Difference between revisions of "Union Memorial (Regional)"
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=== About === | === About === | ||
Union Memorial (MedStar) is a regional anesthesia elective available to CA-3s who have completed their initial regional rotation downtown. You will work | Union Memorial (MedStar Health) is a regional anesthesia elective available to CA-3s who have completed their initial regional rotation downtown. You will work directly with attendings (some remote Hopkins grads) and interact with experienced CRNAs. | ||
=== Getting Started === | === Getting Started === | ||
| Line 26: | Line 26: | ||
* You'll park in Garage A first day and park in Garage B once you have your parking associated with your employee badge. | * You'll park in Garage A first day and park in Garage B once you have your parking associated with your employee badge. | ||
** If there is a parking attendant outside the garage that asks if you are a patient, just say yes otherwise they won't let you into the garage | ** If there is a parking attendant outside the garage that asks if you are a patient, just say yes otherwise they won't let you into the garage | ||
* You'll confirm your Powerchart access, get scrubs/meal card, and meet with Dr. Dishon (Josh) who will take you around, expect to jump into a block as soon as opportunity arises[[File:UMH Campus Map.png|thumb|Union Memorial Hospital Campus - Parking located off Calvert Street (turn onto 34th street).]] | * You'll confirm your Powerchart access, get scrubs/meal card, and meet with Dr. Dishon (Josh) who will take you around, expect to jump into a block as soon as opportunity arises | ||
*There are three floors of ORs: Ground floor (hand +/- shoulders), 3rd floor (newer, knee/hip +/- shoulders), 4th floor (cardiothoracic and vascular [AKA's, BKA's, AVF's]) | |||
*Codes: Block cart (0531), 3rd floor staff lounge (2019)[[File:UMH Campus Map.png|thumb|Union Memorial Hospital Campus - Parking located off Calvert Street (turn onto 34th street).]] | |||
==== Contact Info (please do not distribute) ==== | |||
* Nicole Mitchell (Admin Assistant) 410-554-6559 | |||
* Josh Dishon MD 443-904-2026 | |||
* Mark Jensen MD 585-953-9797 | |||
* Kerry Blaha MD 410-258-5758 | |||
* Tandi Mohammed MD 443-4447-5946 | |||
* Jane Radov MD 443-691-3000 | |||
* Rahul Guha MD 734-223-3061 | |||
* Marcelo Quezado MD 443-801-8889 | |||
* Sumanth Kuppalli MD 443-224-3500<br /> | |||
==== Block Recipes ==== | ==== Block Recipes ==== | ||
| Line 43: | Line 57: | ||
** Vial(s) of 0.5% Ropivicaine | ** Vial(s) of 0.5% Ropivicaine | ||
** Chloraprep, large/poptart Tegaderm, CHG Tegaderm dressing, sterile ultrasound probe cover (standard for all blocks, whether sterile or not), ultrasound gel, sterile gloves | ** Chloraprep, large/poptart Tegaderm, CHG Tegaderm dressing, sterile ultrasound probe cover (standard for all blocks, whether sterile or not), ultrasound gel, sterile gloves | ||
*If two catheter sites, each pump is run at 10 cc/hour intermittent bolus (PIB) without demand. Otherwise patients with single PNC (e.g. single adductor PNC) have PIB pumps programmed as 8/4/20/3 --> cc per hr / cc demand bolus / lockout interval in minutes / number of demands per hr. | *If two catheter sites, each pump is run with '''0.2%''' ropivicaine at 10 cc/hour intermittent bolus (PIB) without demand. Otherwise patients with single PNC (e.g. single adductor PNC) have PIB pumps programmed as 8/4/20/3 --> cc per hr / cc demand bolus / lockout interval in minutes / number of demands per hr. | ||
==== Subsequent Days ==== | ==== Subsequent Days ==== | ||
* Arrive by 7:00 AM to catch attendings for any first start blocks (in room by 7:30 AM) | * Arrive by 7:00 AM to catch attendings for any first start blocks (in room by 7:30 AM) | ||
*Expect to feel like a medical student until you get to know attendings better | *Anticipate bouncing between floors for 1st case starts -> PACU catheters -> preop blocks | ||
*'''Expect to feel like a medical student''' until you get to know attendings better | |||
*Josh will often help connect you with attendings doing regional cases in the morning, but you will need to hover frequently | |||
*Some attendings will get better about texting you when there is a block | |||
* APS is a good opportunity for blocks/catheters on the floor. Dr. Jensen (Mark) runs APS service and is very good about keeping you in the loop, and proactive with creating block opportunities | * APS is a good opportunity for blocks/catheters on the floor. Dr. Jensen (Mark) runs APS service and is very good about keeping you in the loop, and proactive with creating block opportunities | ||
*Fridays start with administrative meeting, thus case starts are at 8:30 AM | *Fridays start with administrative meeting, thus case starts are at 8:30 AM | ||
*Before going home, peek at the list of cases for the following day to figure out the best OR to show up to and when | |||
**The anesthesia schedule is published separately and around 3 pm, so you'll likely have to ask someone if you want to know where specific attendings will be | |||
=== Miscellaneous === | === Miscellaneous === | ||
Latest revision as of 06:11, 26 June 2025
About
Union Memorial (MedStar Health) is a regional anesthesia elective available to CA-3s who have completed their initial regional rotation downtown. You will work directly with attendings (some remote Hopkins grads) and interact with experienced CRNAs.
