Each first and second year resident has responsibility for taking call from home with a pager. When called, the resident is expected to handle the call promptly. This means that the resident must be available and reachable for the time he/she is on call.
The first year residents are assigned to one weekday call (Friday) per week. Each first year resident is assigned to one weekend call every 4 weeks. Each second year resident covers one weekday call per week (Monday through Thursday). When on call, the resident provides care at both hospitals. It is the responsibility of the resident seeing the patient on call to make appropriate recommendations for follow up evaluation by an Attending. The resident also must personally inform the Attending faculty about the identification and location of patients who were seen so that the Attending may review and countersign the consultation documentation.
The senior residents take back-up call every four weeks for one week. They are available by telephone to advise the resident on call, and should be called when any patient is admitted. An Attending faculty member is always available to consult by telephone and will come to evaluate any patient the resident determines needs such attention. The resident on call can contact the Attending directly at any time. A complete schedule of attending physician coverage is determined for the succeeding six months and is posted in the department. This also shows the best way to contact the Attending. Any disposition of a patient with respect to admission and/or surgery should be made only after consultation with the Attending. In situations where the decision to admit is not that of ophthalmology (e.g. patient with poly-trauma with eye injury,) the Attending should be notified if surgery is thought to be indicated for the eye injury and should indicate the action to be taken by the resident. All patients seen in the emergency room must be recorded on their personal consultation/emergency room log sheet.
The attending on call is ultimately responsible for patients seen by the residents. The patients seen on call may provide welcome educational experience for the senior resident. It is important therefore that first and second year residents on call contact their third year for all "serious" surgical and non-surgical cases.
Any "serious" surgical and non-surgical case which includes a patient requiring a minor surgical procedure, must be discussed with the on call attending by the THIRD YEAR RESIDENT. Prior to this policy, attendings were notified at the discretion of the resident on call.
Emergency Eye Care
- Familiarize yourself with the Hines Eye Clinic, the Loyola Emergency Room, Consult Room and the Burn Unit.
- All patients examined in the Consult Room should be documented in the login book on the desk. The Hines Eye Clinic is locked. Security will let you in or you may check out a key from the surgical staff office on the 7th floor (get a key).
- All residents will need a valid Hines ID to allow access to the VA after hours.
- All patients seen in the Emergency Room should have a complete and fully documented eye exam (with x-rays if metallic foreign body or fracture is suspected.)
- All patients must have follow-up appointments the next day or Monday. Recommend compiling your own emergency eye kit including: Diamox tablets, Pilocarpine, Timoptic, Fluorescein strips, antibiotics, ophthaine, and dilating drops, lid speculum, cotton tip swabs, eye patches, etc.
- You may be called to the floor and have nothing available otherwise. (All are available in Consult Room.) Make sure you have your own direct, indirect ophthalmoscope working with a good penlight with blue filter with you on call. (All available in Consult Room at LUMC and at Clinic at Hines.)
- Retain a copy of the pink consult sheet for filing and/or follow up by an attending that day or on Monday, if seen as an emergency room patient over the weekend. Completed consults are filed by you in a binder kept by the fax machine (Room 2609) in the administration office If you are at Hines, give the pink sheet to the resident stationed at LUMC.
- All consults sheets must be filed within 36 hours
- Complete eye exam includes:
- History, medications, allergies, previous eye history.
- Vision with/without glasses and pinhole near and distance vision.
- Glass prescriptions - not on call.
- Extraocular muscles/motility.
- Visual fields
- External eye exam - lids, lashes, conjunctiva
- Slit lamp exam cornea, anterior chamber, iris, lens.
- Tension and time of exam.
- Fundus - type of dilation used, if any, and description of disc, macula, vessel and periphery.
- Complete ER log sheet for all patients.
Holiday Call Policy: Loyola/Hines
When Loyola has a holiday and Hines does not, the Hines resident on call is not responsible for call at Loyola.
- Residents at Loyola take call.
- The name of the resident(s) on call at Loyola must be listed on the monthly call schedule.
- When Hines has a holiday and Loyola does not, the Loyola resident on call is not responsible for call at Hines.
- Residents at Hines take call.
- The name of the resident(s) on call at Hines must be listed on the monthly call schedule.
The last two days in June:
- Current 3rd year residents are back-up.