Category:Consults: Difference between revisions

From Guide to YKHC Medical Practices

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==Internal (Bethel) Consult Services==
==Internal (Bethel) Consult Services==
===Pediatrics: ===
 
There is a pediatrician ‘on call’ and available 24/7 for pediatric consultation, help managing a patient or to assume care of a difficult or critical patient. Page the “On Call-Pediatrics” pager not a pediatrician’s personal pager. Most pediatricians only wear their ‘on call’ pager when they are on call.  
===Breast Feeding===
On call beepers are text pagers. If you have an emergency issue, put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page, even if they are on the way.  
We have one lactation consultant in clinic (Dr. Roll), a WIC Peer Lactation Educator, and most of the OB nurses are able to provide lactation support.
If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine page, please page again (not all the pages go through) OR call the on call physician’s cell number that is listed on the medical staff contact list and/or try their personal pager.
 
===Dental===
There is a dentist on call and available 24/7 for consultation and help managing a complex or concerning dental patients. They can be contacted through TigerConnect by messaging the "Dental On Call" Role.  The ER also has a list of dentists and their cell numbers.
 
===Emergency Department Bethel===
Any ER emergencies, if in Bethel, simply call the ER and talk to the MD on call to transfer and have your charge nurse talk to their charge nurse. In the subregional clinics feel free to call the ER MD with questions, or if you are thinking about medevacing someone, call/TigerText the wards doctor. Please upload any images or EKGs to the patient's chart. If you are having difficulty uploading to the chart, images can also be sent through TigerText.
 
===High Risk OB (HROB): ===
===High Risk OB (HROB): ===
There is a physician ‘on call’ and available 24/7 for high-risk obstetric consultation. The HROB provider is available to help manage a difficult patient or to assume care of a patient needing a C-section. Page the “On Call-HROB” pager not the physician’s personal pager. A HROB physician may only wearing their ‘on call’ pager when they are on call.
There is a physician ‘on call’ and available 24/7 for high-risk obstetric consultation. The HROB provider is available to help manage a difficult patient or to assume care of a patient needing a C-section. TigerText the “OB High Risk On Call HROB” role not the physician’s personal TigerText as on call schedules can occasionally change.
 
If you have an emergency issue, put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page.
If you have an emergency issue, put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page.
If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine consult page, please page again (not all the pages go through) or call the on call physician’s cell number that is listed on the medical staff contact list and/or try their personal pager.
If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine consult page, please page again or call the on call physician’s cell number that is listed on the medical staff contact list.
===Emergency Department Bethel===
 
If an emergency curs in Bethel, call the ED and talk to the MD on-callHave your charge nurse talk to their charge nurse.
===HIV===
===Dental===
Contact our Community Case Manager to report and coordinate care of any newly diagnosed casesThe case manager can also assist with mandatory reporting to Public Health at 543-2110.
There is a dentist on call and available 24/7 for consultation and help managing a complex or concerning dental patients. The ER has a list of dentists and their cell numbers. If there is not an up to date call schedule then feel free to call each cell until you reach the first available dentist.  
 
Dr. Roll is one of our local HIV experts. Contact her with any questions about HIV. If she is not available, you can contact Alaska State Epidemiology Section on HIV,  Tel: 907-269-8000 Fax: 907-563-0453.
 
===Optometry===
===Optometry===
There is an optometrist available 24/7 for consultation and help managing a complex or concerning eye patients. The ER has a list of optometrists and their cell numbers. If there is not an up to date call schedule then feel free to call each cell until you reach the first available optometrist.  
There is an optometrist available 24/7 for consultation and help managing a complex or concerning eye patient. They can be reached through TigerConnect by messaging the "Optometry On Call" Role. The ER also has a list of optometrists and their cell numbers.
 
===Pediatrics===
For non-urgent pediatric consults, please utilize the pediatrician that is scheduled in your hallway to discuss management or address questions.  For urgent pediatric consults that require a higher level of care, or if the outpatient pediatrician is unavailable, there is a pediatrician ‘on call’ and available 24/7.  TigerText "Peds Wards On Duty" to contact the on call pediatrician.
 
If you have an emergency issue, please put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page, even if they are on the way.
If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine page, please page again OR call the on call physician’s cell number that is listed on the medical staff contact list or one of the "Peds cell" numbers listed on the '''[[media:Peds Reference Phone Numbers.pdf|Peds Reference Phone Numbers]]''' List.
 
For any toxic-appearing or critically ill children, please contact the Emergency Room doctor for urgent transfer from clinic to the ER and notify the on call pediatrician.  Do not wait for the on call pediatrician to return your text.
 
===TB===
===TB===
There are several ‘TB officers’ available for TB or possible TB patient consultations. They do not have a call schedule or a TB consult beeper. Any one of them is happy to be contacted, when they are available, to provide consultation and help you manage a TB patient’s care. Adult TB officers are Ron Bowerman and Elizabeth Roll. The pediatric TB Officers are Mien Chyi and Cynthia Mondesir
There are lots of TB cases in the Delta.  For any TB questions, and for assistance with any active TB cases, contact one of our physicians who has special training [Dr. Bowerman (inpatient); Dr. Tyree, Dr. Johnson, and Dr. Roll (outpatient); Dr. Chyi and Dr. Fisher (pediatrics)].
===Breast Feeding===
 
For breastfeeding questions we have two lactation consultants. Dr. Roll is available in clinic and WIC also has a peer Lactation educator as well.
Upper lobe infiltrates in adults should prompt contacting a TB expert.
 
