ummD - Logistics - VA vascular

Logistics - VA vascular

General flow:

Parking: You can park in the two lots closest to Miranda or the back parking garages
Workrooms

Vascular: 3A-139 (building 100). Head down the left hallway towards the back, the workroom is the big door on the right near the end. Code is 3-2-5-Enter
Gen surg (leave signout lists here): 3C (building 100). Head down either of the hallways towards the back, find the bathroom in the back, the workroom is right next to it. Code is 4+2 (press simultaneously), then 3, then enter, then turn the doorhandle

Rounds/Making the list

Update Excel List (S:\\Surgical\Vascular Lists\Vasc Lists 2019): Room #s, meds, PODs
Print list -> add vitals/labs/I/Os (or type them in).

Ward: Vitals are in CPRS → Cover Sheet → click on bottom box of vitals. I/Os are in physical chart in pt room.
ICU/IICU: go to computer at bedside, or from your computer/CPRS:

Tools → Specialty Applications → PICIS Remote Application.
Log in to Citrix Receiver w same login that you use for Windows/computer, click 'Bedside', and then open the application "Critical Care Manager" on desktop.
Select patient, 'Remote View'
Select "1 hr x 24" from dropdown to view vitals
Select "Fluid balance", then click "Weekly", then select date to view I/Os.

Copy lists (copier at 3A nursing station)

Check patients in for OR/IR before 730 AM
Assist with pre-ops (Clinics - PAD-VASC-Staff-Preop)
Sign out to nocturnist

Check vitals and update Excel list for sign out. Put your name and phone number at the top of the list every evening so the nocturnist knows who to call for sign out. Put a copy of the updated list in the General Surgery workroom on 3C; There is a green folder on the wall to your left when you first enter.

Consults: gen surg R2 consult resident takes care of vascular consults
Weekends: crosscover gen surg + vascular ward AND consults during day
Clinic - alternating W/F (see below) (Clinics - PAD-Vasc-Staff)

Thursday afternoon is post-op clinic; Renee NP sees these patients (PAD-Vasc-Staff-Postop)

M	T	W	Th	F
Stanford vascular conference until 830 AM. Intern usually goes straight to VA to round/check patients in OR start time is 9 AM instead of 8 AM	IR - Aalami	730 AM case conference - indications, department updates	OR - Arya	OR - Aalami/Ross
OR - Stern		IR - Stern/Arya (1st/3rd W) AM - Aalami minor vein procedures		OR - Aalami/Ross
OR - Stern		PM - Arya clinic A (2nd/4th W)		AM - vein clinic (1st Fri) AM/PM - Aalami clinic B (1st/3rd Fri)

