To raise another point on this topic...I recently had an altogether
different experience requesting an emergency CT head scan on a patient out
of hours. Me (SpR) to Radiologist (Consultant at home in bed) brief
clinical history, interrupted by "right so you need a CT then, call the
radiographer and ask her to call me when its done." Patient had scan and
went straight to neuro theatre. As they left the scanning suite radiologist
appeared (the image link to home was faulty) muttering "I dont know why you
need me - you guys are trained to interpret these images well enough",
coutersigned my written report in the notes and left.
Now some may feel A&E ordering and provisionally reporting is a perfect
situation, but I was left a little disconcerted. Sure, the large extradural
haematoma was not difficult to spot....however we often scan for ?SAH and
small amounts of subarachnoid blood can be difficult. Surely what we need
is a team approach to the patient. Cooperation and understanding is only
going to come from good communication. Xray/CT meetings are a great forum
for discussion and generating mutual understanding and respect, and when
colleagues work well together amazing things can happen.
I have worked in one hospital where the radiologist on-call was on the
Trauma Team bleep, and responed quickly enough to advise on imaging
modalities, and then get it all organised whilst we did our bit in resus.
The holy grail? It is possible....
Dr.Marten C. Howes MRCP(UK) FFAEM
Specialist Registrar
Accident and Emergency Medicine
Royal Preston Hospital
Preston
PR2 9HT
Lancashire, UK
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