On 17 Aug 2006, at 10:04, Dunn Matthew Dr. (RJC) A & E - SwarkHosp-TR
wrote:
>
>> And in this regard I have run up against antagonism
>> from other doctors: a radiologist who looked at a grossly positive
>> image from a FAST scan, but wouldn't use it as an indication
>> for CT.
>
> It isn't. It's an indication for a laparotomy. If it's that
> positive there's a risk that the patient will crash in CT. I
> presume this was his thinking rather than "Stick the patient on the
> ward and we'll scan in a couple of days if he's still around."
True, I appreciate it's an indication for a laparotomy, this was
about 4 years ago, the patient was deemed conscious and "stable" and
"well" and let's just say that a laparotomy wasn't happening... and I
was just off my FAST course. But laparotomy wasn't what this
radiologist was arguing for, and we had a bizarre conversation
wherein he would look at the positive FAST images but wouldn't
acknowledge them and instead demanded proof only relating history and
examination which indicated significant trauma, and then he agreed to
take the patient in CT. CT was positive but I forget what it was
positive for, all I remember now is my self-righteous annoyance!
Jason Carty
SpR NE London
www.netrag.co.uk
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