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/Rigamoroll]

Long time MRI tech here. After years of on call service, IMHO it should absolutely be the radiologist on call, after consulting with the attending to determine the acuity of the case, and to determine the appropriate modality for imaging, who informs the technologist to come in and scan the patient. Otherwise, in my experience, we are on multiple phone calls all night and constantly coming in for routine scans, wrong modality choice for optimal imaging, or cases that won’t go to the OR until 3pm the next day, all night long. If it is emergent, then of course it is appropriate. No disrespect to the docs and residents out there, but “emergent” is increasingly becoming confused with “convenient”, and/or “we just want it now”. Please don’t forget we still have an entire shift to work the next day. All we ask is that all ducks are in a row before we are asked to drive in in the middle of the night. 🤷🏻‍♀️

[u/Former_Bill_1126 → u/Rigamoroll]

The issue with this, however, is that it is frequently clogging up an ER even if the rad tech or even radiologist doesn’t consider the test “emergent”. That can adversely affect patient outcomes if someone is taking up a bed for 14+ hours waiting on a CT or ultrasound.

Further, 95% of the studies we do probably have negative results, but we get them to catch the 5% positives. In other fields this would seem very wasteful, but in medicine, we are dealing with people’s lives.

It’s one thing for a doctor to say “oh it looks fine, it doesn’t look like torsion” and another for a doctor well validated imaging study to show good blow flow to the testicles. If it were you, your husband, your child, you’d probably want the imaging rather than the doctor’s opinion. Particularly in a litigious society such as the US, I’m wanting to confirm my diagnosis with imaging to make sure I’m not missing anything.

Also, at many small hospitals, the CT can radically affect the next steps. Stone in the common bile duct? Well we don’t have ERCP, so we will need to transfer that patient. It’s much easier to transfer from ER than from inpatient, so if we had admitted that patient to sit and wait for CT in the morning, it may delay their transfer for days to get the appropriate procedure they need.

Nothing we do is to frustrate people. It’s all in the name of either what’s best for the patient or, admittedly, covering our own asses so we don’t get sued. A lawsuit it an absolute nightmare and something that MOST ER docs will at some point have to deal with. The stress it places on you is unfathomable. Reducing the risks of that nightmare are very important to us.

[u/4883Y_ → u/Former_Bill_1126]

As CT, I always be scanning regardless. I’m much more likely to send you a message asking if you want anything else while they’re on my table/before they go upstairs to avoid multiple trips. 😂

[u/Former_Bill_1126 → u/4883Y_]

You’re the real MVP lol. Techs are under appreciated, and you guys frequently save the day. I’ve had a brain bleed missed by radiology that CT caught. I’ve had CT call me and recommend adding on additional imaging that had caught critical findings. Literally cannot imagine life without 24/7 CT.

[u/4883Y_ → u/Former_Bill_1126]

Thank you so much. That really means a lot to us. 🥹❤️