Monday
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Tuesday
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Wednesday
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Thursday
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Friday
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Daily Tasks
6:00-6:30 AM: A note documenting add-on procedures or essential calls from the prior night should be emailed to the physicians and nurse practitioners no later than 6:30 AM.
6.45 am – Any imaging performed on inpatients in the last 24 hours should be reviewed.
Lab results for patients on the schedule should be reviewed.
All fellows on service to assign themselves to one of the morning cases.
7 am (8 am on Wednesday): Board rounds.
7.15 am (8.15 am on Wednesday): In-patient rounds.
Pre-procedure:
Post-procedure:
5 pm:
Other Daily Tasks:
6.45 am – Any imaging performed on inpatients in the last 24 hours should be reviewed.
Lab results for patients on the schedule should be reviewed.
All fellows on service to assign themselves to one of the morning cases.
7 am (8 am on Wednesday): Board rounds.
- The patients are presented by the fellows.
- All of the patients (with the exception of GJs) are reviewed (with brief history, procedure to be performed, positioning, equipment required and labs). At least one IR attending and the anesthesiologist will be present.
7.15 am (8.15 am on Wednesday): In-patient rounds.
- The NPs will present updates on inpatients to the fellows and the consult attending.
- All add-on procedures, calls, and queries from families will be discussed.
Pre-procedure:
- Verify that the order is placed by the primary team and is accurate.
- Consent the patient (Some on your own, some with the attending)
- Same day assessment is required for all outpatients. Click box that says “other” and type “IR Preop” for outpatients.
- Pre-procedural notes should be completed and photographs taken if required.
- All of the imaging performed should be reviewed and relevant images selected to be displayed during the procedure.
- Fellows should be present in the room prior to prep. Sonography should be performed as necessary. Choice of ultrasound probe, patient positioning and area to prep should be communicated to the tech assigned to the case.
- The procedure nurse should be informed of all medications and sclerosants to be used during the case.
- Have relevant imaging displayed in the PC in the control room so that it will be visible on the screen in the room during the case.
- Confirm patient positioning, area(s) to prep, and perform ultrasound (if necessary) prior to prep.
Post-procedure:
- Orders There are power plans for IR procedures.
- Formula 1 If the patient is from ICU, you will accompany the patient to ICU and do an in-person handover.
- Brief op note in Epic “Procedure performed by” is always the attending (even if you do the procedure yourself) and you are the assistant. GJ changes do not require a brief op note.
- Communication
- Sign-out info to one of our NPs when procedure is finished
- Communicate with the family
- Dictation – (Power Scribe) – Please use standardized templates if available. They begin with “zzz IR Standard” so they are easy to find. If the specific template for your procedure does not exist, please use the “zzz IR standard blank template” and either dictate the technique section freely or cut and paste from previous or similar procedure. (See note on Montage below)
- Discuss the remaining schedule with the board runner and assign yourself to the next available case.
5 pm:
- The on-call fellow will round on the patients in the afternoon following completion of all of the cases.
- The on-call fellow is responsible for ensuring a verbal sign-off from the NPs prior to the end of the day.
- The cases for the next day should be reviewed. In consultation with co-fellows, fellows should assign themselves to cases for the next day and address any outstanding issues with the relevant attending. Place signed consents in the appropriate folder in the drawer in control room 14.
- All inpatients scheduled for the next day should be consented, including phone consent if necessary. This the responsibility of the on-call fellow.
Other Daily Tasks:
- Decide which fellow is doing which cases the following day.
- Prepare for the cases you will perform and/or present on rounds.
- Assign yourself to the case on Epic
- Look up patient on Epic for relevant history, labs, etc.
- Review the procedure protocol
- Look up relevant imaging to prepare and plan
- On post-call mornings, please email any overnight issues/updates or requests for procedures to be added on. It is best to do this before 6:30. Use the IR pt list distribution email address: [email protected]
Wednesday Morning Meetings
The Wednesday meetings follow a 4-week schedule as follows:
Week 1,3 and 4: 6.45-7.45 am: Attendings: IR MD, IR MD/NP Admin meetings.
