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Tue Oct 6 23:19:42 BST 2009

Norm made a mistake in his evaluation of the below  situation.    He did 
not insert the word "He--" in front of his  use of the word "no."    On the 
other hand, if an emergency  physician is married to an oncologist, then the 
ordering of the CT just might  add to the job assurance for the future.    We 
have seen our  first lymphoma caused by an excessive amount of radiation 
from many many CTs  etc.     In children, the dose is not very  big.    
Plaintiff lawyers are already having seminars to  teach them how to sew doctors in 
class action suits (just as they did with  asbestosis exposure) when their 
clients get leukemia and lymphomas from CT  scans, unnecessarily ordered in 
the EC, ICU, etc. 

k

In a message dated 10/6/2009 5:05:34 P.M. Central Daylight Time,  
nmcswai at tulane.edu writes:

After  the insertion of a chest tube for a GSW of the chest today, It was
very  difficult to convince the ED resident that the chest radiograph
showed the  chest tube in the correct position and the bullet pathway was
through the  lung was medial to lateral (obvious on the film) therefore
the CT of the  chest would provide us with no additional usefully
information. Whatever  happened to thinking? Is this my senility to
believe that a physical  examination, a simple chest radiograph and an
eye-scan coupled with  thinking would properly assess care of the
patient? Oh and yes the vital  signs were within normal limits as well. I
even touched the patient, felt  warm, moist skin, that was pink and with
good capillary refilling  time

They still wanted a CT. I said "no" to their unhappiness. They  asked me
3 additional times. The answer to each was  "NO"

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Norm McSwain made a mistake Re: ABC - a different take