r/emergencymedicine • u/Former_Bill_1126 ED Attending • Jul 20 '24

Advice US won’t come in if pain >12hrs

Working at a new site, US techs are very picky, will not come in for torsion studies if pain is >12hrs. I talked her into coming in and she’s pissed af, said she knows I’m new and “I’ll learn the protocol”.

Am I in the wrong?

Edit: Does anyone support the US tech or rad protocol and do you have any studies or evidence to support this practice? I’m just wondering if they pulled this out of their ass or where they got the arbitrary 12 hour thing?

161 Upvotes

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523

u/Drew_Manatee ED Resident Jul 20 '24

Sounds like your next patient will have been having pain for only 10 hours. And then once the US tech gets to the hospital you can let them know you must have misheard the patient and as it turns out, their pain has been for more than 12 hours. "But since you're already here, why don't you just scan them anyway?"

Alternatively wait until after the scan to report that the patient is now remembering they had the pain for more than 12 hours. Those silly patients, always losing track of time.

169

u/Former_Bill_1126 ED Attending Jul 20 '24

Yeah, it’s actually an NP patient, but I wasn’t comfortable with them not getting the US so called the tech back myself. I told him my new thing will be “yeah patient says 3 days of pain but it suddenly got worse 11 hours ago”

-142

u/KumaraDosha Jul 20 '24

And this is why ultrasound techs don’t trust y’all. Do not do this.

55

u/Kabc Jul 20 '24

Would help if people could get tests that rule out things that can make them lose body parts in a timely manner

-16

u/KumaraDosha Jul 21 '24

In this case, warning the sonographer that they will reported in a MIDAS event or other such documentation/contact if they don’t come in on call for this is all you need. There’s no need to stoop to unethical and untrustworthy tactics that erode vital and irrecoverable trust. If they still say no, there are protocols to use to treat this as an incident where there is no ultrasound staffed. I’m fairly confident this method won’t have to be used many times before the issue is resolved (or else you need to work elsewhere, lmao).

25

u/Crunchygranolabro ED Attending Jul 21 '24

lol. “I threatened a patient safety report” isn’t a viable med-mal defense. If I worked in this department I’d have the heads of radiology and the CMO on speed dial.

5

u/KumaraDosha Jul 21 '24

Also a valid option! I don’t know why people think I’m arguing things I’m straight-up not arguing over. You’re literally coming up with ideas alternative to lying all by yourself, which is what I encouraged in the fist place, good job.

11

u/Comprehensive_Elk773 Jul 21 '24

I don’t think you know what you are talking about there

-6

u/KumaraDosha Jul 21 '24

Oh do tell me which part you’re ignorant about.