Episode 82 – Emergency Radiology Controversies

Emergency Medicine Cases

Dr. Anton Helman

Science, Courses, Medicine, Health & Fitness, Education

4.7 • 602 Ratings

🗓️ 7 June 2016

⏱️ 69 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

EM Cases Episode 82 Emergency Radiology Controversies, pearls and pitfalls: Which patients with chest pain suspected of ACS require a CXR? What CXR findings do ED docs tend to miss? How should we workup solitary pulmonary nodules found on CXR or CT? Is the abdominal x-ray dead or are there still indications for it's use? Which x-ray views are preferred for detecting pneumoperitoneum? When should we consider ultrasound as a screening test instead of, or before, CT? What are the indications for contrast in abdominal and head CT? How should we manage the patient who has had a previous CT contrast reaction who really needs a CT with contrast? What is the truth about CT radiation for shared decision making? And much more...

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases Podcast.
0:05.8	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC Studios in Toronto. In this 82nd episode on radiology controversies, we have the one and only
0:31.5	walking encyclopedia of emergency medicine, Dr. Walter Himmel.
0:36.0	And for the first time ever on EM cases, a radiologist,
0:39.7	Dr. Ryan Margoe, the clinical director of interventional radiology and the deputy chief of
0:44.8	medical imaging at North York General Hospital. Now, before we jump into the radiological
0:49.8	pearls and pitfalls episode, I wanted to let you know about a fantastic course to help you sharpen
0:55.7	your orthopedic skills, the Casted course. It's hands down the best hands-on orthopedic
1:02.5	course for emergency doctors. The amazing thing about the course is that Aaron and his crew travel
1:07.7	all over the country to bring you the course. So he does dozens of these courses every year.
1:13.6	Go to castid.ca.ca.
1:15.3	To find a course that's near you.
1:17.6	And if you haven't already signed up for the EMKase's Q&A Pearl of the week,
1:21.8	where you receive one free practice changing pearl in your inbox each week,
1:25.7	go to the EMKase's website and hit the sign up for our
1:29.0	newsletter button. And now, radiology controversies. In the U.S. over the last 15 years, there's
1:36.3	been a faster increase in imaging utilization than any other physician service, including
1:42.3	major procedures and lab tests. In Canada, we run up an annual
1:47.7	radiology bill of more than $2.2 billion. This escalation in imaging is likely due to a variety
1:56.8	of factors, including availability of technology, inappropriate imaging referrals, increasing
2:04.1	patient expectations, overuse of follow-up imaging, vague reports, incidental findings,
2:10.8	increasingly busy practices, and a paucity of resources and guidelines.
	...

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