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.
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
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
Variable definition of nephropathy
Jamie’s audit showed 16 patients actually had improvement in renal function!!
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.
Guidelines for writing SAQs…for registrars presenting at Footscray to incorporate into their presentation:
Guidelines for Writing the Fellowship SAQ Examination Paper
Thanks Dr Jess Roberts for her presentation on interpretation of the brain CT.ct-brain-dr-j-roberts