--- Rowley Cottingham
<[log in to unmask]> wrote:
> > --- Ray McGlone <[log in to unmask]> wrote:
> And furthermore, the short femoral clot is exactly
> what the femoral injecting addict gets. I find all
> this hoop-jumping extremely
> tedious and irritating.
I have a certain sympathy with the radiologists. They
have to fight a continual battle against people
requesting investigations without thought and with
little if any clinical justification. The protocols
are their defence against abuse of the system. One of
my particular bugbears is the "routine" CXR for
medical admissions. Our medics seem to think every
patient admitted as a medical emergency needs a CXR -
no they don't!
> Look at John Hall's posting
> for an example. The test that determines with a
> pretty good sensitivity and
> specificity what is going on is the Doppler
> ultrasound. That can provide a definite answer from
> below the trifurcation to the IVC.
> However, because, as Fred says, it needs a
> radiologist, we have to do lots of 'screening' tests
> of dubious veracity such as D-dimer,
> venometry and so on before they will deign to do the
> test. How did we let them get away with this? I
> don't do chest
> plethysmography before asking for a CXR, for
> example.
>
I've always found our radiologists very reasonable if
you go round and talk to them and explain why you want
something done, regardless if it comes within
protocols or not. Once you get the reputation for
being reasonable and thinking before requesting it is
much easier on subsequent occasions.
Cheers Fred.
P.S. One good tip is to present them with the problem
and get them to suggest the investigation!
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