As I write this I have a patient waiting outside X-ray who has a tender
calcaneum after jumping into a swimming pool that someone had forgotten to
put the water in. Came in a couple of days ago and the SHO correctly
elicited calcaneal tenderness and requested calcaneal views. Duty
radiographer refused to X-ray the calcaneum. Allegedly (from patient) said:
"You have to jump from the sixth floor to break your calcaneum. I can't take
an X-ray because this will expose you to harmful radiation." Patient has now
turned up at follow up clinic and I have sent her off for the appropriate
X-ray. So sorry to swear, but this sort of c**p is becoming a recurrent
theme. Hell, why go to medical school and do all that training when you can
make risk assessments on clinical issues by learning how to take X-rays?
I tried to have a sensible discussion with our local radiologists (who
weren't really interested) and radiographers (who didn't seem to
understand).
I now give all such patients full details on the complaints process.
Jeremy Harrison
-----Original Message-----
From: Steve Meek [mailto:[log in to unmask]]
Sent: 12 April 2002 12:31
To: [log in to unmask]
Subject: Re: 5th metacarpal base fractures
mmmm.....bet your tongue was firmly in your cheek when
you put this up Vikki.....across the country, a
hundred Emergency Department doctors are now under
sedation after reading this.
Your hospitals' protocol sounds likely to increase the
risk of these injuries being missed and the risk
management committee should be informed. I don't know
where you work but it sounds like Jurassic Park.
You also don't say whether you are defending the
protocol.........go on, tell us, we've taken our beta
blockers!
Steve Meek
--- Vikki Chase <[log in to unmask]> wrote:
> You are welcome to request such views, but the
> radiographer may have to
> refuse to provide them, depending upon locally
> agreed protocols. The
> radiographer ( in addition to the requesting doctor)
> is potentially liable
> when deviating from written protocols ( IRMER 2000
> regs)- just because it is
> requested by a doctor ( or suitably qualified nurse)
> doesn't mean
> radiographers can do it. Where I currently work, we
> routinely provide
> lateral views for A and E requests if we spot
> something, otherwise only
> orthos can ask ( written protocol).
> Vikki Chase
> Diagnostic Radiographer
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]]On Behalf Of Ray
> McGlone
> Sent: 11 April 2002 22:30
> To: [log in to unmask]
> Subject: 5th metacarpal base fractures
>
>
> Lesson of the Week
>
> Some time ago a male patient presented with
> swelling and tenderness over
> the base of his 5th metacarpal (dominant hand)
> following trauma. A hand view
> was reported as being normal by the radiologist and
> doctor. Patient
> presented about 2 weeks later with continuing
> symptoms, he had a dislocation
> of the 5th metacarpal base. It was then successfully
> K-wired.
>
> These injuries are not uncommonly missed, I have a
> little collection in my
> library of films (usually picked up by the
> radiologist). If you are
> considering a dislocation of the 5th metacarpal base
> it is best to request a
> true lateral in addition to the other views.
>
> Any views?.. pardon the pun.
>
>
> Ray McGlone
>
> A&E Consultant
> Royal Lancaster Infirmary / Westmorland General
> Hospital
>
>
>
http://www.mbha.nhs.uk/morecambe_bay_hospitals_trust.htm
>
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