OR/IR Cases

OR 3rd floor, past ICU. OR7 is the hybrid OR (able to do IR cases)	IR 1st floor - go down 3A staircase, through 'Radiology'
Pre-op labs INR <1.3 for major vascular cases Check K+ for dialysis patient on day of surgery -> should be less than 5 Cr >1.3 for angio cases -> may need prehydration Vascular Surgery orders → Contrast Media Premedications → Renal Protection → Order Mucomyst and the sodium bicarb Order Blood: T&C 4 units = thoracic stent grafts, open AAA T&C 2 units = EVAR, LE bypass, BKA T&S = carotid surgery No blood needed = varicose veins	(Try to do these day before otherwise IR calls you incessantly in the morning) Order labs: Interventional radiology orders → Labs → CBC, Chem8, PT/INR/PTT (Jane usually puts these in, but check to make sure) See left for guidelines. Order IR Imaging: Vascular Surgery orders → Imaging → RAD/NUC MED/VASC → Imaging type: “ANGIO/NEURO/INTERVENT” → imaging procedure: Angio = “ANGIO EXTREMITY BILAT S&I” Fistulogram = "AV DIALYSIS GRAFT FISTULA EVAL" EVAR = "OR STENT GRAFT AAA REPAIR"??? (not sure) Order meds: Interventional radiology orders → IR intra procedural orders → Fentanyl/Midazolam/Heparin NS/5000u heparin Interventional radiology orders → IR pre procedure orders → "Oxygen therapy", and "Sodium Chloride" OSS bed if needed (e.g. last case of day) Jane usually does this; if need to can talk to Nursing Supervisor (located in 3A)
Patients check in at 3A nursing station starting at 6 AM. Find them either in 3A or in PACU/holding
Computer consent Tools → iMedConsent (sign in with CPRS credentials) → All Documents → Vasc Surg (ortho for BKA) → Consents - Basic → select procedure → begin consent Go through check boxes → list all surgeons on consent (Aalami, Arya, Ross, Stern, and resident/fellow) Can prepare ahead of time and then click hold for signature to save time. Find it again in "Documents to Sign" section to review and sign with patient (pt can sign on electronic pad). Make sure to find a COW that has the signature pad	Needs 2 consents Computer: iMedConsent (see left) Eg: “LLE Angio w/ possible intervention” -> mod anesth -> N/A blood -> check vendor -> hold for sig. Fill out a paper 'vendor consent' (located in workroom cabinet) and place in chart - this allows the product reps to be in the room
H&P "H&P VASCULAR PREOPERATIVE" - normal H&P Most patients are seen in 3A preop clinic < 30 days before surgery for H&P and consent; make your own "Interval H&P template" (see below in Computer Setup)	Needs 2 H&Ps on day of procedure "H&P VASCULAR PREOPERATIVE" - normal H&P "IR/VASC PROCEDURE PRE-SEDATION H&P". Asks for ASA/Mallampati info...usually copy this from a prior anesthesia pre-op note
Holding anticoagulation: OK to continue ASA. Usually hold NOACs 2d, coumadin 5d, Plavix 7d
Marking - use initials and date. Self-explanatory if case is lateral. For EVAR etc., mark bilateral groins.
Post-op orders DELAYED Orders -> Vasc Admit Admit to ward, fill out check boxes Admission order set -> go through check boxes Order meds: select outpt meds -> actions -> transition to inpt -> vasc Order new meds as needed Pain and bowel regimen Labs: usually don’t need POD0 labs, check with team for POD1 Diet: most can be on clear liquid IVF: most need hydration post-op Isotonic preferred, D51/2 NS if NPO, ½ NS if diabetic Wean once PO intake ~1L/day Order PT consult: for mobility/functional status and discharge planning Order OT consult: for wheel chair use (amputations) Talk to Case Management – discharge to SNF/rehab Dressings: most removed POD2 For amputations – dressings stay on 48h, then wounds checked/dressed daily xeroform, gauze, kerlex, ACE Antiplatelet agent Check with team Anticoagulation: if patient was on coumadin pre-op, check with senior about post-op plan Vasc orders -> pharm to manage orders -> anticoag	Delayed vascular admit orders – 3C obs Admit to OBS <23h stay NV checks (leave time blank) Dx: angiogram of LE Pulse check: bilateral fem/AT/PT Bedrest 6h + stop time, head of bed flat 6h 4 hours if used perc-closure device Normal diet Cancel IV sodium bicarb order Maintenance fluids (except ESRD) If angioplastied (e.g. balloon/stent, not diagnostic): Plavix 300mg loading dose, 75mg daily x 6 weeks Restart home meds Discharge home if will complete bedrest before 7 PM. Otherwise needs obs bed; discharge POD 1 DC notes: discharge with Plavix x 6 weeks; no pain meds (or just Tylenol), removed groin dressing POD 2.

