Zuckerberg San Francisco General Hand Service Protocol

Zuckerberg San Francisco General Hand Service Protocol 2017-12-20T16:25:38-08:00


The Zuckerberg San Francisco General hand service is responsible for the care of ACUTE hand injuries and infections for patients presenting to the Emergency Department, Urgent Care Center, Primary Care clinics or inpatient services. This service covers upper extremity problems below the elbow. The hand service is jointly staffed by Orthopedic Surgery and Plastic and Reconstructive Surgery. Consults are assigned to the team on call at the time the consult is received. To determine the on call team, please contact the operator.  

Service Specifics

  • All consults placed to the hand service will be managed by the team (Orthopedics or Plastics) responsible for the hand service at the time the consult is received. Any subsequent communication with the hand service should occur with the initial consulting team (Orthopedics or Plastics). Each service will add consults they receive to their consult list and/or clinic list to ensure continuity of care.
  • The Orthopedic Surgery and Plastic Surgery services are equally qualified to care for acute hand injuries.
  • When splinting of an acute fracture is required, the referring provider may perform splinting, as long as the proper equipment is available and the referring provider has received appropriate training. The hand service may provide clinical guidance by telephone in this setting.
  • During business hours, when the referring provider is unable to perform splinting, the following steps should be taken:
    • Consult to hand service is placed by the referring provider
    • After review of imaging by hand service, a recommendation for type of splinting is communicated to the referring provider
    • Referring provider contacts Jeff Cox, Registered Orthopedic Technician in 3M-10. Please call 3M at 415-206-8673:
  1. Diagnosis (type of fracture)
  2. Splint required (as recommended by hand consult)
  3. Physician name and service consulted (ie. Orthopedic Surgery or Plastic Surgery)
  • Patient is sent to 3M to see Jeff for splinting
  • After hours, it is the responsibility of the hand consult resident to provide timely splinting.
  • Any follow-up care should be directed to the service (Orthopedics or Plastics) that performed the initial evaluation and/or treatment.
  • For non-urgent hand consults, please use eReferral.
  • For systematic or clinical issues requiring Attending-level communication, page Dr. Nikki Strauss Schroeder (Orthopedic Surgery) or Dr. Scott Hansen (Plastic Surgery). Contact information is available for providers through the SFGH operator.

The complete protocol, which is posted on the DPH intranet because it includes pager numbers, can be downloaded here. If your computer does not have access to the DPH intranet, you will need to access it using your token.