Neurosurgical SpRs become understandably tetchy about becoming a
radiology head scan service at 3 am for x amount of normal scans.
50 years ago, did doctors rely on radiologists / respiratory physicians
for Chest X-ray interpretation at 3 am ? Surely with both the patient
and the head scan in front of us, we should be able to train ourselves
to sift out the grossly normal from those which can benefit from
neurosurgical/ neuroradiological review next day.
Paul Ransom
-----Original Message-----
From: Accident and Emergency Academic List
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Sent: 29 June 2004 14:31
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Subject: Re: Scaphoids, Brains & Out of Hours Radiology
>'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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