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Cardiovascular Medicine Fellowship Program
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Cardiology Night Float

The Night Float Rotation is an adjunct to inpatient ward/cardiac intensive care unit (CICU) training. It is designed to enable all three years of cardiology fellows to enhance their knowledge and skills in inpatient management, acute care and phone triage. The fellow is stationed primarily in University Hospitals CICU and works directly with the CICU residents so that all admissions are supervised by the night float fellow, as well as any urgent nighttime cardiology consults. On a case-based individual basis, the fellow also provides personal teaching through supervision of the on-call resident in the CICU.

Clinical Content/Fellows Responsibilities

The overnight pager for fellows in the Cardiology Night Float Rotation is 30990. Sign-out from the CICU day fellow to the night float fellow takes place at 6 p.m. every day, and sign-out back to the CICU day fellow occurs at 7 a.m. the next morning. You should receive email sign-out for the interventional/structural heart service.

Specific Fellow Responsibilities

  • Cross covering the inpatient interventional/structural heart service and any post- transcatheter aortic valve replacement (TAVR) patients that remain in the CICU
  • Directly staffing/supervising all CICU admissions
  • Performing bedside echocardiograms
  • Placement of bedside Swan-Ganz and temporary transvenous pacemakers
  • Seeing urgent/emergent cardiac consultations
  • Supervising all bedside procedures
  • Teaching CICU residents

VA Cardiac Admissions

Monday through Friday the night float fellow is responsible for staffing VA cardiac admissions (via telephone) with the residents, as well as seeing any urgent/emergent VA cardiology consultations. Monday night is the night off for the night float fellow.

Echocardiograms

In regard to echocardiograms, sonographers are on call from 5 - 7 p.m. on weekdays, 3 - 5 p.m. on Saturdays and 8 a.m. - 3 p.m. on Sundays and holidays. The sonographer schedule is sent out weekly by Raymond Musarra (check your email) and pagers are often written on the whiteboard down in echo lab outside of the sonographer office.

An echo attending is scheduled for on-call nights, weekends and holidays (available on QGenda). Studies performed while on-call should be stored for review the next working day with the echo attending. A note detailing the preliminary findings should be written on any patient receiving an echocardiogram after-hours. These studies should have an attached order: "Card Echo non-bill outside study". The preliminary study worksheet (copies are located above the consent forms at the CICU secretary desk by the fax machine) should be faxed to x42249.

The various programmers (MedTronic, St. Jude, etc.) are located in the EP control room (or in the EP labs). If used overnight, please print any interrogations and place in the chart, and return the programmer as you found it. At the VA, the programmers are available in the attending office in the cath lab area (door opens with BB1 key).

STEMI and Shock Team activations may be called in via the transfer center (x4111).

Educational Resources

There are myriad educational resources available for fellows on the Cardiology Night Float. Many resources that will help with overnight call are the same as CICU, cath lab, echo and other rotations and include the following:

  • CardioSource Plus, ACC SAP, and Cath SAP questions (available on ACC website while on UH IP address as a Fellow In Training)
  • Grossman's Cardiac Catheterization, Angiography and Intervention by Donald S. Baim
  • Manual of Cardiovascular Medicine by Brian P. Griffin MD is high yield and covers just about every topic you may encounter in the CICU. This manual is particularly useful for first-year fellows.

For More Information

For more information on the Cardiology Night Float, please contact the following:

Faculty Contact: Richard Josephson, MD
Richard.Josephson@UHhospitals.org