Consult Night Float


Last Updated: 6/24/2019

CONSULT NIGHT FLOAT

Brief Description:  
Consult night float is the rotation with the most responsibility as you (outside of the NICU fellow) are the most senior neurologist in house. You will be the face of our department, and many other doctors (including attendings!) will look to you for guidance on neurological issues.  Remember to be professional and a excellent representative from the Neurology Department

Links: See Stroke Logistics tab for link for: TPA worksheet, Extended Window Protocol and Raven Documents

Schedule Highlights:  
Weekends: Sunday night 6pm
24s: No 
Holiday: Not holidays covered by 24hour call 
Sick Pull: No  
Weekday Shift: 7pm-9am (pager 7pm-730am) SUNDAY 6pm-9am (pager 6pm-9am)

Important Contact information:
Consult Pager 86876
Stroke Fellow Pager 80021
ANF Pager   87276  
NICU Fellow – 82665 (8COOL)
Rapid Response – 72743
Stroke Code Activation
MRI radiology supervisor  82736 (“82- REM”)
PPOC 697-7762 (697-PPOC)
Neuro Onc email: NeuroOncologyOps@lists.cumc.columbia.edu
Raven email: neuroravenclinic@columbia.edu
Barb email: bma2125@cumc.columbia.edu
  
Detailed Description 
Locations NI -1 

Staffing 
All consult must be staff by attending within 24 hours of consult request
All consults being discharged MUST be staffed with attending: General (NYP on call attending) Stroke (Putnam Service attending) 
You will staff GENERAL cases in the morning. 

STROKE cases: sign out cases to Stroke Consult in the morning, they will staff in afternoon rounds. 

Detailed Schedule
Start 7pm, Sunday start 6pm 
Must leave by 9am.

Tips
*NYP on call and Putnam Stroke Service attending is ALWAYS available to discuss cases
*If you think there is a high probability that a patient will be discharged pending a test, you can call the attending earlier in the night to discuss your plan if the test shows what you predict, and contingency plans for other results 
*If you are ever unable to reach the on call attendings, you can always call Dr. Lennihan or Chief Resident
*Attending preferred contact information is on Contact Tab 
*NICU fellow is available to discuss emergent, urgent and ICU questions. Other questions CNF should call on call attendings 
*Add all consults to appropriate List “Neuro Consult” or “Neuro Stroke Consult Service” or “Neuro-Oncology)
*Getting an MRI for dispo in the ED needs to be discussed with an attending first. These patients do not need to be admitted for MRI, but we’re really trying to cut back on the number of MRIs we do to triage admit vs. discharge

Admitting Patients
Floor and SDU: It is YOUR responsibility to touch base with the admitting team (at least senior, sometimes junior too) to give signout and notify ED team of admission
The ED attending can admit patients to Neurology, despite our assessment for discharge. Discussion between attendings can always be organized by you. If this occurs and you are not notified of the change of dispo, please send MRN to chief resident. (This occurs rarely, but often leads to communication errors since we do internal sign out Neuro Consult to Neuro in-patient service, which can leave a patient unattended to)
NICU: The NICU fellow must be notified and to help with bed assignment. It is your responsibility to continue to monitor the patient closely and advise/recommend the ED for ordered. closely by the consult resident prior to getting a bed. A MD needs to accompany the patient to the unit, but it can be the ED resident.
For any patient that there might be a chance that they go to the NICU (even if deciding between the NICU and stepdown), call the NICU fellow as soon in the consult process as possible.
Any blood in head MUST be discussed with the NICU fellow