RADIOLOGY HOUSE STAFF MANUAL

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1 RADIOLOGY HOUSE STAFF MANUAL The Department of Radiology offers a wide range of services/procedures and operates 12 divisions/sections, which are listed separately below. The procedures offered are listed in the computer system on the on-line Order Entry screens. A radiologist is available 24 hours a day for consultation as to appropriate procedure, proper sequence and patient preparation. All procedure preparations are found online with hospital manuals. Referral of inpatients to other facilities, including VA and MMRC, must be approved and arranged through hospital administration. The main department, consisting of Adult Diagnostic Division, department chairman and administrative offices, the main file room and the main reading/consultation rooms, is located in the basement in S011 and S011-A. Requests for Services Requests for procedures are placed through the hospital on-line order entry computer system except Interventional Radiology, which are placed by consultation (UMC form 1788). Instructions for placing these requests are found in the Invision Order Entry System manuals located at computer terminals in all nursing units and clinics. SEE THE APPROPRIATE DIVISION/SECTION FOR SCHEDULING PROCEDURES. All STAT requests will be honored as soon as possible. Abuse of STAT requests will only serve to delay the examination of those that are really STAT. Radiology Reports Reports are available via digital dictation system as soon as dictated. They can be accessed at any hospital terminal as soon as typed. Instructions for viewing are found in the Invision Life Time Clinical Record LCR manuals. FILM FILE ROOMS Films may be viewed on the PACs (Picture Archiving Communication system) any time on terminal located in the radiology department and throughout the hospitals. Main Film File Room The Main film file room is located in S011-36A and is open Monday through Friday, 7:30 am until 4:30 pm. Copies of Radiographs may be reproduced by CD or film. Pediatric Film File Room The pediatric film file room is located in the Pediatric Radiology Department at room S079 and is open Monday through Friday from 7:30 am until 5:00 pm and on Saturday and Sunday from 8:00 am until 12:00 noon. Jackson Medical Mall Film File Room The Jackson Medical Mall file room is located in the Ambulatory Care Radiology Department. The file room is open Monday through Friday, 8:00 am to 4:30 pm, Films for Clinics, Conferences and Research Special arrangements for clinics, conferences and research may be made by contacting the Film File Room supervisor (4-2530) or the department head. Due to limited file room personnel, adequate notice must be given. Radiographs requested may be viewed on PACs.

2 SCHEDULING PROCEDURES Routine procedures, i.e., chest, spine, head and extremities, do not need to be scheduled during normal operating hours. An appointment clerk is available during departmental hours to schedule procedures that must be scheduled. These include: 1. Fluoroscopic procedures 2. Procedures involving any contrast media including air 3. Procedures involving the introduction and/or manipulation of catheters, wires, stints, and needles for purpose of a biopsy, etc 4. Mammography (in-patient only) 5. Procedures requiring special equipment, (i.e., Tomography, C-Arm) Special patient preparation orders are necessary for many radiographic procedures. The most common of these procedures include upper GI series, IVP s and barium enemas with or without air. A current list of procedure preps may be found at each nursing unit and ON-LINE (SEE HEALTH CARE, MANUALS, RADIOLOGY PATIENT PREPARATION ) Special Requirements for Procedures Using Contrast Except for emergencies, patients having procedures requiring intravenous contrast should have current (90 days) creatinine and BUN if they are in one of the below listed groups: 1. Over 50 years of age 2. Known diabetic (Creatinine, BUN within 30 days) 3. Known hypertensive on medications 4. Known renal disease 5. Known blood diseases such as multiple myeloma, sickle cell disease and leukemia ADULT DIAGNOSTIC DIVISION The Adult Diagnostic Division is located in the basement of the south wing of the hospital in room S011, and the telephone extension is Routine radiologic service is provided 8:00 am until 5:00 pm, Monday through Friday. There is limited staff available until 8:00 pm Monday through Friday and 8:00 a.m. until 4:00 p.m. on Saturday, Sunday and Holidays. PEDIATRIC RADIOLOGY DIVISION A radiology unit for pediatric patients is located in the basement of the Children s Hospital, room S080, phone extension The hours of operation are 7:30 am until 5:00 pm Monday through Friday and 8:00 am until 4:00 pm on Saturday and Sunday. EMERGENCY RADIOLOGY DIVISION A radiology unit adjacent to the Emergency Department provides service to emergency room patients 24 hours a day. This unit also provides emergency radiographic procedures for in- patients when the main department is closed. Call before sending patients. RADIOLOGY INTERVENTIONAL/SPECIAL

