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Fri Oct 22 07:58:08 BST 2004

I don?t disagree with you, sal, but internists, Emergencists and intensivists
must know the basic.
Like: is there blood in the brain? air/fluid levels in the retroperitoneum?
etc,etc.
CT?s are becoming today what an easy CXR was in the past.
and nobody knows how to see it!This is not fair!
It?s disgusting having to wait hours for a radiologist to diagnose simple
things.In the meantime, the patient dies, so the radiologist won?t make
the difference.
I prefer to work with a full-time radiologist by my side, but since it?s
not possible, what to do?
I?m an intensivist, but I know how to interpret an EKG - imagine if I were
to wait for a cardiologist arrhythmologist to diagnose ever reentrant AV
nodal tach I got in the ICU - I?d be lost.
That doesn?t mean I don?t recognize his qualities, for sure.
claudia
 '>'-- Mensagem Original --
 '>'From: SJASMD at aol.com
 '>'Date: Fri, 22 Oct 2004 02:36:13 EDT
 '>'To: trauma-list at trauma.org
 '>'Subject: Re: Trauma Care and Telerad
 '>'Reply-To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
 '>'
 '>'
 '>' 
 '>'claudia and caesar
 '>'my mentor, gerald shaftan, was a surgeon and he taught me a great deal
 about
 '>'
 '>'diagnostic imaging in trauma.  
 '>' 
 '>'Whether you are a radiologist or an emergency physician is not the issue.
 '>' 
 '>'Any one who studies the literature and catalogs in his mind the appearance
 '>' of 
 '>'variants, subtleties and artefacts, is the person who is going to  recognize
 '>'
 '>'them.  I think a good radiologist is more likely to have  that catalog
in
 '>'his 
 '>'brain.
 '>' 
 '>' its those subtle spine fractures,  the hepatocaval avulsion, the  missed
 '>'
 '>'accessory renal artery laceration or the type II urethral injury that
 will
 '>'get 
 '>'overlooked. 
 '>' 
 '>'sal
 '>' 
 '>'In a message dated 10/21/2004 11:42:53 PM Eastern Standard Time,  
 '>'cvteles at globo.com writes:
 '>'
 '>'THUMBS  UP CAESAR!!!!!
 '>'claudia
 '>''>'-- Mensagem Original --
 '>''>'Date: Fri,  22 Oct 2004 09:22:59 +1000
 '>''>'From: "Caesar Ursic"  <UrsicC at SESAHS.NSW.GOV.AU>
 '>''>'To: "Trauma & Critical Care  mailing list" <trauma-list at trauma.org>
 '>''>'Subject: RE: Trauma Care  and Telerad
 '>''>'Reply-To: Trauma & Critical Care mailing list  <trauma-list at trauma.org>
 '>''>'
 '>''>'
 '>''>'
 '>''>'I'll  play the Devil's Advocate. 
 '>'
 '>''>'What's the big deal about not having  a radiologist available to
read
 '>'a trauma-related
 '>''>'CT scan at  night?  What abnormalities are we likely to find on an

 '>'emergency
 '>''>'CT scan of a trauma patient that a well-trained emergency  medicine
doctor
 '>''>'or surgeon cannot discern on his/her own?   Hemoperitoneum? Fractured
 '>'solid
 '>''>'organs?  Air/fluid in the  retroperitoneum?  Mediastinal  hematoma/gas?
 '>'Subdural/epidural
 '>''>'hematomas? These are things that  anyone who is on call in a trauma
center
 '>''>'should be comfortable  diagnosing on his/her own.  If it's so subtle
 '>'that
 '>''>'it  requires three radiologists to hem and haw about for half an
 hour
 '>'before
 '>''>'dictating "..possible 'xxx', cannot exclude 'YYY',  recommend clinical
 '>'correlation,"
 '>''>'then maybe it's not that critical  to know about it STAT, and it
can
 '>'wait
 '>''>'until the daytime  radiologist reads the scans.
 '>''>'Then again, I could be all worng about  this...
 '>''>'
 '>''>'CM  Ursic
 '>''>'Sydney
 '>''>'
 '>'
 '>'
 '>' 
 '>'--
 '>'trauma-list : TRAUMA.ORG
 '>'To change your settings or unsubscribe visit:
 '>'http://www.trauma.org/traumalist.html

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