Add on case not on schedule:

Fill out pink add-on form (in workroom cabinet): look up appropriate ICD10 and CPT codes online
Bring to OR front desk
Talk to anesthesia

Admissions

Must write new admission/transfer orders for any patients who go to the OR or are admitted from ED
Orders must be written under “DELAYED” tab or they will just go to the patient’s current active orders and become inactive once patient is transferred to ward
DELAYED Orders -> Vasc Admit
Admit to ward, fill out check boxes
Order meds: select outpt meds -> actions -> trans to inpt -> vasc

Discharges

Check in with case manager for ALL discharges to make sure you don’t miss anything
Check in with Home Skills nurse for any home patient needs (lovenox, abx, wound vac, etc)
Order “pharmacy discharge medication alert” - tells pharmacy to start preparing meds for pick up
Under meds tab → select meds you want to continue as outpatient (e.g. Plavix/statin)

Actions → transfer to outpt meds → check “window” for dispensary so pt can pick up here
Put in new order (Discharge Medications) for pain medications +/- stool softener

Put in DC Instructions Note

New Note → "Discharge Instructions Surgery" → go through boxes and sign

Put in “Return to Clinic Orders”

Orders → Outpatient/Return To Clinic Orders → Return to Clinic Follow up OTHER
Clinic = PAD-VASCULAR-STAFF or PAD-VASCULAR-STAFF-POSTOP depending on if you're scheduling from clinic visit vs discharge
Fill out return to clinic date (see below for common f/u times)
Check "Not OK for Recall" and "Schedule PAD-VASCULAR-ULTRASOUND"
Comments: (# studies) PAD-VASCULAR-ULTRASOUND-NC appt up to 30 days prior.

e.g. if will need ABIs and ultrasound prior to appt, write (2 studies) PAD-VASC...

While this dialog box is open, click 'Options → Save as Quick Order' to access it more easily next time

Put in studies/labs (vasc surg orders → Imaging - RAD/NUC/MED → Vasc Lab) or (OUTPATIENT ORDERS → Vascular Surgery → Imaging) for common orders

A = Wednesday, B = Friday
Angio 4 weeks ABI/waveform
U/LE arterial imaging order (US)

EVAR 4 weeks CTA

Carotid 4 weeks Carotid duplex

Bypass

Fistula 2 weeks wound check
fistula US at 4 weeks
7-10 days = staples/sutures, wound check
2-3 w = AAA/TAA, aortobifem, renal stent, carotids, bypass

Put in Nursing DC order + potential follow up appointment time
Write DC summary (under D/C Summ tab) (within 48h)

To check advance directive status - click top right box "Postings" and check for advance directive note
"Vascular DC Note"
Still need inpatient progress note on day of discharge

On Excel List → move patient from vascular tab to discharge tab
Remove from your CPRS list
Put in coumadin consult if patient needs anticoagulation follow up
If patient is going to short stay rehab or Menlo Park:
- Call Doctor for report and to make sure bed is available before 11am: 650-444-7488

Frequent consults/cases

Carotid endarterectomy (CEA)

Complications	CVA (1-5%), MI, hematoma, vagus nerve injury, hypoglossal injury, thrombosis, reperfusion syndrome
If then	If headache – concern for reperfusion syndrome, tighten SBP control to <135 with prn metoprolol/hydralazine, tell senior if moderate-severe HA Neurological changes – evaluate patient and compare to sign out neurological exam, if changes notify senior. Febrile POD1 or 2 encourage IS, evaluate patient. POD3+: encourage IS, culture (blood aerobe and anaerobe), UA, CXR, (notify senior) UOP <30 cc/hr – bolus 500 cc bolus and follow (NOT in ESRD, call senior for CHF)
Sign-out to dos	*Report neurologic and incision site exam at sign out,* check SBP* once overnight on POD0*
POD 0	→ ICU vs D2/D3 Patient should receive Aspirin (ASA) 325 mg immediately post-op in the PACU and should continue ASA 81 mg daily indefinitely (unless history of GI bleed/GI ulcer, which will need to be discussed with attending) Post-op antibiotics x 24 hours SBP goal of < 150 mm Hg and > 100 mm Hg (use prn IV metoprolol/hydralazine) Patient can be put back on all home meds unless contraindicated Head of bed should be 30-45 degrees Diet: Clear liquid Activity: ambulate as tolerated *Report neurologic and incision site exam at sign out*
POD 1	Transfer to floor if in ICU, foley out, regular diet, saline lock, PO pain meds only if needed, dispo home in PM
POD 2	Home unless other complications.

