--- Doc Holiday <[log in to unmask]> wrote:
> --> Where was this anecdotal experience? How long
> ago?
USA, 2 years!
> "CT Rich" - does that mean often-used? Many
> investigations are becoming like
> that, for example, we now work in an ECG-rich
> environment, which is a good
> thing, no?
Not the same! CT involves large dose of radiation, ECG
does not!
>
> Not every negative CT means early discharge, but
> many can.
Well I never saw anyone discharged after a negative
scan!
>
> Not every head injured patient with low GCS MUST
> have a CT as part of MX as
> a rule EVERY TIME even when where "rich" - in a
> "recurrent attender" such
> as mentioned here on the list, it may well be better
> for the patient to skip
> a CT despite exactly the same GCS getting a CT in
> someone else. A different
> case... CT is just a tool...
>
Agreed, but that doesn't mean just because we have
that toll we have to use it every time, particularly
when that tool involves exposure to a significant dose
of radiation. I was brought up on the principle that
you should only request an investigation if the result
was going to alter your management. Whether the result
you are looking for is a positive or negative one is
irrelevant. If early negative scans lead to a change
in management - such as early discharge then it is
justified, if it doesn't then surely you need to
explore the reasons for doing it.
Cheers Fred.
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