IR Call Crash Course
SUNY Downstate and Kings County Hospital
YOU JUST GOT PAGED
YOU JUST GOT PAGED
ATTENDING ACCEPTS
KINGS COUNTY CALL CASES
Level 1 Trauma
KCH EPIC STEP 1
login to Epic as KC INTERVENTIONAL RAD or change context
KCH EPIC STEP 2
Change Worklist to KC Rad IR Consults Protocol Worklist, all inpatient consults should be listed there.
If no consult has been placed you can place all orders and notes by looking the patient up via Patient Lookup and going to step 4
Level 1 Trauma
Change Worklist to KC Rad IR Consults Protocol Worklist, all inpatient consults should be listed there.
If no consult has been placed you can place all orders and notes by looking the patient up via Patient Lookup and going to step 4
KCH EPIC STEP 3
Highlight the patient you are doing to the procedure on and in the bottom right corner there is a protocol box, that asks “Clinic Appt Needed?” click No and then click Finalize & Open Chart
This will automatically take you to the correct ENCOUNTER and into the PRE-PROCEDURE tab where you can place orders and answer the consult note
Level 1 Trauma
KCH EPIC STEP 4
Having clicked “FINALIZE & OPEN CHART” in the protocol worklist, you’ll be taken to a screen that looks like this (if you use Patient Station it should take you here as well)
Level 1 Trauma
KCH EPIC STEP 5
Everything you need is under the Pre Procedure Tab,
Place your orders under Orders and respond to the consult under Consult Note
When responding to a consult note, click the box next to inpatient IR consult as shown on the picture in the upper gray box as well as clicking the box for cosign required.
When writing note, please add a header of “IR Consult Note” or “VIR Consult Note” via free text. You must review chart, labs and trends, anticoagulant status and coag profile, current abx if any, diet status, vitals, imaging (this should be obvious do not just look at the impression).
Also clearly understand the consent status of the patient or who may be providing consent. You will be responsible for obtaining consent, which may mean contacting family/NOK.
Always keep track of who you speak with from other services and their contact information.
Your note should clearly convey an understanding of the context of the consult, the request for procedure itself, and the clinical indication and pertinence of the request.
Level 1 Trauma
KCH EPIC SMART PHRASES
There are IR smart phrases you can copy and use to provide a template for note writing
Click on the epic button in the top left then go to tools then my smart phrases
In the User bar type the name of a current ESIR resident and their smart phrases will populate below
Right click IRCONSULTNOTE and click on “Add to my smartphrases”
Now when writing a note in epic type “.irconsultnote” and the smart phrase text will appear as an option to choose from
1
2
3
4
5
6
KCH EPIC STEP 6
When performed a procedure on call, you will need to ORDER the appropriate procedure under the pre-procedure orders section. All orders will begin with “IR”. Go under order tabs, type in the box that says “During Visit”.
All other orders, such as pre-op antibiotics, versed, fentanyl, will be done via the during visit order tab as well.
Level 1 Trauma
KCH EPIC STEP 7
After typing “IR” in during visit orders tabs, click search or hit enter. You will encounter the following screen. Scroll through and find the appropriate procedure. This must be done, without an order, there can be no procedure performed.
For most trauma you will likely be doing an angiogram, put IR ANGIO into the search box and select the appropriate study (likely extremity, pelvic or visceral selective)
Other common procedures are nephrostomy and drainage (see picture)
Level 1 Trauma
KCH EPIC STEP 8
Go to SNAP BOARD in the top left corner and DRAG the procedure onto the schedule
Level 1 Trauma
Level 1 Trauma��KCH EPIC STEP 9
Level 1 Trauma
Level 1 Trauma
UHB CALL CASES
Weekend Cases
May get called for semi-urgent cases that cannot wait until Monday
Abscess Drainages, PCN, etc.
Discuss case with attending and try to set up time for case to be performed
Non-urgent cases: No need to call attending these procedures are never performed on call
IV access (midline, picc) HD access (permcath)� Gastrostomy/PEG, Paracentesis/thoracentesis, Biopsies
If requesting IV access, central line can be placed on floor if patient is unstable requiring urgent IV access
If requesting HD access, temporary HD cath (shiley) should be placed by renal if patient requires urgent HD
If requesting Paracentesis/Thoracentesis it should be attempted first at bedside by primary team with documentation of unsuccessful attempt
Follow up and Transfer of Care