Workshop On Call Imaging

Learning objectives Interpret chest and abdominal X-Rays in a systematic manner and be able to identify both normal and abnormal radiological findings commonly seen during on call shifts. Establish a knowledge of how to request urgent imaging, assessment of request urgency and who to speak to regarding this when working out of hours. Have an awareness of the guidelines for CT Head imaging requests during out of hours. Employ verbal communication skills to handover and request urgent imaging over the phone (this will also be covered in other workshops).

Handover

Case 1

Case 2

Case 3

Case 4

For each X-ray Is this a suitable film? Is this the right XR for the case? What does the XR show? What would you document? Please write an entry as you would do in the notes. What is the proposed management plan for the patient as a result of this?

Case 4 Repeat CXR

You get a call from the nursing staff about Ian Turner (the patient you reviewed with the consolidation). “He is becoming SOB and sats have been gradually dropping and now only 91%. HR 95, temp 37.2, RR 22. Please can you review him?” What would be the symptoms and clinical signs of pulmonary oedema? What would you do now? Case 2 Development

Have a go at calling the radiographer

Case 3 Development Whilst awaiting the CXR for Mr Turner to come back you get another bleep: “Mary (case 3) has now tripped over her slipper on the way to the bathroom and fell. She has hit her head. Can you please come and review her”. What would you do now?

Case 2 Repeat CXR for Mr Turner Would this change your management?

Summary and Questions