2023-05-29 10:38:32
Behind the International Day of Emergency Medicine and Emergencieswhich was this Saturday, from the Spanish Society of Medical Radiology (SCARY) shows that between 6 and 8 patients out of every 10 patients who attend the Emergency Services undergo one or more urgent imaging testsso that approximately 15 million radiological studies of this type per year in public hospitals. To this we must add other urgent studies carried out on admitted patients and ICUs, as the medical society itself has pointed out.
It is estimated that every 8-10 years in large hospitals the number of CT scans urgent (TCs), whose complexity has also increased. According to Jose Maria Artigasformer president of the Spanish Society of Emergency Radiology (Serau), one of the sections of SERAM, “CT is the ‘star tool’ in urgent pathologywhich has revolutionized all guidelines for clinical action “from head to toe”.
The use of CT in the Emergency Department is today essential in the management of pathologies such as stroke, chest pain, acute abdomen, gastrointestinal bleeding or severe trauma, among others. It improves diagnostic confidence and the admission or discharge decision and reduces the average stay and hospital costs.
Also the sonography it continues to be an essential tool in the ER, according to the SERAM. The demand for studies grows in quantity and especially in complexity, which is why proper training is important. “In clinical settings it has been defined as ‘the stethoscope of today’, which I consider a risky approach; are well known the bias inherent in mixing clinical judgment with diagnostic imaging impression or overuse. The ideal use of the integrated image is one of the training keys of the radiologist”, points out Artigas.
In the case of plain radiography, especially osteoarticular and thorax, continues to be very useful in the Emergency Department, where half of the total number of studies of this type carried out by the Radiodiagnosis Service are carried out, the figure of which remains the same or grows slightly in most centers. However, the magnetic resonance (RM) is gradually making its way as diagnostic support for Emergency Medicine (EM), adds the press release.
Importance of Emergency Radiology
The great demand for urgent imaging made it necessary to dedicate resources that later took on a “life of their own”, fostering a new way of doing Radiology in response to the specific needs of the urgent patient and to the cognitive guidelines of the EUTM. “Emergency Radiology (RU) is one that cannot be programmed. It means management to organize and temperance to do so in a sometimes difficult clinical and human context. In addition to the design and continuous evaluation of the care circuits with other services and within the Radiology Service. The protocolization of explorations and critical situations (breakdowns, saturation, catastrophes) can avoid errors and bottlenecks in the processes”, points out Artigas. In addition, “it makes it possible to immediately have precise information about a patient about whom everything can be unknown, it is of the utmost importance” he points out.
Radiology has been effectively and efficiently integrated into the algorithms and action protocols hospital emergency services, being a key tool in the management of their cases, from the most serious to mild cases, in order to refer each one to the appropriate care facility.
Artigas comments that “the role of the radiologist is fundamental, prioritizing those examinations that are more ‘time-sensitive’, such as a CT study in a potentially treatable stroke, or immediately communicating the most relevant findings on the vital or functional level, such as a focus of hemorrhage in a traumathe leading cause of preventable mortality in this clinical context. And both in large and small centers, wherever a clinician requests an urgent examination, a radiologist must quickly validate it and then manage its performance according to the clinical situation of the patient and the available resources”.
The Emergency Radiologist must “expect the unexpected”, immediately identify any finding that implies vital or functional risk, and be capable of evaluating large volumes of patients/studies, even managing catastrophes. All this, at ungodly hours, with frequent interruptions and in an environment prone to chaos.
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