MSD Resident Emergency Backup
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UPDATED February 2020
MSD RESIDENT AFTER HOURS POLICY
If there are non-call GOR residents in rooms after 6pm, they will stay until they can be relieved by a GOR call resident. In general, non-call GOR residents should not be relieved by specialty call residents (cardiac, peds, or liver). The GOR residents will follow the 10 hour ACGME recommendation should they stay past 8:30 pm.
Once GOR residents are sent home, including 5th, 4th, and 3rd call, they are not to be called back. This is when calling in the specialty services comes into effect, as per the call back policy below.
The relief shift resident works from 3:45 pm - 1:00 am M-F (except for lecture day when the resident will start after attending lecture). The relief shift resident will be relieved after MSD 3 call but before MSD 2 call, and no later than 1:00 am. If sent home early, the relief shift resident can be called back until 1:00 am.
MSD RESIDENT EMERGENCY BACK-UP
Pulling a resident from another service should only be temporary while back-up help from home arrives, additionally this should be an attending to attending conversation. If the anticipated need for help is greater than 30 mins, back up help from home should be called in.
Weekdays:
For cases which occur during the night, residents should be assigned in the following order:
- First call OR (6pm - 7am)
- Second call OR (can be called in from home until 7am)
- Relief shift OR resident (shift is 3:45 pm - 1am, can be called in from home until 1am)
- Third call OR (can stay til midnight. Not to be called in from home)
- Acute pain night float resident (if holding airway pager, cannot be called to OR, pager: 2-PAIN)
See airway schedule available on ether website under “Airway Coverage” tab
- Peds 1 call (only if peds fellow or attending is also in-house) phone number: LPCH Anesthesia Resource voalte 650-721-9705; LPCH Anesthesia Emergency voalte 650-721-9706
Fellow-in house schedule available on Amion
- Liver call (if not already working in OR)
- Cardiac 1 or 2 call (if not already working in OR)
4th, and 5th OR call not called back in from home.
X-shift attendings are generally relieved after 4 call, but before 3 call/relief shift. This is flexible at the discretion of the call attending based on feasibility of resident coverage in multiple locations and safe patient care.
Weekends:
After the 1st and 2nd call residents, the 2nd call attending, and regional attending should be called in as backup to start solo rooms.
Residents should be assigned in the following order:
- First call OR: Saturdays are split into two shifts: MSD1 AM 7A-6P, MSD1 PM 6P-7A
- Second call OR 7A-7A
- Acute pain night float resident (if holding airway pager, cannot be called to OR, pager: 2-PAIN)
See airway schedule available on ether website under “Airway Coverage” tab
(Note: Resident is in-house weekends from 5P-7A. Not to be called in from home)
- Peds 1 call (only if peds fellow or attending is also in-house) phone number: LPCH Anesthesia Resource voalte 650-721-9705; LPCH Anesthesia Emergency voalte 650-721-9706
Fellow-in house schedule available on Amion
- Liver call
- Cardiac 1 or 2 call
NOTE: The intent of the 10-hour-break rule is to allow residents sufficient time after patient care duties to commute home from the hospital, to obtain adequate sleep, and to commute back to the hospital to resume patient care duties refreshed. Practically, this means that residents should be sent home at 8:30pm to come in the next day at 6:30am. The only exception to this rule is a resident choosing to stay past 8:30pm for educational purposes. If a resident works 24 hours, they require at least 14 hours prior to returning to work.