Fellows: Didactic Lectures by non-IR MDs will be scheduled at this time.
Week 2: IR M&M meeting - Please see details below.
Mortality and Morbidity/Quality Improvement Rounds
All Safety Event Reporting System (SERS) events from the last 5 weeks will be discussed. The fellows are expected to present at these rounds in coordination with Dr. Shaikh. There should be a brief discussion of the event, classification of the complication and a brief literature review.
Week 1,3 and 4: 6.45-7.45 am: Attendings: IR MD, IR MD/NP Admin meetings.
Fellows: Didactic Lectures by non-IR MDs will be scheduled at this time.
Week 2: IR M&M meeting - Please see details below.
Mortality and Morbidity/Quality Improvement Rounds
All Safety Event Reporting System (SERS) events from the last 5 weeks will be discussed. The fellows are expected to present at these rounds in coordination with Dr. Shaikh. There should be a brief discussion of the event, classification of the complication and a brief literature review.
Friday Morning Meetings
6.45-7.30 am:
Journal Club
Interventional radiology papers published within the last 2 years are reviewed. One study is discussed in length, with the fellow expected to summarize the findings and present a comprehensive critique of the paper, including the methodology and conclusions. A brief review of another 5-10 papers is then performed.
Clinical Case Conferences
One fellow and one attending will be assigned to this conference. There will be a review of recent interesting cases, followed by discussion.
- Didactic Lectures - Series of lectures covering the spectrum of conditions seen in pediatric IR.
- Journal Club
- Clinical Case Conferences
Journal Club
Interventional radiology papers published within the last 2 years are reviewed. One study is discussed in length, with the fellow expected to summarize the findings and present a comprehensive critique of the paper, including the methodology and conclusions. A brief review of another 5-10 papers is then performed.
Clinical Case Conferences
One fellow and one attending will be assigned to this conference. There will be a review of recent interesting cases, followed by discussion.
Evening Meetings
Wednesday - Vascular Anomalies Conference and Clinic
Attendance and presentation at the Vascular Anomalies Conference is an essential requirement. The fellows will alternate responsibility for the conference and clinic. The diagnostic fellows rotate through IR for 2 weeks each; they are expected to present at VAC conference during those weeks. It is the fellow's responsibility to review all of the cases prior to the conference/clinic and discussed these with the assigned IR attending. Following the conference, a summary of imaging findings and interventional recommendations should be emailed to: [email protected] and copy the IR attending who reviewed the cases.
Every other Thursday - Mid-aortic and Renal Artery Stenosis Meeting
The fellows and IR resident rotate responsibility for this conference, which takes place every 2 weeks. A list of patients will be emailed to everyone earlier in the week, with occasional last-minute add-ons. The diagnosis is usually established. We review new patients and existing ones with updates. If a CTA or angiogram is available, this is usually the best initial imaging modality to present. Core members of the team are nephrology, IR, interventional cardiology and vascular surgery. The conference is attended by Drs. Chaudry and Kim, so please review cases with them.
Attendance and presentation at the Vascular Anomalies Conference is an essential requirement. The fellows will alternate responsibility for the conference and clinic. The diagnostic fellows rotate through IR for 2 weeks each; they are expected to present at VAC conference during those weeks. It is the fellow's responsibility to review all of the cases prior to the conference/clinic and discussed these with the assigned IR attending. Following the conference, a summary of imaging findings and interventional recommendations should be emailed to: [email protected] and copy the IR attending who reviewed the cases.
Every other Thursday - Mid-aortic and Renal Artery Stenosis Meeting
The fellows and IR resident rotate responsibility for this conference, which takes place every 2 weeks. A list of patients will be emailed to everyone earlier in the week, with occasional last-minute add-ons. The diagnosis is usually established. We review new patients and existing ones with updates. If a CTA or angiogram is available, this is usually the best initial imaging modality to present. Core members of the team are nephrology, IR, interventional cardiology and vascular surgery. The conference is attended by Drs. Chaudry and Kim, so please review cases with them.