Percutaneous procedures (e.g. Lower extremity, Mesenteric angio/stenting, etc)

Complications	Hematoma, oozing, hemorrhage, thrombosis, pseudoaneurysm formation
If then	Oozing – Have RN apply pressure x 15 minutes, evaluate groin site (hematoma, aneurysm, swelling, arterial bleed), NV exam Arterial hemorrhage – apply pressure, notify senior, Check HCT & PT/INR Hematoma (new) – if changes in pulses → “VASlab” to evaluate for pseudoaneurym, notify senior If bleed after 20 minutes of pressure, call senior
Sign-out to dos	no required follow up generally, if part of post-op check just evaluate for hemorrhage/hematoma, document neurovascular exam.
Pre-procedure hydration/pre-medication	Hydrate if have CKD with Cr>1.4 prior to contrast On admission = NPO at midnight, Chem 7, PTT/INR, D5 ½ NS at 1 cc/kg/hr maintenance fluid, diabetic use ½ NS at 1 cc/kg/hr + ISS + ½ lantus Day of procedure = repeat chem 7 Order set = Radiology Contrast Dye Pre-Medication, nursing order to call radiology for procedure time, Mucomyst 20% for 4 doses, NaHCO3 at 3ml/kg/hr 1 hr prior to procedure, then 1 ml/kg/hr If patient needs to be pre-medicated due to contrast allergy use the same Radiology order set for ordering Benadryl and steroids
Post-procedure course for angiography only	PPD0 → stay in PACU 6h for bedrest (unless vascular closure device used), then DC home after meeting PACU criteria, if pre-admit for hydration -> 2 doses of mucomyst and 6h of IV bicarb before discharge
Post-procedure course for stenting or angioplasty	PPD0 → usually admitted to C1 for obs, bedrest 6h (unless vascular closure device used), NV check q1/q2/q4 x6 hours, regular diet, DC IVF, restart home meds including ASA (Plavix if stented) PPD1 → Discharge home.

If perc-close device used, bedrest x 4 hours. Usually can use this unless femoral artery is very calcified.

EVAR/TEVAR

Complications	access site oozing (see above), access site hematoma, MI, compromise of distal extremity, contrast nephropathy TEVAR - also watch for respiratory failure, dissection, paraplegia
If then	Changes in neurovascular exam (distal pulses or neurological) à let senior know Like to have SBP <140 or approximate to baseline, metoprol prn and hydralzine ok for this. Febrile >38.5 POD1 or 2 encourage IS, POD3+: encourage IS, culture (blood aerobe and anerobe), UA, CXR, (notify senior) UOP <30 cc/hr – bolus 500 cc and follow (NO BOLUS if ESRD, call senior if CHF)
Sign-out to dos	*Report neurologic and incision site exam at sign out,* check SBP* once overnight on POD0*
POD 0	→ monitored floor vs ICU, clear liquid diet, vascular checks, ASA 81 mg, OOB to chair after 6 hours of lying flat, home meds (no nephrotoxic drugs), 5 mg IV metoprol prn; Monitor for groin hematomas. Pt may not have heparin reversal in cath lab so PTT can be elevated immediately post-op – don’t tx unless symptomatic (bleed) TEVAR - definitely ICU. if spinal drain –> managed by anesthesia. 24h abx. metop/hydral PRN
POD 1	all home meds, Reg diet, OOB to chair, foley out, f/u Cr. EVAR - If eating tolerating diet, ambulating, voiding → home
POD 2	Home unless other complications.

