MSK - ON CALL

Mount Sinai On-call MSK Policy:

The policy below describes the site-specific expectations of radiology residents when approaching cross-sectional MSK cases, particularly when ordering physicians request finalized reports. At the very least, NF and weekend call residents are expected to:

1.      Review all ER and inpatient CT and MRI studies.

2.      Provide a preliminary impression (either in the form of a complete report or a brief, one-liner impression), which are then assigned to the following weekday or Monday MSK attending.

a.       All urgent, on-call extremity CT examinations should be finalized by the scheduled NF attending (Dr. Serge Sicular is in agreement).

3.      Resident preliminary reports should answer the main emergent questions (i.e. osteomyelitis, fracture, fluid collections, bone erosions, etc.) and should be communicated to the primary team if positive.

4.      A finalized MSK report will be published on the following business day, unless there is a proper request for a finalized report, as described below.


On-call MSK Attending:

Residents should only reach out to the on-call MSK attendings under certain extreme orthopedic emergencies, which are specific to each site’s in-house orthopedic coverage.

-         Mount Sinai Hospital, Morningside, and West:

o   Only when requested by an orthopedic surgery attending who wants to clarify uncertain findings that may result in a change in acute management.

§  Only an orthopedic surgery attending may request an emergent finalized report from an MSK attending after hours.

§  Upon this request, the resident should obtain the contact information from the orthopedic surgery attending before reaching out to the MSK attending.

o   Osteomyelitis and r/o fractures cases ARE NOT EMERGENCIES that require an MSK attending to review a case after hours.

o   If the NF attending is consulted, their feedback and name should be included in the preliminary report.

o   MSK-trained attendings are occasionally available on weekends and late shifts (Obedian, McLaughlin, Pfaff, Fast, Benitez, Irish, Roach) and should be consulted at any site.

 

-         Mount Sinai Beth Israel:

o   When requested by an orthopedic surgery attending who wants to clarify uncertain findings that may result in a change in acute management.

AND

o   When requested by an ordering physician who states the finalized report will affect the disposition status of the patient.

o   Otherwise, follow the same protocol as outlined for MSH, Morningside, and West.

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Drew Gunio,
Feb 10, 2020, 5:01 AM