Inpatients/MBS 

Given the scheduling complexity for the fluoroscopy resident, Inpatient emergent fluoroscopy studies (r/o leak after bypass, etc) as well as any Modified Barium Swallow study can be performed by an onsite resident in place of the fluoroscopy resident.  However, if the fluoro resident happens to be on site when the study is requested, they should do it.

At SL, the fluoroscopy coverage is: 1) MR Body (Thursdays), 2) Body CT W (if on site), 3) US SL, 4) Neuro
At W, the fluoroscopy coverage is: 1) Body CT W, 2) Chest W, 3) Neuro W, 4) Nucs W, 5) Body MR. 
At BI, the fluoroscopy coverage is: 1) Body CT S, 2) Neuro BI, 3) Nucs BI

GOALS AND EXPECTATIONS

Goals:
Residents will become proficient in performing many non-interventional fluoroscopic examinations including but not limited to upper GI studies, barium swallows, esophagrams, small bowel follow through, barium enema, diaphragmatic sniff test, intussusception reductions, enteric tube placement, and fistulograms.

Expectations: 
  • Dressing in scrubs is appropriate
  • Give your pager number to techs at 3 sites at the start of your rotation.  Use IDX to see the schedule for the next day, and coordinate with the techs so that the patient's are scheduled at a time when you will be on site.
  • The schedule for each day should have been finalized/planned the previous day.
  • Complete fluoroscopy studies, initially with attending guidance and later on your own
  • Backup Body/Chest CT - As fluoro is sometimes slow, while waiting for fluoro studies (or when there simply are none), touch base with Body/Chest CT attending at the site you are currently located, and read Body CT cases, including protocolling,.



Resources:


Ċ
Charles,
Jul 4, 2018, 7:59 PM