Pediatric surgery rotation

3 minute read

People and roles

Attendings

Dr. Harmon

Dr. Vali

Dr. Ham

Dr. Perry (Plastics)

There is one Surgeon of the Week (SOW) who cares for the inpatient service, staffs consults and does addon cases for the week. All inpatient progress, discharge summaries, and consult notes must go to the SOW, unless there is a different attending covering the night shift.

Fellow

Ruchi Amin ASCOM 323-3595

Resident team

Intern ASCOM 323-3093 (x1)

The intern is responsible for the floor service. He/She should work with the APPs to ensure all floor notes and tasks get completed. The intern will also help on MD clinic days. They are expected to assist Dr. Perry in pediatric plastic surgery cases on Fridays. They can help see routine floor and ER consults with the residents.

PGY2-3 Residents (x2)

They are expected to see all consults, especially should take the lead with PICU and NICU consults and staff them with Ruchi. Will pre-round, present, write notes and communicate with the primary team for all NICU and PICU patients. Provide case coverage for Drs. Harmon, Vali and Ham. They assist with clinic when not in the OR. One of them will send out an email for the following day assigning case and clinic coverage

Advanced practice providers

Theresa, Lynn and Karenza are the daytime APPs. They help with floor tasks, notes, orders and clinic. They generally take care with niche pediatric surgery tasks like certain wound cares and g-tube teaching. Karenza helps Dr. Perry in the OR on Wednesdays.

Alex is an APP that specializes in wound and burn care. She works closely with Dr. Perry in plastic surgery. She will often help us see burns and other complex wounds on inpatients during the week.

Joel and Jenna are the nightime APPs. They cover most nights which allows us to have only the intern do a single 24 hr call most weeks.

Medical students (x2)

Typically pre-round and present 1-2 patients each and write the progress note for the day. A resident will open a note for them to complete. They will then cover cases or help complete floor tasks or see consults as appropriate.

Schedule

Arrive at 5:45 for pre rounds.

6 AM rounds start

PM rounds between 2-5 pm

6 pm Zoom signout

In general the intern does a 24 hr call on Friday and is post-call Saturday and off Sundays. The PGY2/3s split the Saturday and Sunday days. There is a call room on J11 near the elevator that is for general surgery and can be accessed with your Kaleida badge.

Site specifics

Pre-rounds

Arrive at 5:45 to do computer pre-rounds. Pull numbers, look at xrays and labs and prepare to present the patients. Urine output reported as cc/kg/hr. PGY2-3 residents should present NICU and PICU patients

Consults

Add all consults to the Powerchart list as soon as we are called about them. Whoever receives the consult should text out the relavent information to the group Whatsapp. All consults seen by a PGY2/3. All consults should be staffed with Ruchi prior to calling the attending. Do not refuse any consult without first discussing with Ruchi. Pediatric surgery has a broader scope and may include problems not typically handled by adult general surgery.

Documentation

There is a large focus on appropriate documentation and coding. Every note should have the problem list reviewed and updated if indicated and should include an ICD 10 code(s). Every preoperative note, postoperative note, operative note should have an ICD 10 code in the indication, as well as the procedure and CPT code.

When admitting, always ask that status the patient should be admitted to. Example is that acute appendicitis as ambulatory surgery status, but ruptured appendicitis is inpatient status.

Refer to Dr. Ham’s handbook for all the additional details you will need.

List management

The list is re-created daily by copy pasting the current day, and dating the new one for the next day.

All list updates should be to the next day’s list.

When adding patients you must use the template found at the bottom of the list. It has special boxes that auto-update. If a box has an equation in it, do not update it. It will auto-populate based on other data boxes.

Rotation specific surgical diseases

Rotation specific procedures