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?

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u/Crunchygranolabro ED Attending Jul 21 '24

How do you propose they ensure appropriate diagnostics be done for a time sensitive issue?

You are aware that intermittent torsion is a thing right?

-10

u/KumaraDosha Jul 21 '24

Yep, posted about it myself in a different chain of comments. I never said I agree with the sonographer’s opinion; not showing up for a testicle is wild (let alone saying flat-out no to a doctor for almost anything within scope of practice). What I don’t agree with is lying. If imaging is unavailable or refuses to perform for any reason, there are plenty of alternatives to lying to your staff. Have you never had your CT machine/s go down? Transfer, send the problem up the chain of command, etc.

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u/D15c0untMD Jul 21 '24

What are the alternatives? When the CT goes down we have procedures in place that spread the load across the other machines on site, or even divert ambulances to other hospitals with working diagnostics. If my rad techs just dont do their job, what am i supposed to do, call dispatch and say „divert emergencies to hospital xy, our techs don’t feel like it today.“? I have a problem to solve now, and more than likely more than one. If the the results are important i‘ll do whatever is most feasible to get them, if that’s lying to the rad tech about a patients history to circumvent their personal brand of idiocy then that’s what i‘m gonna do and we’ll have the official discussion with all our supervisors later after shift

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u/KumaraDosha Jul 21 '24

How will lying next time it happens fix your current problem? Also yeah, if you have no CT staff, you do the thing you said. Good job, you figured it out!