1) Schedule the case
Email vs. Phone based on time of day
ㅤ | OR Scheduling | OR Front Desk |
Contact Info | PUHORScheduling@upmc.edu 647-3345 | 647-3270 |
Use for | non-emergent case for the next day or after | - same day emergencies - Case in next 24 hr, outside of business hrs |
Availability | M-R: 8am - 5:15pm F: 8am - 3:45pm Sat: closed Sun: 8am - 2:45pm | 24/7 |
Mercy Contacts
MercyORScheduling@UPMC.EDU
wilestl@upmc.edu
mcfeelyk3@upmc.edu
devinneyd3@upmc.edu
harbaughm@upmc.edu
weibelc@upmc.edu
If emailing (most cases), use the template below. Ask chief or attending if unsure about anything, including Bed/Add-ons, start time.
Attending:
Date:
Start time: ALWAYS ASK ATTENDING
Patient: (DOB/MRN)
Location:
Procedure:
Bed:
Add-ons:
see Vendors by attending - this is crucial as reps are not by default at PUH
Duration:
Anesthesia:
Intubation status: not currently intubated
Signature to include your name/pager
Add-ons
Cranial + Spine | Cranial | Spine |
Neurophys (SSEP / MEP) Microscope (with mouthpiece) Beds - Jackson - Mizuho Head stabilization: Horseshoe vs. pins? Radiolucent mayfield? Prone vs. supine | Image Guidance Gleolan Cranial nerve EMG Plastics tray (wound closure) Shunt: lap instruments | C-arm vs. O-armJacksonJackson bumpyLevo head holder |
Always confirm they actually post it by checking assigngen.upmc.com
2) Consent Patient
- Must include patient stickers on at least every first page of every consent form or otherwise write name/MRN.
- For every surgery: print out (1) general consent form (2) surgery-specific consent form (if it exists) (3) blood consent form
- every spine procedure: include the phrasing "with additional levels as needed"
- every procedure with sidedness use the phrase "left possible right" unless it is very obvious you will do one side (e.g. crani)
- ⚠️**EXCEPTION TO ABOVE:
- For Moossy, list only specific procedure on consents. No possibles.
- No abbreviations anywhere (especially Blue consents)
- INCLUDE SIDEDNESS where appropriate. Do not mess this up.
- (optional) Take a picture of the consent form being placed into the correct patient chart (binder)
- If patient is in ED: not sufficient to put completed consent in the chart, they may lose it. You still put one there, but once a consent is completely filled out (signed and witnessed), make a copy in ED and put the copy in the consents bin in resident lounge).
- Even if it was a moonlighter/trauma junior who should have consented the new consult, it's your responsibility to personally check if the patient is on your service. You can ask them if the patient still needs consent or just go check the patient's binder yourself.
3) Preop patient
TIP: Put all these orders in a dedicated PRE-OP folder in your favorites and it will take you < 10 seconds. Order everything STAT and give nurse a courtesy call kindly saying this needs to be done tonight and not with AM labs. Consolidate all orders so patient is stuck only once. Very little known fact: nurses cannot actually draw blood from standard peripheral IVs (the veins blow out), those are generally reserved for injecting drugs!
- Within hospitalization: CXR, UA, EKG
- Within 72 hours of surgery: T&S, CBC/BMP, Coags (PT/PTT/INR)
- Midnight before: NPO, DVT ppx off, IVF on (use MD Calc maintenance fluid calculator for the rate)
- Pre-operative risk stratification if patient is not an elective case that is coming from SDS
- CPC is always preferred but only works business hours (no weekends/evenings). Tiffany from CPC is the PA and is great, give her a courtesy call and if you have multiple patients give her a prioritized list.
- Med A is the backup if needed overnight/weekends. You must consult AND page them if it is needed overnight. Don't be a gome and say "can you clear for surgery" without knowing anything about the patient. Have a quick high level understanding of their systemic health (cardiac/respiratory and liver/kidney function) status and social history (smoker/drinker) and ask them pre-op risk stratify. THIS CONSULT ALSO MUST BE SIGNED OUT TO NIGHT FLOATER.
- (Nitin patients): Order the preop neurosurgery powerplan "Preop Neurosurgery Powerplan"
IMPORTANT: ORDER ALL THESE THINGS ASAP TO GET THE WHEELS ROLLING AND ENSURE ALL IS COMPLETE BEFORE YOU SIGN ANYTHING OUT TO NIGHT FLOATER. It is your responsibility not merely to order these things, but to ensure they are completed and resulted in the chart and if absolutely necessary sign out to the night floater (although you really want to avoid that). Moreover it's also your responsibility to follow-up on the actual results and act as appropriate, e.g. if the pt has a UTI then it needs treating, an arrythmia then senior needs to know and pt will need a cardiology consultIf you are signing anything out to night floater, you need to call nurse and kindly ask that they get things done, that is not something you can dump on night floater.
OR Tables
Mizuho table
Jackson table
Wilson Frame
Made with Bullet