Negative pressure rooms are available in Yukon and Delta clinics for any suspected active TB cases.  Please refer to LTBI and Active TB Guidelines for assistance.


===HIV===
If none of these local providers are available you can contact Dr. Michael Cooper, MD, MS Section of Epidemiology Tel: 907-269-8000 Fax: 907-563-7868 Email: michael.cooper@alaska.gov
Dr. Hunt and Dr. Roll are our local HIV experts. Contact them with any questions about HIV. If these providers are not available you can contact Alaska State Epidemiology Section on HIV,  Tel: 907-269-8000 Fax: 907-563-0453.


===Palliative Care===
No local consultation services available at this time
===Wound Care===
===Wound Care===
Physical Therapist can provide direction and help with wound care management.
Currently, physical therapy manages Wound Care at YKHC.  Basic abscesses etc., can be sent to Nurse Only Specialty Clinic for repacking, but any concerning wounds need to involve physical therapy.  PT should be contacted and provided pictures (with tape measure) in Multi-Media if possible.  Marking the area of a wound is advised and very helpful for ongoing monitoring.


==External Consult Services==
==External Consult Services==
===ANMC Adult Specialists===
 
(*97) 800 478-6661. IM, Surgery, Ortho, ER, GI, Infectious Disease, Urology, Neurology, Heme-Onc, ENT (adult and peds), Pulmonology/Intensive Care, Cardiology, Rheumatology, Renal Nurse Practitioner for chronic renal failure, Podiatry, Endocrinology,  
===ANMC Specialists===
===Tele-Radiologists YKHC===
*(*97) 800 478-6661.  
There is a published calendar of who is on call posted in all the units. The radiologists live in Ohio, which is 4 hours ahead. Only call them after hours if it is urgent to avoid burning them out. Speed dials are: Warren (*54) Voss (*94) Vanderburgh (*95)
*'''Adults''' - IM, Surgery, ER, GI, Infectious Disease, Urology, Neurology, Heme-Onc, Pulmonology/Intensive Care, Cardiology, Rheumatology, Renal Nurse Practitioner for chronic renal failure, Podiatry, Endocrinology
===TB===
*'''Adults and Peds''' - Ortho, ENT
Francis Curry National TB Center Warm Line (877) 390-6682
*'''Peds''' - Peds Surgery, Peds Urology, Peds Endocrinology
 
===Providence Specialists===
 
===HIV===
===HIV===
[http://nccc.ucsf.edu UCSF HIV Consultation on line]
[http://nccc.ucsf.edu UCSF HIV Consultation on line]
Website with helpful information on HIV and contact information for more assistance.
Warm Line (800) 933-3413 M-F 9 a.m.– 8 p.m. EST.
Phone number for providers to call to get a consultation on a HIV-related issue. This can be done for post-exposure prophylaxis or for patient related questions if the ANMC infectious disease physician isn't available.


===HIV Warm Line===
Warm Line (800) 933-3413 M-F 9 a.m.– 8 p.m. EST
===Poison Control===
(*98) 800-222-1222
===Seattle Children’s Hospital===
206 987-7777 (ask for doctors consult line)
===MEDCON Seattle===
===MEDCON Seattle===
800 326-5300
MEDCON is a 24/7, toll-free phone line to UW Medicine experts in oncology, cardiology, OB/GYN, infectious disease, neurology and other specialties. 800 326-5300
 
===Pathology===
===Pathology===
Call ANMC (*97) 800 478-6661 and ask for Pathology Department
Call ANMC (*97) 800 478-6661 and ask for Pathology Department
Line 50: Line 69:
===Palliative Care===
===Palliative Care===
Call ANMC (*97) 800 478-6661 and ask for Dr Piromalli Telemedicine/AFCHAN
Call ANMC (*97) 800 478-6661 and ask for Dr Piromalli Telemedicine/AFCHAN
===Poison Control===
(*98) 800-222-1222
===Seattle Children’s Hospital===
206 987-7777 (ask for doctors consult line)
===Tele-Radiologists YKHC===
There is a published calendar of who is on call posted in all the units. The radiologists live in Ohio, which is 4 hours ahead. Only call them after hours if it is urgent to avoid burning them out. Speed dials are: Warren (*54) Voss (*94) Vanderburgh (*95)
===TB===
Francis Curry National TB Center Warm Line (877) 390-6682

Revision as of 23:19, 26 February 2019

Internal (Bethel) Consult Services

Breast Feeding

We have one lactation consultant in clinic (Dr. Roll), a WIC Peer Lactation Educator, and most of the OB nurses are able to provide lactation support.

Dental

There is a dentist on call and available 24/7 for consultation and help managing a complex or concerning dental patients. They can be contacted through TigerConnect by messaging the "Dental On Call" Role. The ER also has a list of dentists and their cell numbers.