Getting Started
Site coordinators
- Joshua Dishon (Chair of Anesthesiology Department at Union Memorial)
- Nicole Allen (Administrator)
The Experience
- 2 week call-free rotation at major orthopedic surgery center
- Expect to get significant experience with both upper and lower extremity blocks. Arguably, the rotation rounds out blocks we do not perform as often at other sites. Most commonly:
- Total Shoulders: Interscalene (single-shot)
- General Hand: Infraclavicular, often with catheter placement (preferred over supraclavicular per general institutional preference)
- Total Knees: Post-op adductor catheters
- Miscellaneous Knee Procedures: Adductor/IPACK
- AKA/BKA: Fem/Sciatic catheters
- Other (less frequent): PECS catheters, TAP catheters
First Day
- Union Memorial Hospital is located at the Hopkins Homewood campus (201 E University Parkway)
- You'll park in Garage A first day and park in Garage B once you have your parking associated with your employee badge.
- If there is a parking attendant outside the garage that asks if you are a patient, just say yes otherwise they won't let you into the garage
- You'll confirm your Powerchart access, get scrubs/meal card, and meet with Dr. Dishon (Josh) who will take you around, expect to jump into a block as soon as opportunity arises
- There are three floors of ORs: Ground floor (hand +/- shoulders), 3rd floor (newer, knee/hip +/- shoulders), 4th floor (cardiothoracic and vascular [AKA's, BKA's, AVF's])
- Codes: Block cart (0531), 3rd floor staff lounge (2019)
Contact Info (please do not distribute)
- Nicole Mitchell (Admin Assistant) 410-554-6559
- Josh Dishon MD 443-904-2026
- Mark Jensen MD 585-953-9797
- Kerry Blaha MD 410-258-5758
- Tandi Mohammed MD 443-4447-5946
- Jane Radov MD 443-691-3000
- Rahul Guha MD 734-223-3061
- Marcelo Quezado MD 443-801-8889
- Sumanth Kuppalli MD 443-224-3500
Block Recipes
- By and large, you will be using 0.5% ropivicaine for everything
- General volumes (more than you'll be used to):
- Interscalene: 20 cc
- Supraclavicular: 20-40 cc (I'm serious)
- Infraclavicular: 30 cc
- Adductor/Saphenous: 20 cc
- Popliteal/Sciatic: 20 cc
- 21G 100 mm block needle (exception: shorter needle for interscalene)
- Fent/Versed sedation universally
- General volumes (more than you'll be used to):
- For catheters, supplies include:
- PNC kit
- Vial(s) of 0.5% Ropivicaine
- Chloraprep, large/poptart Tegaderm, CHG Tegaderm dressing, sterile ultrasound probe cover (standard for all blocks, whether sterile or not), ultrasound gel, sterile gloves
- If two catheter sites, each pump is run with 0.2% ropivicaine at 10 cc/hour intermittent bolus (PIB) without demand. Otherwise patients with single PNC (e.g. single adductor PNC) have PIB pumps programmed as 8/4/20/3 --> cc per hr / cc demand bolus / lockout interval in minutes / number of demands per hr.
Subsequent Days
- Arrive by 7:00 AM to catch attendings for any first start blocks (in room by 7:30 AM)
- Anticipate bouncing between floors for 1st case starts -> PACU catheters -> preop blocks
- Expect to feel like a medical student until you get to know attendings better
- Josh will often help connect you with attendings doing regional cases in the morning, but you will need to hover frequently
- Some attendings will get better about texting you when there is a block
- APS is a good opportunity for blocks/catheters on the floor. Dr. Jensen (Mark) runs APS service and is very good about keeping you in the loop, and proactive with creating block opportunities
- Fridays start with administrative meeting, thus case starts are at 8:30 AM
- Before going home, peek at the list of cases for the following day to figure out the best OR to show up to and when
- The anesthesia schedule is published separately and around 3 pm, so you'll likely have to ask someone if you want to know where specific attendings will be
Miscellaneous
- There is a full gym (free weights, machines, cardio) adjacent to the anesthesia offices in the 33rd Street Professional Building
- Nearby cafes for studying if preparing for ITE/Advanced:
- Bird in Hand (free wifi, outlets for laptop/phone, good food/beverage selection)