11 Tips for New FY1s - How to Request Imaging
There's no reason to be scared of radiologists - here's what to know before you request a scan
Â
1) Know your patient and summarise effectively:
If a colleague asks you to "just arrange a scan" and you aren't sure why...ask them!
2) Have a clinical question:
"PE or not PE" is a much easier question for a radiologist to answer with a CTPA rather than "chest pain ?cause".
Radiologists can suggest the type of scan to best answer your question, with the lowest radiation dose
3) For CT:
Contrast Allergy Renal function Pregnancy Cannula
4) For MRI:
Pacemaker or other metal implants Renal function Contrast Allergy (gadolinium) Pregnancy Claustrophobia Need for sedation
5)For Ultrasound:
There are virtually no contra-indications! For abdominal ultrasound - the last meal and fasting time
6) How stable is the patient?
Do they need an urgent portable ultrasound or xray? If they come to the radiology department, do they need a medical escort?
7) Not all hospitals will require you to call the radiologist:
Some scans will be approved based on an electronic form. Radiographers are often able to approve requests that meet certain guidelines such as the NICE head injury rules
8) Know the urgency of your request:
For example, chronic symptoms such as weight loss, abdominal mass, and loss of appetite may warrant a CT. However, this would not usually be performed out-of-hours, when the imaging department needs to focus on emergencies.
9) Is there relevant previous imaging?
Radiologists will compare a new and old scan ie to assess if a cancer has grown or shrunk.
10) Ask yourself - what actions will I take based on the results?
This is the best way to focus your thinking down to a clinical question
11) Lastly, see it as a referral to another specialty, not an admin task:
Use your slick OSCE skills to present the case. Or, visit the on-call radiologist in person. It's lonely in the reporting room, and we'd love to answer your questions and sell you on the best specialty!