Responsibilities & Duties:

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

  • Ensure Combined list is caught up (both Eve-Eve, AND Eve-NF)

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

• 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 QC/verified time

• Inpatient studies, responsible for:

  • XRs: None, unless called/directly requested

  • Ultrasounds: All.  By timestamp OR if you received the phone call, you should dictate it or verbally handoff to the next resident. Make sure to check the daytime US lists, as the US techs may not call you/may just leave a note)

  • 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

• 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

  • If peds attending agrees for study to be done emergently and you are not at MSW, need to call in the backup resident, get in touch with Xray tech and tell them we need to do an emergent fluoro study, have NICU team bring down patient

  • when patient 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).

QC/verified timestamps:

• ER US scanning: Perform and dictate all necessary and appropriate ER US requests up to 30 minutes prior to end of shift.  

  • DO NOT CALL for an Ultrasound to come up/to be performed, if YOU are not the one performing it!

• Follow up on studies that are in “Arrived” status for more than 1 hour. Open exam and investigate why it is taking so long. DO NOT LEAVE IT FOR THE NEXT RESIDENT.

MONDAY-FRIDAY

• Weekday Eve (M, W, BI): 

  • ER: All studies verified by 11 pm, and

  • Inpatient: STAT/msk/neuro/body inpatient studies VERIFIED by 11 pm 

  • (if caught up time-stamp-wise, continue to read until 12 AM!). 

• Weekday NF (MW, BI): 

  • ER: All studies verified after 11 pm, and 

  • Inpatient: STAT/msk/neuro/body studies verified after 11 pm - 7:45 am

SATURDAY-SUNDAY

• Weekend day/NF shifts (M, W, BI): 

  • Both/all ER and inpatient studies, verified 15 minutes before the end of your shift

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). 

  • If ED technicians call requesting a protocol, they should have a specific question. You should:

    1. help techs answer/protocol over the phone; or 

    2. ask them to help you find/page the ED team directly to your # to discuss further.

Common courtesy/Professionalism tips:

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

• Use the common worklist (as time allows), to keep an eye on all sites/help with volume across sites

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

• Send an email to the assigned attending on Qgenda at the start of your weekend shift stating your hospital site, contact number, and coverage period

• CAN dictate from resident lounges, or offices, if reading station up-to-date AND phones are forwarded properly (*This policy updated due to COVID-19 social distancing guidelines, and recent upgrades to the reading stations. May revisit policy at later date.)

Prelim's and Drafts:

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

• R1s: 

  • XR, US: allowed to independently prelim, ideally after January 

  • CT, MR: draft only, EXCEPT if case reviewed with attending or senior resident, then can prelim 

• R2-R4s:  

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