How to Make a Referral to Interventional Radiology

1.       Initial Request

2.       Required referral information

3.       The Appointment is Scheduled

4.       Schedule Required Labs

5.       Advise patient about medications and allergies

6.       Pre-procedure interview and consent procedure

7.       Patient preparation

8.       Procedure

9.       Recovery

10.     Care after discharge

1. Initial request

Contact the Interventional Radiology Scheduler by calling (843) 792-9271 or MEDULINE toll-free at 1-800-922-5250. If you need to speak to an IR attending physician to discuss a patient case or procedure, MEDULINE will page the physician of the day for you.

2. Required referral information

The Interventional Radiology scheduler will ask you to fax the following information to 843-792-2670:

Exam to be ordered
Clinical indications
History
Name of referring physician

3. The Appointment is Scheduled

The Division of Interventional Radiology will contact you with your patient's appointment date and time.

4.Schedule Labs

Schedule required labs within seven days of the procedure.

Draw a Creatinine if:
-The patient is 65 or older, or
-The patient is insulin dependent (any age)

Draw platelet count, PT/PTT, creatinine if:
- The patient has a diagnosis of cancer, or
- The patient has or is suspected to have liver or renal
disease

DO NOT draw creatinine if patient is currently receiving dialysis treatments.

If not drawn at MUSC, fax lab results to (843) 792-2672 before the procedure date.

5. Advise patient about medications and allergies

Stop taking blood thinners (Coumadin, Lovenox, Plavix) at least 72 hours before the procedure.

DO NOT stop Plavix before a Carotid Stenting procedure.

If the patient is allergic to contrast dye, write a prescription and give to the patient for Prednisone 50mg p.o. times three to be taken 13 hours, 7 hours, and one hour before the scheduled procedure.

The patient should take Benadryl 50 mg p.o. 1 hour before the procedure.

6. Pre-procedure interview and consent procedure

For some procedures a consult will be scheduled in advance.

The IR staff explains to the patient and family the procedure to be performed, and what to expect during and following the procedure.

The risks and benefits of the procedure are also discussed with the patient and the informed consent is obtained.

7. Patient Preparation

All patients are requested to stay NPO after midnight, but oral medications may be taken with a small volume of water.

Insulin-dependent diabetic patients are given instructions on adjusting the morning insulin dose, and they are usually scheduled for the first slot of the day.

8. Procedure

Patients should arrive one hour before the scheduled time wearing loose clothing that will be comfortable after the procedure.

During all procedures, surgical and medical backup and admission are available as necessary.

Upon completion of the procedure the radiologist contacts the referring physician with a verbal report on the patient's condition and a written note is added to the chart, with the main findings. A final report is usually provided within 24-48 hours.

For outpatients a letter will be sent to the referring physician.

9. Recovery

After the procedure the patient is transferred to the recovery room and monitored by the nursing staff and physicians for at least one hour, then they are transferred to the short stay unit in the main hospital for discharge later in the day.

Patients are discharged after two to eight hours if the vital signs are back to baseline and stable.

A summary physical examination is performed checking for extremity pulses and non-bleeding puncture site.

The patient is reminded about limitations to activity for that night.

If these and other criteria are met, the patient is discharged if they are under the supervision of a responsible adult who can drive them home and stay with them in case of a complication.

10. Care After the Discharge

Written instructions for immediate care is provided.

ER telephone number and on call radiology resident/fellow telephone number is given to the patient to call in if any problem arises.

Within 24 hours of the procedure a nurse from IR calls to follow-up with each patient and provide any necessary information.

Long term follow-up will be scheduled by the RN Patient Care Coordinator.