List Archives

Sun Oct 24 08:53:12 BST 2004

andrew,  while my hospital is no longer a trauma center, we run into the the same shit here..radiologist is 'offsite', meaning at home in bed at night...we often wait wait hours for reports...one  rad tech is known for 'batching' her scans, and  has been told aout this technique many times....on top of that, we often run into problems where the  dept has problems transmitting the films or the doc can't  recieve them...this whole 'outsourcing' bit  is ridiculous when it comes to emergency medicine...and in particular when the radiologist oncall won't commit to a reading..."needs  further study" which isn't available at night at our place...so you either send the patient home, needing further study, or try to transfer to the appropriate facility...
Lee
CreedyRN

Andrew J Bowman <sumieb at compuserve.com> wrote:
Listers,

Well just came off of a very enlightening shift in the emergency department.

I work in a moderate sized Midwest city, home to a Big 10 university. Two hospitals in town which over the past 6 years have merged and become one organization owned by a Catholic service. We serve about a 10-15 county area in this Midwestern US city and have a helicopter based in our town for EMS transport from other hospitals and the scene.

Until last night at midnight we had 13 radiologists with 4 being interventionalists covering the two hospitals whose ED's see over 70,000 patients/year combined. WE have an open heart program and take care of just about all trauma except significant burns and pediatric critical care. The ED's are staffed by board certified emergency physicians. Historically at night the radiologist on call was camped out at one of the hospitals for overnight reads (sometimes traveling between the 2 as we are about 1 mile apart).

Last night at 12:01 am a new group of radiologists replaced the old group due to the political upheaval in our community healthcare. Now have 8 "permanent" radiologists and about 10 "locum tenems" and the interventionalist can place PICC lines, central lines and Hickman caths (hell I have been trained to do 2 of those and regularly place central lines myself). No angio, no embolization, no stents.

At night (11p-7a) all CT, ultrasound and MRI will be read by a radiologist in IDAHO!!!!!!!!! 

We had a "Trauma One" patient (our term for patient whose vital signs or mechanism suggest actual or potential significant injury). Stable vitals on arrival and off to CT within 20 minutes.

Got off CT table and it took 1 hour and 17 minutes to receive an interpretation on this "Trauma One" CT.

Does anybody besides me find this unacceptable????!!!!????

I have been doing ED nursing for 22 years in this same community and this is the worst I have ever seen it.

Sorry for venting, it was a long, bad night (because of other similar issues).

Andrew B
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/traumalist.html

List Archives

For your convenience, find the Trauma List Archive Below

Trauma Care and Telerad