From: Dieter <[EMAIL PROTECTED]>

Our department of casual medicine has recently introduced guidlines for the 
requesting of abdominal xrays which are both reasonable and 
intuitive.  They go a long way to reducing axr -sup and erect on every abdo 
pain that walks through the door.

Unfortunately the new batch of interns/residents needs to be retrained 
along those guidelines, hopfully before their 6 months is up and they move 
on and we get another batch.

I'll post the guidelines soon

Dieter

At 08:44 4/02/2003 +1000, you wrote:
>  From: "Fraser Levey" <[EMAIL PROTECTED]>
>
>Maybe so, but it does suggest to referring doctors what is clinically 
>relevant and
>does reduce spurious requesting to some extent. It gives the radiographer 
>some
>written back up when faced with a request of dubious clinical worth.
>Anything which backs up the radiographer's position as the radiation 
>safety expert
>has to be a good thing.
>
>I'm fine thanks, and you?
>
>
> >>> John Andersen 02/03/03 02:53pm >>>
>Really!! That book is written with the $'s sign in mind, not radiation health.
>
>
>How are you by the way?
>
> >>> [EMAIL PROTECTED] 3/02/2003 12:48:30 pm >>>
>From: "Fraser Levey" < [EMAIL PROTECTED] >
>Try the RANZCR Imaging Guidelines book, the UK's College of Radiologists 
>does a
>similar book as well, both contain useful information on what is viewed by
>radiologists as clinically relevant.
>I strongly recommend the use of the RANZCR Imaging Guidelines though.
>Fraser.
>
> >>> [EMAIL PROTECTED] 02/03/03 11:41am >>>
>From: "Izan Gill" < [EMAIL PROTECTED] >
>
>I'd be very interested to see the rationale for supine only. I get rather 
>a lot of
>"routine" erect/ supine AXRs with CXR and would like some way of cutting 
>back,with
>literature (not necessarily from textbooks) to back this up. I've heard 
>this viewpoint
>before.
>
>For shaky/ frail patients I used always sit them with their back to the 
>erect bucky,
>(provided they could sit up that is) and do an erect film that way. The 
>thighs did tend
>to get in the way a little, but it worked well. However, where I 
>work  now, the tube
>does not come low enough to do that. So it's either risk standing 
>the  patient up or a
>decubitus.
>Izan GiIl
> >>> [EMAIL PROTECTED] 02/02/03 04:48pm >>>
>From: "Rita Richter" < [EMAIL PROTECTED] >
>
>
>
>Very valid point about the radiation dose with the extra erect abdo film.
>
>Does that mean therefore that most places do only a supine film and AP 
>chest=20
>in the bed?
>
>
>Rita
>
>-----Original Message-----
>From: [EMAIL PROTECTED][ mailto:owner-
>[EMAIL PROTECTED]]On Behalf Of Fraser Levey
>Sent: Friday, 31 January 03 1:37 PM
>To: [EMAIL PROTECTED]
>Subject: Re: [AIRNEWS] Risk Management
>From: "Fraser Levey" < [EMAIL PROTECTED] >
>Interesting point from a radiation safety perspective too. Many UK 
>hospitals do not
>routinely perform Erect Abdomens as they are seen as clinically 
>irrelevant. Most
>pathology demonstrated is either clinically obvious or radiologically 
>ambiguous.
>
>The elimination of such examinations would reduce a patients skin entrance 
>dose
>by about 3.5 mGy, which is a fair old amount, which equates to about 35 PA=20
>chest exposures worth of radiation.
>
>This, combined with the far greater risk of patients keeling over, would 
>make me
>wish to ensure that the referral is justified before exposing patients.
>
>Fraser.
>
> >>> [EMAIL PROTECTED] 01/31/03 09:33am >>>
>From: "Garry Cain" < [EMAIL PROTECTED] >
>
>do you really need an erect abdo at all. we have one radiologist that 
>insists we do
>not. Is it then possible to eliminate this exam and thus the risk (we 
>haven't been
>able to eliminate due to referral base and other radiologists non acceptance)



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