IR and Vik Agarwal

Which Neuro-radiology Team to Contact

Team
APP Spine Team Jackie Smith PA-CMegan Heron PA-C
Dr Vikas Agarwal
Procecures Performed
Lumbar Punctures
Pumpograms
Myelograms
Cisternograms
Lumbar DrainsBlood PatchesSpinal Injections (ESI/SNRB)DiscogramsBiopsies

Protocols for APP Team

1. Place Order
IR consult for everyone, with specification as to what is needed (LP etc.)
Myelogram request: also place with accompanying CT orders (cervical, thoracic, lumbar, etc)
2. Call Neuroradiology PA-C at 578-9430 to discuss/review request
we are always checking the IR queue for any new or recent orders but admittedly have missed a few depending on how the order is placed. So best practice would be to contact us so we are aware!
Business Hours
The two APPs myelo/lp service and work M-F 7:00am-3:30pm.  With regard to hours, we lose our rad tech at 4pm and so any request for a procedure that comes in around that time will have to wait until the following day, unless of course it is deemed *stat* and then of course would become a call case.
Requirements
  • Plts/INR - within 72hrs is fine unless actively being anticoagulated on Coumadin or Heparin gtt or of course are thrombocytopenic, in which case we would want within 24hr
  • Do NOT need a type and screen
  • Failed bedside attempt needs to be documented in powerchart, unless there is some limiting factor (patient size, lumbar scoli, previous surgery making landmarks difficult etc)
  • Do not need to hold aspirin or dvt prophylaxis with subq heparin or lovenox
  • Eliquis and xarelto are 3 day hold
  • Plavix is 5 day hold
  • Patient does not need to be npo
  • Please remember we prone patients to perform procedures so if not hemodynamically stable without use of pressers, might be best to consider stabilizing first before attempting to prone
  • We are not IR therefore we do not have an RN assigned to our room.

Vik Agarwal

Simply email Dr Vikas Agarwal, copy attending and all team members with a request for whatever procedure.
If emailing about ESI/SNRB, include specific symptoms in your email.