General preparation for procedures

INFORMATION ABOUT THE PATIENT

  • Determine if patient can give consent – if not, who gives consent?  Get their name and contact info
  • Patient name, age, gender, diagnosis, procedure requested, referring MD name and contact #

IMAGING STUDIES

  • For BIOPSY and DRAINAGE:  MD must review diagnostic study before appointment is scheduled
  • Images should be uploaded to PACS
  • PAMF PACS (iSite) - preferred
  • ECH PACS (Syngo) – if not enough time for iSite upload
  • If everything fails and outside study available, then give CD to PA

INSTRUCTIONS TO THE PATIENT

  • Nothing by mouth after midnight (except medications with small sips of water up to 2 hrs pre-procedure)
  • Bring full list of current medications and allergies
  • If “shellfish” allergy – NO preparation needed
  • If “iodine” or allergy to “dye” or “contrast,” document what type of reaction (itching/hives, shortness of breath, problems with blood pressure or heart).  Some patients with bad kidney function have been told to avoid iodinated contrast, but they are not allergic.
  • If patient has a true allergy to iodinated contrast discuss with IR physician or PA
  • Must have a ride home if same-day procedure
  • Bring clothes and supplies including reading materials if procedure may require overnight stay

PREOP LABS

  • Patients with liver disease/liver tumor and or biliary tubes also need LFTs
  • This should be noted in the scheduling calendar notes (eg. PATIENT HAD LABS DRAWN IN THE CLINIC
  • Patients seen in clinc will have labs done in clinic on the day of the consult or before the procedure
  • Standard preoperative labs include: CBC, Chem basic, INR

TRANSFUSION GUIDELINES

  • INR >1.6 - give 2 units of FFP
  • Platelets < 50k - give at least 1 pack of platelets
  • Hg < 7 - give 2 units of PRBC

IV FLUIDS

  • IV and fluids (at 75ml/hour) started in all patients except CONTRAINDICATIONS
  • CONTRAINDICATIONS TO IV FLUIDS: Renal failure on dialysis
  • CHF
  • NO IV in any dialysis patient for Dialysis Access “fistulogram,” angioplasty, stenting, or declot
  • NO IV in any dialysis patient for removal, exchange, or placement of tunneled dialysis catheter (TDC)

OTHER

  • Ideally all patients should be called 1-2 days after the procedure to see how they are doing.
  • Patient should have prescriptions sent to their pharmacy if possible before the procedure
  • Blood thinners
  • Should be stopped in most procedures

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