Emergency Department Bethel

Any ER emergencies, if in Bethel, simply call the ER and talk to the MD on call to transfer and have your charge nurse talk to their charge nurse. In the subregional clinics feel free to call the ER MD with questions, or if you are thinking about medevacing someone, call/TigerText the wards doctor. Please upload any images or EKGs to the patient's chart. If you are having difficulty uploading to the chart, images can also be sent through TigerText.

High Risk OB (HROB):

There is a physician ‘on call’ and available 24/7 for high-risk obstetric consultation. The HROB provider is available to help manage a difficult patient or to assume care of a patient needing a C-section. TigerText the “OB High Risk On Call HROB” role not the physician’s personal TigerText as on call schedules can occasionally change.

If you have an emergency issue, put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page. If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine consult page, please page again or call the on call physician’s cell number that is listed on the medical staff contact list.

HIV

Contact our Community Case Manager to report and coordinate care of any newly diagnosed cases. The case manager can also assist with mandatory reporting to Public Health at 543-2110.

Dr. Roll is one of our local HIV experts. Contact her with any questions about HIV. If she is not available, you can contact Alaska State Epidemiology Section on HIV, Tel: 907-269-8000 Fax: 907-563-0453.

Optometry

There is an optometrist available 24/7 for consultation and help managing a complex or concerning eye patient. They can be reached through TigerConnect by messaging the "Optometry On Call" Role. The ER also has a list of optometrists and their cell numbers.

Pediatrics

For non-urgent pediatric consults, please utilize the pediatrician that is scheduled in your hallway to discuss management or address questions. For urgent pediatric consults that require a higher level of care, or if the outpatient pediatrician is unavailable, there is a pediatrician ‘on call’ and available 24/7. TigerText "Peds Wards On Duty" to contact the on call pediatrician.

If you have an emergency issue, please put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page, even if they are on the way. If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine page, please page again OR call the on call physician’s cell number that is listed on the medical staff contact list or one of the "Peds cell" numbers listed on the Peds Reference Phone Numbers List.

For any toxic-appearing or critically ill children, please contact the Emergency Room doctor for urgent transfer from clinic to the ER and notify the on call pediatrician. Do not wait for the on call pediatrician to return your text.

TB

There are lots of TB cases in the Delta. For any TB questions, and for assistance with any active TB cases, contact one of our physicians who has special training [Dr. Bowerman (inpatient); Dr. Tyree, Dr. Johnson, and Dr. Roll (outpatient); Dr. Chyi and Dr. Fisher (pediatrics)].

Upper lobe infiltrates in adults should prompt contacting a TB expert.

Negative pressure rooms are available in Yukon and Delta clinics for any suspected active TB cases. Please refer to LTBI and Active TB Guidelines for assistance.

If none of these local providers are available you can contact Dr. Michael Cooper, MD, MS Section of Epidemiology Tel: 907-269-8000 Fax: 907-563-7868 Email: michael.cooper@alaska.gov

Wound Care

Currently, physical therapy manages Wound Care at YKHC. Basic abscesses etc., can be sent to Nurse Only Specialty Clinic for repacking, but any concerning wounds need to involve physical therapy. PT should be contacted and provided pictures (with tape measure) in Multi-Media if possible. Marking the area of a wound is advised and very helpful for ongoing monitoring.

External Consult Services

ANMC Specialists

  • (*97) 800 478-6661.
  • Adults - IM, Surgery, ER, GI, Infectious Disease, Urology, Neurology, Heme-Onc, Pulmonology/Intensive Care, Cardiology, Rheumatology, Renal Nurse Practitioner for chronic renal failure, Podiatry, Endocrinology
  • Adults and Peds - Ortho, ENT
  • Peds - Peds Surgery, Peds Urology, Peds Endocrinology

Providence Specialists

HIV

UCSF HIV Consultation on line Website with helpful information on HIV and contact information for more assistance.

Warm Line (800) 933-3413 M-F 9 a.m.– 8 p.m. EST. Phone number for providers to call to get a consultation on a HIV-related issue. This can be done for post-exposure prophylaxis or for patient related questions if the ANMC infectious disease physician isn't available.

MEDCON Seattle

MEDCON is a 24/7, toll-free phone line to UW Medicine experts in oncology, cardiology, OB/GYN, infectious disease, neurology and other specialties. 800 326-5300

Pathology

Call ANMC (*97) 800 478-6661 and ask for Pathology Department

Palliative Care

Call ANMC (*97) 800 478-6661 and ask for Dr Piromalli Telemedicine/AFCHAN

Poison Control

(*98) 800-222-1222

Seattle Children’s Hospital

206 987-7777 (ask for doctors consult line)

Tele-Radiologists YKHC

There is a published calendar of who is on call posted in all the units. The radiologists live in Ohio, which is 4 hours ahead. Only call them after hours if it is urgent to avoid burning them out. Speed dials are: Warren (*54) Voss (*94) Vanderburgh (*95)

TB

Francis Curry National TB Center Warm Line (877) 390-6682

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