31.1 CT referral checklist
CT referral checklist (see Chapter 7)
The imaging referral form is a legal document. The referrer carries the responsibility to ensure the correct and complete information is conveyed to the Imaging Department so that the patient is appropriately diagnosed and managed.
- Patient identification: The referrer must ensure that the Imaging Department receives the correct identification details of the patient to be investigated: full name, date of birth and hospital identification number are the essentials.
- Clinical status: The referrer must convey the patient’s clinical condition and urgency of the referral to the Imaging Department. CT has now become a mainstay for definitive diagnosis in both the emergency and elective setting.
- Patient mobility: CT can be used to image the very well to the very sickest of patients. However, in unstable patients the clinical risk of transferring the patient to the CT scanner must be weighed up against the clinical urgency for diagnostic information for management planning or therapeutic intervention. This avoids the CT scanner being labelled the ‘doughnut of death’ by reducing the risk of patients suffering a cardiac arrest on the CT table. The referrer must also confirm the CT table’s maximum licensed weight with the scanning radiographer, before referring patients with a high body mass index.
- Patient location and travel details: The need for a clinical escort should be conveyed and the points of departure and return and contact details must also be notified to the Imaging Department to ensure the patient is transferred safely and efficiently. For multi-trauma patients or patients from the intensive care unit, an anaesthetist or intensive care physician escort may well be required.
- Indications: Multi-detector CT can now reveal a huge range of pathology in most parts of the body. CT is also commonly used for interventional radiology procedures, e.g. biopsy and drainage of fluid collections. The referral indication should always include a salient history and a specific question to be answered by CT.
- Contraindications:
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