Tag: radiology

Choosing Wisely campaign

Review the 6 radiology related pathways from the Choosing Wisely campaign, which will be implemented soon.

Most of these are well known to ED clinicians and should already form the backbone of your clinical practice.

If you are unaware of these feel free to review them and discuss with a senior member of staff.

The PE flowchart is complex although can be distilled down – you should first start with a good grasp of the Well’s score and the PERC rule.

 

Acute Ankle trauma and the Ottawa Ankle Rule

RANZCR-Clinical-Decision-Rules-pages-8-11

 

Suspected lower limb DVT

RANZCR-Clinical-Decision-Rules-pages-12-13

 

Suspected Pulmonary Embolism

RANZCR-Clinical-Decision-Rules-pages-15-23

 

Acute low back pain

RANZCR-Clinical-Decision-Rules-pages-25-29

 

Cervical spine trauma

RANZCR-Clinical-Decision-Rules-pages-30-39

 

Head trauma

RANZCR-Clinical-Decision-Rules-pages-40-43

Winter’s Wrap: Registrar Training 19.04.2017 – Organ donation, contrast nephropathy and paracetamol overdose

Organ Donation – Dr Forbes McGain (Intensivist)

SEE FULL PRESENTATION HERE

Brain Death vs Circulatory Death

Clinical Testing – normothermic

– Sedating drugs excluded – *Baclofen mimics brain death

– cranial nerve testing

– Apnoea test

Imaging – if inappropriate for clinical test, unstable, spinal reflexes present

 

ED responsibility:

Contact Donor Coordinator – ICU registrar or Consultant, or Donate Life via switchboard

Initiate conversation but ensure family aware ICU attendance is NOT too prolong life but for consideration of organ donation

 

consider for donation if:  Brain death or imminently dying and withdrawal of cardiorespiratory support planned

Intubated and Ventilated

BP adequate for organ perfusion

No Malignancy or HIV

Age 1-80 years

donatelife.gov.au

 

Contrast Nephropathy – Dr Jamie MacGilivray

Limited evidence

Variable definition of nephropathy

Jamie’s audit showed 16 patients actually had improvement in renal function!!

http://www.sciencedirect.com/science/article/pii/S0196064416313889

In summary – understand the clinical indication for the scan requested and the timeframe within which results are needed. Renal function should not delay an appropriate CT.

Paracetamol Overdose – Dr Deb Maher

https://www.mja.com.au/sites/default/files/issues/203_05/Guidelines_paracetamol_Aus_NZ_2015.pdf

 

EXAM QUESTIONS

Guidelines for writing SAQs…for registrars presenting at Footscray to incorporate into their presentation:

Guidelines for Writing the Fellowship SAQ Examination Paper