From: "Izan Gill" <[EMAIL PROTECTED]>

Thanks Dieter, I'd like to see those guidelines.

With no close Radiologist backup, it's reasonably easy to convince 
the 2 ho=
spital doctors of any change to previously accepted gospel, but 
much harder=
 to win over the 8 local GPs.=20

Last year's PHO has gone to start his Radiology training and I've 
asked him=
 for details; I assume that the RNZACR Imaging Guidelines book is 
his regul=
ar bedtime reading.=20

As to price - is this the same for erect/ supine and plain supine? I 
just f=
ill in the Medicare form as AXR, not E/ S and have had no queries.

Izan Gill


>>> [EMAIL PROTECTED] 02/05/03 09:09pm >>>
 From: Dieter <[EMAIL PROTECTED]>

Our department of casual medicine has recently introduced 
guidlines for the=
 requesting of abdominal xrays which are both reasonable and=20
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=20
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=20
>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=20
>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 
hea=
lth.
>
>
>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=20
>this viewpoint
>before.
>
>For shaky/ frail patients I used always sit them with their back to 
the=20
>erect bucky,
>(provided they could sit up that is) and do an erect film that way. 
The=20
>thighs did tend
>to get in the way a little, but it worked well. However, where I=20
>work  now, the tube
>does not come low enough to do that. So it's either risk 
standing=20
>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=20
>chest=3D20
>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]=20
>Subject: Re: [AIRNEWS] Risk Management
>From: "Fraser Levey" < [EMAIL PROTECTED] >
>Interesting point from a radiation safety perspective too. Many 
UK=20
>hospitals do not
>routinely perform Erect Abdomens as they are seen as 
clinically=20
>irrelevant. Most
>pathology demonstrated is either clinically obvious or 
radiologically=20
>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=
=3D20
>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=20
>insists we do
>not. Is it then possible to eliminate this exam and thus the risk 
(we=20
>haven't been
>able to eliminate due to referral base and other radiologists non 
acceptan=
ce)



 
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