Interventional Radiology and Hospital Medicine

1. Interventional Radiology and Hospital Medicine Bill Schaeffer, MD Chief, Interventional Radiology University of New Mexico and Sandoval Regional Medical Center

2. 5 Things Hospitalist should know • People • Clinical Service • More to come • Processes • Inpatient Triage • Inpatient NP’s (cavalry) • Procedures • Patient Prep • Lines

3. Providers • 6 Physicians • 5 Interventional Radiologists • 2 Board Certified IM • 1 Interventional Neuroradiologist • 2 Nurse Practitioners • 1 Fellow in 2015-2016 • Coming in 2016 - 3 additional IR and 2 NP’s

4. Coverage • SRMC added in 2014 • Call is 24 -72 hours at a time without time off for good behavior • Attending:Resident ratio not 1:1 • Attendings are present for every case in its entirety • 6000 cases / year • 60% inpatient • 40% outpatient

5. Staff • 12 Radiologic Technologists • 14 Nurses • 1 UBE • 2 PCC • 1 Clinic nurse • 2 Supervisors

11. Triage • Finite space in which to work • 12 to 20 inpatient requests/day • Scheduled outpatients performed in same location • Difficult to send and receive patients during shift change • Managing the flow is a lot like air traffic control • Accessed through Power Order • After hours these orders are not seen by us

13. Patient Prep • Labs: Coags/platelets and Bun/Cr if contrasted • Stop anticoagulation: Time variable depending on therapeutic vs prophylactic. • Stop antiplatelet therapy: Most of the time. • We follow our Society’s guidelines • Conscious Sedation • 6 hours NPO

14. Lines Don’t put PICC’s in patients with poor renal function-preserve the veins for future dialysis use We will place tunneled power lines for you

15. Inpatient Biopsies Prefer to do as outpatient unless absolutely necessary

16. Location • Department of Radiology • Contact • Inpatient referrals 272-2883 • Outpatient referrals 272-1818 • After hours non-emergency inpatient referrals 272-8351 • After hours emergency inpatient referrals 951-0991 or of course the PALS line