US won’t come in if pain >12hrs

[u/Former_Bill_1126]

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?

[u/thedailyscanner]

I’ve been traveling for a long time, all over the US, and I’ve never heard of such a dumb US protocol. Not only is that unacceptable, but that techs attitude sucks. I’d be nervous to have them do the scan in general, because that just reeks of incompetence to me, and ultrasound is very tech dependent.

I’ve had to take call for multiple locations at once before (same hospital system), and sometimes I would have a 2-3 torsion studies ordered at the same time. It always sucked because it felt like having to choose which to do first was “practicing medicine”, and I would go by which clinical indication sounded most likely to be torsion. It was a disaster. As it turns out, I can’t predict shit because A: I have not accomplished medical school/residency and my education has serious limitations B: I haven’t examined the patient and C: Can’t be in more than one place at a time. The hospital wouldn’t pay to keep a tech staffed overnight, especially not at the satellite ER’s. Our department begged, to no avail. We were all freaking exhausted.

It took ONE bad outcome. ONE.

Apparently the cost of one lawsuit greatly outweighs having a few extra techs on staff. All of the locations are staffed overnight now. All these years later I still wonder what the settlement was. I bet it wasn’t even that crazy, the lawyer fees were probably more.

If that’s an actual protocol, your hospital needs to pull its head out of its ass, AND so does that tech. Torsion is one of those things where “protocol” goes out the window. It’s ultrasound for fucks sake, which is about as harmless as it gets.

If I were in your shoes, I’d probably do a POCUS course. I don’t trust techs that drag their feet during actual emergencies. And never, never trust admin to do the right thing by the patient.

Ps. I’m sorry for the asshole tech. We aren’t ALL awful… there are at least a dozen of us that still care lol

[u/Former_Bill_1126 → u/thedailyscanner]

100% you’re not all awful; I love the US techs. Vital member of the team, and completely integral to appropriate patient care which is why it’s so frustrating when you aren’t available 😂. That sounds like a rough spot you were in, and it’s difficult to ask an ER doc “ok but for real, I have 3, is yours the most important?” Because they’re all likely to say theirs is the most important :P. That being said, a good ER doc understands how to work within limited resources, and I’ll be honest, the few cases of real torsion that I’ve seen, I was on the phone with urology immediately after seeing the patient, not waiting on the ultrasound :P so some of that is on the doc for not escalating care more quickly unless it was a really abnormal case and she was absolutely shocked that the scan showed torsion. She should’ve called the urologist early on that one.