Amputations

Complications
If then
Sign-out to dos
POD 0	→ transfer to floor, regular diet, vascular checks, anesthesia regional team manages PCA/pain catheters/pain meds Place PT/OT consult to begin rehab and get rehab recs Place amputation center PAD outpatient consult for prosthetics
POD 2-5	perform daily wound checks, continued PT/OT, pain management, remove nerve catheter around day 3-5 per regional team
POD 6-7	talk to case manager about discharge to short stay rehab (pt can go home if cleared by PT/OT and has good support)
	RTC in 2 weeks for wound check and 6 weeks for staple removal

Open triple AAA/Open Thoraco-abdominal Aneurysm Repair (TAA)

Complications	MI, bleeding, stroke, ischemic colitis, respiratory failure (TAA repair), paraplegia (TAA repair)
If then	Hypertension: SBP > 160 or DBP > 100, prn IV metoprolol or hydralazine depending on HR, consider increasing pt home dose meds when appropriate Hypotension – BP < 90, ensue workup and treatment for possible bleeding versus severe MI versus bowel ischemia with associated SIRS response Assess patient’s clinical status, if patient acuately ill call rapid response team/code blue Bolus IVF (1-1.5L if CHF), order EKG, CBC/BMP/divalents, PT/INR, lactic acid, troponin/CKMB x3 Bloody diarrhea – assess patient for hemodynamic stability, stat CBC, PTT/INR, consult to GI for possible colonoscopy, contact senior promptly Febrile POD1 or 2 encourage IS, evaluate patient. POD3+: encourage IS, culture (blood aerobe and anaerobe), UA, CXR, (notify senior) UOP <30 cc/hr – bolus 500 cc bolus and follow
Sign-out to dos	vitals, LE motor exam, evaluate promptly if changes in hemodynamic instability
Pre-op	Ensure patient typed and crossed for 4 units and that blood is available for OR
POD 0	→ ICU, Q1h NV checks, 24h peri-op abx, labs CBC/CMP, NPO, hold home meds, activity bed rest, spinal drain managed by anesthesia if TAA
POD 2-3	Transfer to step-down (D2/D3), Q4h NV checks, daily CBC/BMP/PTT/INR, advance diet, restart home meds, d/c foley, activity OOB w/ assistance, PT/OT eval
POD 4-7	Truly dependent on patient’s post-operative course, titrate BB/statin/BP meds, case management discharge planning

Open bypass procedures

Complications	MI, stroke, graft infection, graft occlusion/failure, bleeding
If then	If ANY change in pulse exam – examine ASAP, document pulses, check skin motteling, compartment synd for motteling, mortor/sensory, call senior
Sign-out to dos	When patient in ICU, does not get signed out to night float unless anticipated transfer to floor. If on floor -> sign out pulse exam, follow up labs
Pre-op	Ensure that patient has ABIs documented prior to procedure
POD 0	→ ICU for Q1 NV checks of fem-pops, fem-distals, redo revascularizations; D3 for ilio-femoeral reconstructions or popliteal aneurysm repairs; ASA/Plavix daily, foot cradle/sheepskin booties, clear liquid diet, bedrest
POD 1-2	Transfer to floor, BID pulse checks, q4h vitals, advance diet, wean off IVF, PO pain meds, activity OOB w/ assistance, PT/OT eval
POD 3+	Prior to discharge document ABIs. DO NOT place blood pressure cuff over distal graft site

