CONSULTS

Interventional Radiology (CVDL)

The Cardiovascular Diagnostic Lab is located on Blalock/CMSC 5. To schedule an interventional radiology test, you need to call the CVDL fellow on call (3-CVDL).

Line Service / PESS (lines & TPN)

There is also a Line service [AKA: parenteral nutritional support service (PESS)] for bedside tunneled line placement. They can place central lines for patients on the day you need a line provided the patient has a current PT/aPTT and that you have called them before noon. They also are responsible for consults for in-hospital PPN/TPN & tube feeding and arranging for home IV infusions and home tube feeds.

- PPN can be started on any patient without a PESS consult. Central line TPN can only be ordered with a PESS consult. Make sure PN is ordered by 2:30PM, as the production of the bags has been outsourced.

Office 5-2568

Beth Maguire 3-0783

Renee Tyler 3-0781

Surgery Consults

Halsted Surgery is the Surgical ACS service. For faculty surgeons and cardiothoracic surgeons call the secretary for that surgeon. All vascular surgery consults go through Halsted surgery. Patients with abscesses or other processes of the hands or forearm are evaluated by either plastics or ortho (on a weekly rotating basis). Orthopedics handles all abscesses above the elbow and on the legs. Sacral decubitus are operated on by plastic surgery. Patients who need a chest tube, call either Halsted Surgery or Thoracic Surgery. Patients who have an A-V fistula that needs evaluation, call Transplant Surgery.

Wound Care

Amanda Clark, medicine wound care nurse provides excellent recs (5-5447 or pagerbox). Call PT for whirlpool / pulse lavage (& put consult order in ordernet).

Palliative Care Consults

Provides care for patients whose disease may not respond to curative treatment. Indications for a consult are: new diagnosis of cancer, symptom management, multiple admissions with chronic illness, hospice questions, help with end-of-life decisions, communication/conflict resolution/family meetings. Contact: 4-5284 or text page under Palliative Care.

Gastroenterology

The following consult teams are available Monday-Friday (8 am–5 pm).

Liver Consult Team (pager: 3-9425)

Handles all liver-related consults, including known variceal bleeding, liver failure, etc. In addition, this team includes a Liver fellow (contact via direct pager) who cares for all post-liver transplant patients.

GI Consult Team (pager: 3-1307)

This team handles all general GI consults including evaluation for ERCP’s (except if clearly liver-related).

Senior Endoscopy Team (pager: 3-8015)

This limited service is available for inpatients who are in stable condition, in need of endoscopy, and do not require a full consultation for the following elective procedures: surveillance for colon cancer, evaluation for heme–positive stool or iron deficiency anemia.

This service is not intended for the conditions below, which will continue to be addressed by the GI Consult team: admission for GI bleeding, percutaneous gastrostomy (PEG) placement, patients on heparin or Coumadin (or with abnormal coagulation profile or platelet count), patients in which the need for endoscopy is unclear or a full consultation for a GI Problem is necessary, complicated patients such as those with severe COPD or recent MI or those in the MICU or CCU, or patients who are unable to give consent.

On-Call

On nights, weekends, and holidays, page the GI fellow on-call. The on-call schedule for the GI division can be found at: http://www.insidehopkinsmedicine.org/gastroenterology/

Private Gastroenterology Attendings

There is a private GI attending service, comprised of four local gastroenterologists who rotate on a weekly basis, which functions separately from the above teams and performs GI consults. The in-hospital attending can be reached at pager 410-806-0972 (text message via http://www.arch.com/message/) or by calling one of the office phone numbers below. In general, if a patient has previously been seen by the private attending service, any future consults on the patient should be referred back to them.

Office phone: 410-583-2920

David Cromwell, Linda Lee

Office phone: 410-583-2630

David Hutcheon, David Kafonek

Other private GI attendings who may individually admit patients to the Garrett Service:

Marshall Bedine Peter Belitsos James Novick

PHYSICAL THERAPY/REHABILITATION

Make referral via POE and mention PT and OT needs to the NCIII on the patient’s floor. If you need to make the referral yourself, call 5-6214 or page the PT on call. Physical therapy and occupational therapy are on pagerbox. You can just page the patient name, location, and reason for referral.

OT will help assess patients’ functional status; i.e. can they attend to their activities of daily living? They also have a kitchen where they can perform safety evaluations for independently living patients.

PT focuses on ambulation and conditioning. PT also provides chest therapy for CF patients and whirlpool / pulsed lavage for patients with wounds.

General Medicine/Oncology 3-0675 (PT) 3-0685 (OT)

Cystic fibrosis PT 3-0717

Halsted 3 is the inpatient rehab floor where patients must be able to do at least 3 hours/day of PT. Patients unsuited for this environment can be sent to sub-acute facilities. PT will generally write a recommendation in the chart about what type of place is suitable. To request a formal consult from a Halsted 3 PM & R physician call 532-4701.

PAP Smear

Call 5-5088 or page 3-2277 for PAP smear nurse (often done same day).