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Type of Fluid Collection
Type of Fluid Collection
Simple:
Unilocular
No septations
No or low risk for enteric fistula
No underlying inflammatory bowel disease
Complex:
Multiloculated
Septated
High risk for enteric fistula
Underlying inflammatory bowel disease.
*The ultimate decision for CT at follow-up is at the operator's discretion.
*Cholecystostomy, nephrostomy, pleural effusion, ascites drainage tubes are not included in this protocol.
Patient Call-Back Procedure
Patient Call-Back Procedure
Providers:
After drainage catheter placement, please send an EPIC message to the "VIR CLINIC UNC CLINICAL STAFF" in the basket pool. Patients will be placed on a follow-up list.
Please Indicate:
Whether the patient is inpatient or outpatient at the time of placement
Whether or not CT follow-up is needed.
Callback Nurse:
Place the patient on the callback list
Indicate whether inpatient or outpatient at the time of placement and whether a CT is ordered for follow-up.
CT scheduling may need to be facilitated by Michelle Hinton, Rachel
Two weeks post placement:
If still on inpatient, do not call for follow-up
Otherwise, during the phone call, ask the patient:
Drain and sutures in place and intact
How much is draining
If draining > 10 mL per day and drain intact, continue to drain care and call the patient again in two weeks.
If draining < 10 mL per day, schedule the patient for a clinic visit for drain eval/removal
If the drain is leaking and painful, and the patient has a fever, or the drain is pulled back, consult their provider at the clinic to see if CT or fluoroscopic study is needed
If so, the provider will order the appropriate study, and the nurse will contact schedulers.
After Abscess Drainage Catheter Placement
After Abscess Drainage Catheter Placement
The procedure report and post-op note should document a detailed follow-up plan
Follow-up orders need to be placed in EPIC by the IR provider who performs the procedure.
Outpatients:
The PRU nurse can facilitate communications with the schedulers and include the follow-up plan with patient instructions.
The IR provider at PRU will help with follow-up and CT orders.
Inpatients:
Follow-up orders & instructions in EPIC and communication with the primary team can help facilitate post-discharge follow-up.
CT order can be placed either by the primary team or IR provider
Relaying Information to the Meadowmon VIR Clinic Nursing Staff:
When you finish a drainage catheter placement, please send an EPIC message to our RN Rick Hopwood and Michael Yellin.
Please include the below information in the EPIC message:
IP (inpatient) or OP (outpatient)
Whether clinic follow-up is required.
Whether CT is needed before the clinic visit
Follow-up Instructions
Follow-up Instructions
First follow-up in 2 weeks
All patients will be scheduled at Meadowmont (MM) VIR clinic for the first follow-up.
IR provider will decide on a standard or virtual clinic visit for the first follow-up. For example, a simple fluid collection (e.g., small seroma) can be evaluated via a virtual clinic visit without CT.
IR provider (scheduled at MM clinic that day) will evaluate the patients and the drainage catheters.
For patients who need CT, virtual appointments may help avoid patients’ additional travel to Chapel Hill.
Afternoon and evening CTs are available especially when working with a two-week lag time.
If the follow-up is scheduled with surgery, VIR follow-up can be skipped.
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