Arterio-venous Fistula placement

Complications	Flow limiting hematoma, acute thrombosis, vascular steal, infection
If then	incisional pain (ok with Tylenol/Vicodin), distal pain could be vascular steal (numb/tingling/weakness/pulseless) -> assess and contact senior
Sign-out to dos	If not already done, post-op check documenting items listed in 2b
Pre-op	Ensure that patient has ABIs documented prior to procedure Abx - kefzol Positioning: arm out on the large table attachment Anatomy: lateral to medial: cephalic, brachial, basilic. Median nerve is medial to the brachial vein, then artery at the antecubital fossa. For the basilic, want to dissect just medial to the edge of the biceps.
POD 0/1	Attending dependent. Most patients go home same day. For DC: assess and document presence of bruit/thrill, distal pulses, extremity strength and sensation, absence of vascular steal (e.g. numbness, tingling, pain, poikilothermia, etc) Patient instructions: expect swelling over next few days, keep arm elevated, perform hand exercises (open/squeeze object), go to ER if new pain/numb/tingle/weak, RTC 2-4w

VNUS Ablation/Stab phlebectomy

Complications

oozing from incision site, cellulitis, thrombophlebitis, rarely distal DVT

Pre-op

Ensure that patient has ABIs documented prior to procedure

POD 0/1

DC from the PACU. OTC pain meds for saphenous ablation; Tylenol #3 +/- Vicodin for stab phlebectomy

Patient instructions: keep ACE on for 48h, then can remove/shower, leave steri strips on until first clinic apt, conintue regular activity and walk as tolerated, elevate leg if sitting/laying down
Discharge: Orders should include pain Rx if needed; Discharge home: “When patient meets PACU criteria”; Patient should have a known follow-up appointment in the next 2-3 days.

Anterior Spine Exposure – Assist with exposure, neurosurgery/ orthopedic surgery primary

Preop -> consent patient electronically via iMedConsent (may need to create new step-by-step consent if can’t find template)
- Risks = bleeding, infection, incisional hernia, nerve injury, retrograde ejaculation, vascular injury requiring primary repair

Stanford side:

Inpatient/clinic pearls

•All patients with stents/angioplasty should be on plavix for 6 weeks

•Always ask about anticoagulation

•Always ask about antibiotics

•Pretty much everybody should be on baby ASA.

•Statins for everybody -> follow lipid guidelines, but starting point is usually lipitor 40mg daily

•Ask about contrast allergies

•If patient has contrast allergy and you know about it in advance: Prednisone – 50 mg by mouth at 13 hours, 7 hours, and 1 hour before contrast media injection, plus benadryl– 50 mg intravenously, intramuscularly, or by mouth 1 hour before contrast medium.

•If emergent: Solu-Medrol 40 mg or hydrocortisone sodium succinate (Solu-Cortef)200 mg intravenously every 4 hours (q4h) until contrast study required plus diphenhydramine 50 mg IV 1 hour prior to contrast injection . Note: It is preferred that steroids be given beginning at least 6 hours prior to the injection of contrast media.

•For patients on dialysis, if they need it while inhouse, nephrology pager 24309. Know pts' dialysis schedule, who their nephrologist is, access site, and how much volume they usually take off. Have BMP done before you call

•Vascular lab imaging

•Orders -> type in "vaslab" and it should pop up with the vas lab options, like ABIs, graft duplex studies, venous duplex studies

Typical post-op courses

•Angiograms

•Bedrest for 4 hours

•Ok to eat

•If they need dialysis, talk to nephrology and they stay overnight in CAPR

•Check their groins for hematoma, their legs for pulses/warmth

•EVAR

•Bedrest for 24 hrs

•CLD, sometimes ok to eat

•Usually home POD1 or POD2

•Blood pressure SBP<140

•Aortic dissections

•Non-op management first with tight BP control. Initially usually go to ICU, with esmolol, nicardipine, clevidipine gtts

•They need to be transitioned to oral regimen before they can come out of ICU

•Rib resections

•Usually do not need PCA

•CXR in PACU, CXR POD1 AM

• Ok to eat

•Pain control (and anxiety control) are usually the main things

CPRS access: first initial + last name (usually), pw same as SHC epic

Computer set-up

S-drive access: Bayron.Juarez@va.gov, x63464

After he gives you access, need to restart the computer you're accessing S-drive from
To my knowledge, cannot access S-drive from remote access...
Bayron also helps you set up remote access, scrub cards, etc.

