ROTATIONS‎ > ‎

VIR (INTERVENTIONAL)


FOR RESIDENTS ON VIR ROTATIONS, PLEASE STAY ON ROTATION IN LIEU OF MEGACONFERENCE.

VIR @ BI
  • Faculty representative: Dr. Rajesh Patel 
  • Location: Cath lab at BI Dazian floor 11 (IR reading room 11D88, x20-3883) every day except Tuesdays (CT area floor 2). 
  • BI IR resident/fellow pager 13215
  • Mon-Fri at BI (7:15 am latest until the last case finishes). An MSH IR fellow or resident will rotate with you.
  • Dr. Patel works at BI Tue/Wed Fri (he is at clinic Mon/Thu). Dr. Rastinehad works at BI Tue/Thu.
  • Coverage should be discussed with the VIR attending and fellow prior to Monday  
  • You can borrow radiation protection glasses, but please return them promptly at the end of the rotation.
  • Charting and rounding through PRISM
  • Consults received via pager or IR secretary (Vincent, Lenika, x20-2509)
VIR @ W

  • Faculty representative: Dr. Adie Friedman
  • Mon-Fri at W (8am until the last case finishes). An MSH IR fellow or resident will rotate with you.
  • Coverage should be discussed with the VIR attending and fellow prior to Monday
  • Tips on this rotation can be found at VIR on Call
  • Charting and rounding done through EPIC
VIR @ SL
  • Faculty representative: Dr. Ronald Dreifuss
  • Mon/Wed/Fri (7:30am - catch the 6:45am Jitney - until 4:30pm or until the last case finishes).
  • You will either be on consult day for Tue/Thu or go to W to work with Dr. Dreifuss.
    • Check with Dr. Dreifuss beforehand and carry your pager those days!
  • Tips on this rotation can be found at VIR on Call
  • Charting and rounding done through EPIC
VIR CONFERENCES
  • REQUIRED: Mon @ 8:00 AM - Monthly didactic lectures - via webconference: LINK
  • Optional/Recommended: Wed @ 7:15 AM - MSH IR Resident Didactic - via webconference
  • Optional/Recommended: Thu @ 7:00 AM - MSH Multidisciplinary Tumor Board - via webconference, including 16 Baird Hall when at BI.
RESPONSIBILITIES
  • Pre-procedure evaluation 
    • Informed consent form
    • Pre-procedure note in patient’s chart
      • Check relevant lab results (especially PT/INR, platelets, Cr, K)
      • Check for anticoagulation medications
      • Check NPO status pre-procedurally 
      • Mallampati, BMI should be in preop H&P for patients getting monitored sedation 
  • During procedure
    • The degree of involvement in procedures will be determined based on demonstrated ability and interest
    • Familiarity with the clinical presentation, including history, physical examination, laboratory and other tests, pathophysiology of the disease process, and an appropriate assessment should precede resident involvement in any case
    • Residents who acquire competent clinical skills and adequacy in the roles of first and second assistant will graduate to primary operator on appropriate cases
  • Post-procedure 
    • surgical style notes and orders will be written on the patients that the resident has performed procedures on
    • Cases may be dictated during the work day only if there are no ongoing procedures without physician first and second assistants
    • Otherwise, dictations should be done after completion of all procedures and readout
    • All procedure dictations and sign offs should be completed before the end of the work day
  • Inpatient SIGN OUT
    • To communicate between the daytime staff and night and weekend coverage
    • W: This sign out is the responsibility of the residents and fellows and can be found on the HDrive under our Radiology Dept, SLW Residency, sub-folder VIR sign-out
    • BI: The sign out can be found on the desktop of the Room 4 computer and is often managed by the PAs during the day.
    • In addition to the sign out, you should email or call the call resident to transfer care for any patients they need to trend labs, write notes, and/or round on over the weekend
    •  The night and weekend coverage should inform the daytime team of any procedures they did as the daytime team will have to follow the patient
  • Consults
    • Place a consult note after seeing the patient and discussing the case with the attending 
    • Keep track of inpatients on the schedule board.
    • At BI, there is a PRISM Consult note on the Room 4 desktop computer you should use for all notes!
  • Rounding
    • This may be accomplished prior to start of the work day or after completion of all procedures and readout in the department
    • More active patients may be seen both prior to and after the work day
    • Less active patients may be seen less frequently or dropped from the inpatient list (this will be determined on a case-by-case basis by the attending Interventional Radiologist)
VIR PROCEDURE LOG (IMPORTANT!)
  • Make sure you keep a procedure log of your procedures on New Innovations, this is the only way to be HIPAA compliant to share it with another program.
  • You may log procedures you are the first assistant in, or a minor procedure you performed it under supervision of senior resident/fellow.
  • An easy way is to take a patient MRN sticker from the chart and keep it in a physical notebook on the rotation, keep a file on your smartphone, or go through Powerscribe to find dictations you did (but the Powerscribe list may not reflect all the procedures you participated in).
  • For any dictations you perform, please remember to report the DAP and air kerma in your dictations!
DOCUMENTATION
  • All procedures require a consent, pre-procedural and post-procedural note 
  • Outpatient notes are handwritten
  • Inpatient notes are placed in the EMR
  • Informed consent on Neuroradiology Primer or on paper at nursing bay
INTERPRETER SERVICES
  • Non-English interpreters can be reached at 36-5096 at W (remember to record the translator #) or using Pacific Interpreters at BI (ask an RN for the number). At BI cath lab, there is a portable translating device in the nursing bay. 
  • There are certified Spanish translators at W (Manny, Geraldo, Marcus) that may be able to assist.

RECOMMENDED BOOKS
  • Interventional Radiology: A Survival Guide by David Kessel (best intro book, there should be a copy at BI at all times).
  • Vascular and Interventional Radiology: The Requisites by John A. Kaufman
  • Vascular and Interventional Radiology by Karim Valji
IR LINKS