>'It is also worth thinking about whether with a bit of training you >can get all your A and E consultants or middle grades up to the stage >where they can provide an initial report that the patient doesn't need >neurosurgery.'
Whilst this has obvious potential I do have a couple of difficulties with it,
The first is actually getting the training to a standard that is safe, after all a 'miss' on a brain CT is not a miss on an ankle x-ray.
The second is has anyone found a good answer to the what is and isn't operable. Without wanting to be disrespectful to our Neuro-surgical colleagues what they take to theatre does seem to vary form day to day and Dr to Dr. So if they don't have any strict operating criteria how are we meant to know?
Hence our radiologists often say (and indeed did last night)
'Yes you can have this out of hours scan, but I wont report it. Just get the N-surgeon to look at it instead. If he has any difficulty get him to phone me'
It would seem logical then, to not involve the radiologist in this loop at all. I should be able to order the scan via the radioGRAPHER and then ask the N-surgeon directly to review the films (whether he/she is just downstairs or 100 miles away).....but I suspect this is radiological heresy........but it would solve the problem as far as brains go.
Peter Cutting
SpR NW Rotation..just
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