Add shortcuts to desktop

Excel list: S:\\Surgical\Vascular Lists\Vasc Lists 2019

Must close out of Excel for other people to edit it. If this is an issue just make a new copy and edit that one.

Surgery schedule: S:\\Surgical\Vascular Surgery Scheduling\Vascular Scheduling Folder

Create CPRS team list:

Open any patient chart
Tools → Options → Lists/Teams → Personal Lists → New List → manually add patients by first letter of last name, followed by last 4 digits of SSN (ex: Richard Dawkins 123-55-1635 = D1635)

Select “All CPRS users” in bottom to make list visible to team
Name it something unique (e.g. initials + vascular); other members of your team can find it by clicking "Team/Personal" and typing in the list name. "Save patient list settings" to make it their default.

Set up printer (This printer is located in the OSS nursing station/front of 3A)

Start -> in the search bar, type \\vhapalprtom01 -> hit Enter.
In the search bar of open window on top right corner, type PAL-DP146785.
Double click and walk through the printer installation process.
To add other printers, Start ->devices/printers -> add printer -> add a network -> click printer not listed -> find printer in directory -> **wait until it searches all items -> search name of printer (“PAL-PT…”) +find -> select and install driver

Create custom templates in CPRS:

Notes tab -> templates -> Right-click on “Shared Templates” → Edit Templates

Expand “shared templates” -> scroll down to “vascular surgery” -> Copy folder to Personal templates

Copy the most used individual objects into the top-level folder 'My Templates' to minimize clicking:

Vascular Surgery → Quick Templates → Quick Notes: all of these (SOAP note, H&P, brief op, clinic new, clinic f/u)
Vascular Surgery → Default Templates: Resident Statement ("patient seen with attending, agrees with plan"), Vascular DC note (dc summ template), Vascular Discharge Instructions
Vascular Surgery → Individual Note Objects: Vitals

New Template → create a name → copy plain text from templates found in S:\\Surgical\Vascular Lists\Templates → paste plain text into “Template Boilerplate” section → Apply

e.g. make one for Interval H&P, etc.

Additional CPRS smartphrases under “Shared Templates” → “Patient Data Objects”
You can also make any tab as your default tab so that you do not have to scroll down each time. Just right click and select “mark as default”.

Other CPRS apps:

Tools → Specialty Applications → PICIS Remote Application = ICU numbers
Tools → Specialty Applications → OR Scheduler (ProtoViewer) = OR schedule
Tools → Radiology (Intellispace) = PACS/imaging viewer

Phone numbers

Vascular work room Room phones: 61968, 64646, 68632, 64634	Code: 3-2-5-Enter
3C - main inpatient unit	64870
Clean supply code	4-2-1
Pixis code	1-2-3-4-Enter; "Floor charge"
4C - "SNF" (if need to speak to MD, ask for Dr. Cousins)	65492
ED	65470
OR	66002 (or 660-OR#, e.g. 66007 for OR 7)
PACU	66019
Pharmacy	65470
Bed control	66969
MRI	63630
Angio	64690
Vasc Lab	65961
IR	68800
Jane Gutierrez (RN)	65467
Bayron Juarez (admin)	63464
Operator press 1, press 1, then extension	6504935000

author: admin | last edited: Feb. 6, 2019, 11:55 a.m. | pk: 154

Contributors: Jessie Ge, Mike Heffner (updated 11/2018), Wilson Alobuia (updated 6/14/2018), John Bonano, Elsie Gyang, Christine Wilson, Remy Lamberts


Angio	4 weeks	ABI/waveform U/LE arterial imaging order (US)
EVAR	4 weeks	CTA
Carotid	4 weeks	Carotid duplex
Bypass
Fistula	2 weeks	wound check fistula US at 4 weeks