Responsibilities & Duties:

• Mount Sinai Critical Value Reporting Policy

• Only leave once touching base with handoff residents at each site

  • Ensure Combined list is caught up

  • HAND OFF/re-forward the phones!!! 

• ED studies, responsible for: 

  • All ED studies - XR, CT, MR, US, Nucs

    • ***Body MRI  (click link for addendum that should be on ALL reports, after regular daytime  hours!!!)

    • MSK  (click link)

    • NEURO (click link)

  • GOAL: Prelim within 90 minutes of exam end time

• Inpatient studies, responsible for:

  • XRs: None, unless called/directly requested

  • Ultrasounds: Only those where a tech calls you with an urgent finding.

  • CT/MRs: Emergent findings must be reported to the team, if applicable.

    • ***Body MRI  (click link for addendum that should be on ALL reports, after regular daytime  hours!!!)

    • MSK  (click link)

    • NEURO (click link)

  • GOAL: no strict timeline (however, do keep an eye on head CTs), may vary depend on urgent request/call, or before you leave your shift.

• Address issues with outpatient or inpatient MRI studies if asked

  • Including consents, "clearing" XRs, etc.

• Address patient contrast extravasations

  • For details: http://www.radrez.com/protocols/extravasation

• When dictating an on-call pediatric ultrasound for torsion, start by contacting your night attending and asking if they would be okay with final signing the study. In the event that the overnight attending  is uncomfortable doing so, then the request should immediately be escalated to the Pediatric Rad attending on call. 

• Perform emergent fluoro if requested, with discussion with covering attending as needed

  • Pediatric fluoro + Neonate/infant US requests: Please call the on call Pediatric Radiology attending for further instructions; further evaluation/care may require transfer to MSH.

  • If you get a request for this (usually MSW), get the information about the baby, callback number, NICU attending name and phone number -discuss the case with peds attending on call to see if it needs to be done emergently

  • When the patient is on table, perform the upper GI with peds attending either on facetime or immediately available to review images (do not send the patient back upstairs or out of the room until confirmed that study is done by peds attending)

• If a CT cystogram is requested, make sure to ask who is coming with patient/make sure someone (i.e. patient's care team) administers the contrast into Foley. Or if you have time, you can also volunteer to do it.

  • Guide here (Click this link)

If any questions, please ask Chief(s).

• Please call the overnight attendings to let them know of any cases from NYEE, as they do not appear on their list at times and need to be finalized. These may incorrectly show up on Epic as outpatient studies. 

MONDAY-FRIDAY

• Weekday Eve (MW, SOUTH): 

  • ER: All studies exam end by 11 pm, and

  • Inpatient: exam end 11 pm (Details below)

• Weekday NF (MW, South): 

  • ER: All studies exam end after 11 pm, and 

  • Inpatient: exam end 11 pm - 7:45 am (Details below)

SATURDAY-SUNDAY

• Weekend day/NF shifts (MW, South): 

  • Inpatient studies, exam end 15 minutes before the end of your shift  (Details below)

Inpatient prelims while on call (same for MW and South):

*** ANY INPATIENT STROKE CODES HANDLE IMMEDIATELY, SAME PROCESS AS IF THEY WERE ON THE ED LIST***

Weekdays

-cover body MRI and MSK MRI cases 3:45PM - 7:45AM

-cover body CT and MSK CT cases 7:45PM-745AM

-cover neuro CTs and MRIs  from 745PM-745AM

Weekends

-cover body MRI and MSK MRI cases all day

-cover body CT and MSK CT cases 7:45PM-745AM

-cover neuro CTs and MRIs  from 645PM-745AM

Protocols

• Inpatient: Daytime + On-Call shared duty, all IP CT and MRI protocols for that day

• ED: Handled by the ED technician(s), using Dr. Friedman's CT protocol book (can forward to the techs if they don't have a copy).  ED technicians may call and request help with a protocol.

Common courtesy/Professionalism tips:

• Begin dictating cases at the start of your shift to help "catch up"

• Assist the junior residents with cases (even at a different site, as time allows)

• Check in with the assigned attending on Qgenda at the start of your shift stating your hospital site, contact number, and coverage period

Prelim's and Drafts:

• Be mindful that the ED may take action based on preliminary reports (including discharging patients). 

• R1s: 

  • Draft all studies

• R2-R4s:  

  • Prelim all IP, ED studies per Responsibilities & Duties above