3 PROCEDURES DIVISION The Special Procedures Division provides normal services Monday through Friday from 8:00 am until 4:30 pm Emergency service is available by consulting with the radiologist on duty by paging. The division is located in the basement of the research wing, Room R017, extension for Vascular and for Neuro. All Special Procedures must be requested by consultation through hospital computer system. A Radiologist will consult with the requesting physician, the nursing unit and the patient concerning preparation, procedure to be performed and a scheduled time. DIAGNOSTIC ULTRASOUND DIVISION The Ultrasound Division is located in the basement of the Medical Center, room N025, extension The Ultrasound Division provides service from 7:30 am until 4:00 pm Monday through Friday. Emergency service is provided at night, on weekends and on holidays. All ultrasound procedures are scheduled by calling extension The radiology resident on call may be contacted for procedures to be performed outside regular hours. Patient Preparation Some ultrasound procedures require special preparation to obtain a diagnostic study and is available ON-LINE (SEE HEALTH CARE, MANUALS, RADIOLOGY PATIENT PREPARATION ) NUCLEAR MEDICINE DIVISION Nuclear medicine is located in the basement of the north and research wings of the School of Medicine, room N023, extension All nuclear medicine procedures are scheduled by calling extension Routine services are provided from 7:30 am until 4:00 pm Monday through Friday. Emergency services are provided after hours, weekends and holidays by calling the radiology resident on call and he/she will make arrangements to perform the procedure. (Radiopharmaceuticals must be ordered at 3:00 pm for next day schedule). Radionuclide Therapy Consults Consultations for radionuclide therapy are obtained by sending a standard UMC consult form (1788) to Nuclear Medicine or the primary physician of the patient should contact the nuclear medicine radiologist for a consult. COMPUTERIZED AXIAL TOMOGRAPHY (CT) DIVISION CT is located in the acute services wing, room X001, extension Routine services are provided 24 hours a day, Monday through Sunday. The radiology resident on call must be consulted. CT CANCER CENTER

4 CT at the Jackson Medical Mall is staffed from 7:00am until 4:30pm for out-patients. CT is located in the Jax Medical Mall in the Cancer Imaging Center room MI 111. To schedule a procedure call extension MAGNETIC RESONANCE IMAGING DIVISION MRI is located in the basement in the acute services wing, room X001, extension Service is provided from 7:30 am until 11:00 pm Monday through Friday. MRI technologists are on call from 11:00 pm to 7:00 am Monday thru Friday and weekends. After 4:00pm the radiologist must be paged at for any urgent inpatient, Adult Emergency Room, or Critical Care Unit MRI procedure that needs to be ordered. A radiologist is available 24 hours a day for consultation as to appropriate procedure, proper sequence and patient preparation. Not All Patients Can Have MRI Scans The following patients cannot be scanned: 1. Patients with cardiac pacemakers are contraindicated for MRI procedures. 2. Patients with neuro-stimulators and aneurysm clips are at high risk. These patients are evaluated on an individual basis by the radiologist to determine if they are acceptable MRI candidates. 3. Patients in the first trimester of pregnancy are high risk and the radiologist assigned to MRI will consult with the requesting physician to determine risk versus benefit to performing the MRI procedure. 4. All patients, staff, and visitors are screened before entering the magnetic field. Patients who are found to have ferromagnetic objects that cannot be removed from their person may be deemed unacceptable candidates for MRI scans. 5. All patients scheduled for a Cardiac MRI and MRAs requiring additional dose of contrast need to have a recent BUN, Creatinine and a Glomerular Filtration Rate test within two months of the scheduled procedure. 6. All MRI Arthrograms and Cardiac exams must be scheduled by the MRI Chief Technologist (extension ) 7. All MRI Breast exams must be referred to the Mammography Radiologist before the MRI will be scheduled. MRI CANCER CENTER To schedule a procedure call extension MRI at the Jackson Medical Mall is staffed from 7:00am until 4:30pm for out-patients. MRI is located in the Jax Medical Mall in the Cancer Imaging Center room MI 111. To schedule a procedure call extension JACKSON MEDICAL MALL RADIOLOGY (AMBULATORY CARE) The Ambulatory Care Diagnostic Division is located in room 1319 at the Jackson Medical Mall. Service is provided 8:00 am to 4:30 pm Monday through Friday.

5 Routine procedures do not need to be scheduled Monday through Friday during the hours of 8:00 a.m. to 4:30 p.m. Call extension for information and scheduling of procedures. JACKSON MEDICAL MALL RADIOLOGY (MAMMOGRAPHY) Mammograms are performed from 8:30 am to 3:30 pm in the Primary Care Department. An appointment clerk is available Monday through Friday during the hours of 8:00 am to 4:30 pm at ext POSITRON EMISSION TOMOGRAPHY (PET IMAGING) PET Imaging is located in Room 1286 at the Jackson Medical Mall. All PET procedures are scheduled by calling extension Services are provided from 7:30 am until 4:00 pm Monday through Friday. All procedures must be ordered in advance.

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