8. Consult Guidelines

  • All consults (ER and floor) must be seen promptly.  Ask for help early if you are behind and there are urgent patient care issues. 
  • If scrubbed, nurses will answer pager and take message – thank them for this!
  • Triage your consults and do not let them pile up.
  • Place all new consults on EPIC list.
  • All consults, even if not getting admitted, require a formal consult note.  MUST include name of requesting physician in the note.
  • Urgent matters require you break scrub or call fellow so patients get seen promptly.
  • Pediatric Surgery Fellows are available at any time of day or night to help triage and discuss consults.
  • All daytime consults should be run through one of the Pediatric Surgery Fellows.
  • Routine evening consults can be communicated directly to on-call attending.
  • If the Pediatric Surgery Fellows are scrubbed or unavailable, the SOW/On-call attending can always be called directly by any resident at any time.
  • Check EPIC on all new consults to see if patient is known to an attending – if recently post-op, or a long-term relationship is established with the patient, then this is the first attending who should be contacted.  Feel free to check with fellows or SOW for guidance as this can be confusing. Otherwise, the following is a good general guide:
    • Weekday Daytime/24 hours Sat-Sun: SOW
    • Weekday Evenings: On-Call attending
    • Trauma Weekday Daytime: New patients staffed with SOW; Trauma Attending or SOW if known inpatient
    • Trauma Weekday Evenings/24 hours Sat-Sun: New patients staffed with On-Call attending; Trauma attending or SOW if known inpatient
    • New Colorectal Patient: Colorectal attending on-call    



NEVER…

  • Refuse a consult – if unclear how to triage a consult, call the Pediatric Surgery Fellow
  • Argue with consultants – disagreements on plans are managed by Fellows/Attendings
  • Provide final plans on patients without checking with fellow or attending