Call

General ER call info:

• Weeknights: 5 – 9:30 p.m.

• Holidays and Weekends: 8 a.m. – 9:30 p.m.

• A medical student answers the phone from 5 -11 p.m. on weekdays and from 10 a.m. to 11 p.m. on weekends

• VA attendings are on call until 10 p.m. on weekdays and weekends.

• Yale Teleradiology covers inpatient and Shoreline studies from 5:30 p.m. – 11 p.m. on weekdays and 2 p.m. – 11 p.m. on weekends

• On weekends, US and Body people are in-house from 8 a.m. until noon, after which time ER is responsible for such studies (inpatient body will be covered by teleradiology after 2 p.m.)

• You are responsible for dictating all studies with “last modified time stamp” between 7:45 a.m. – 4:45 p.m. for day shifts, and between 4:45 p.m. and 9:30 p.m. weekday nights and 9:30 p.m. to 7:45 a.m. for overnight shifts

• Trauma Pager Codes
• 02220 – modified adult trauma
• 52225 – full adult trauma
• 03330 – modified pediatric trauma
• 53335 –  full pediatric trauma 

• There are sandwiches and soda in the resident call room after 6:30 p.m. There is also money on your ID card that you can use in the cafeteria (which is open until 8 p.m.), unfortunately the Atrium is closed!

• If you need to swap a call shift, you can do so directly on Amion (no need to contact the chiefs)

• CTA COW and Petrous bone studies are the responsibility of the Neuro service during the day and evening ED shifts. They become the responsibly of the ED during Night Float/Overnight shifts. 
• Note: there does not seem to be a clinical necessity for Petrous bone studies overnight, per Dr. Abrahams. One exception might be a critically ill patient with known or suspected petrous bone pathology making the trip to the scanner for another issue. These patients can be protocoled and scanned but will be read by the Neuro service in the morning.

First year call:

• Weekends: Arrive in the ER reading room at 8 a.m. Make sure to contact the Chest attending on call with you earlier that week to see when they will be coming in that day, dictate in the ER until they arrive and when done, return to ER to finish the shift.

• Dictate all ER and ICU plain films under “No upload” (Except when you are on with Howie, he likes to dictate the ICU films)

• And if you have any questions, just ask your upper level!

Second/Third year ER call:

• Dictate all CT studies. You do not have to dictate CT extremity studies if they are for preoperative planning, that will be taken care of by the Bone service the next day. However, if the CT is ordered because it is unclear if there is a fracture, then the study is read by ER. This is also valid during the overnight shift.

• Dictate all US after 8 p.m. on weeknights and noon on weekends

• Help with plain films if the lists starts piling up

• Perform emergent fluoroscopic studies when indicated (nonemergent GU/GI studies are NOT performed on the weekend)

• CTA circle of Willis studies from ER are protocolled and dictated by Neuroradiology

Third/Fourth Year Body call

• Weeknights: 5 – 8 p.m.
• Dictate all inpatient and ER US studies. At 8 p.m. you meet with the ED attending to review all the studies. After 8 p.m., you only cover emergent MRI exams (pager call). The ED will protocol and set up the MRI exam and contact you when it is finished, for you to dictate and review with the on call attending.

• Weekends: 8 a.m. – noon
• Dictate all inpatient and outpatient body CT and leave once the list is clear. It may be beneficial to predictate outpatient body CT if you have time during Friday evening US call, as you will have to dictate those exams the next day with the Body attending anyway. Again, you will be on body MRI call during the weekend.

• Vladimir can set up your computer with Synapse and Powerscribe at home. We are currently working on getting IDX access at home which would allow you to dictate from home without a dictaphone.

VA call

• The VA2 resident is responsible for creating the call schedule for the VA.

• Residents are on home call from 10 p.m. – 8 a.m. on weekdays and weekends (you rarely get called in!)

• You are responsible for filling in the triage person (usually a medical student) if that person does not show up for work. You will be compensated for your time.

MSK call

• Weekend, generally reading from 8 a.m. – noon. 
• Speak with the attending ahead of time to arrange the exact time, as you do not have access to the reading room. You will be dictating MR and CT studies from the weekend. 

HOLIDAY CALL

• Firstly, read studies off the ED daytime list - NOT the weekend workday list.

• There is a daytime US person till noon who will read inpatient and ED patients. After that, we're on our own.

• There is a ballroom person reading chest studies until noon.

• Body, MSK, and Neuro are obviously also available.

• Tele starts at 2pm (reading shoreline and inpatient) as per normal weekend rules.

IR call

• Call: 5 p.m. to 8 a.m.:

• You are on call with a fellow one day a week and one weekend during your month.

• Pick up the pager from the consult person and basically you are “consult” after hours for urgent cases. Discuss emergent cases with the call attending; if you have questions about a case, discuss it with the fellow first. If a case discussed with an attending is emergent, you need to page the on call nurse and tech. People should not be paging you for nonemergent studies or to schedule studies the next day, that is inappropriate and you need to document the person’s name who contacted you and their attending’s name (Dr. Pollak collects this information and discussed it with the attendings the next day).

• If you get paged regarding a GI bleed, be sure to ask what the patients vitals are (are they hemodynamically stable), if they have been transfused (how many unit of pRBC), if the source if known (seen on contrast enhanced CT, endoscopy, or tagged RBC study), pertinent labs. If the source is unknown, and it is a UGI bleed, GI must scope the patient, if they are unable to find the source, then a tagged RBC study should be ordered. Until then, IR cannot do anything.

• If the call team has to come in after hours, figure out when the case will be, contact the Tech and Nurse on call (at Yale) and the Tech on call if you are going to the VA. If the patient is an ICU patient, you will not need to call the nurse in, however if  not, the nurse on call at Yale or the nursing operator at the VA will need to be contacted.

• If you get called to the VA after hours, you need to enter from the ER entrance.