Provide Care On Lpch Patients In Specific Areas Of Shc Page 4

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Special Privileges
Description: Must also meet Required Qualifications for Core Privileges
Request all privileges listed below.
Request
Service
Uncheck any privileges that you do not want to request.
Chief
Rec
Administration of Sedation
Use of fluoroscopy equipment (or supervision of other staff using the equipment)
Treatment of patients in outpatient clinics at Stanford Hospital & Clinics
Admit, treat, evaluate or provide follow-up care for inpatients ages 14 years or younger
Spinal cord injury medicine
Pain management
Nerve blocks
Motor point blocks
Interventional spine and intradiscal therapies
Electrodiagnostic procedures
Radiofrequency Lesioning of Medial Branch Nerves (lumbar, thoracic)
Radiofrequency Lesioning of Medial Branch Nerves (cervical)
Cervical Epidural Steroid Injection w/MAC
Acupuncture - Must complete Acupuncture Privilege Form
Published: 12/23/2013
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