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CT stroke protocol
We have to make a phone call to the ordering doctor (usually ER) for these studies, even if negative. Its rather cumbersome when multiple exams are done per day. They usually do an immediate CTA head and neck. I want to switch it to a call if positive standard. Any thoughts about this issue in general?
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5 Replies
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Quote from jimbob899
We have to make a phone call to the ordering doctor (usually ER) for these studies, even if negative. Its rather cumbersome when multiple exams are done per day. They usually do an immediate CTA head and neck. I want to switch it to a call if positive standard. Any thoughts about this issue in general?
What level of stroke facility are you ? Stroke ready, community, comprehensive ?
The requirement for the call is in the accreditation standards. Your call is what triggers the administration of TPA, so ‘call only if positive’ would introduce a delay. If done right , the patient rolls back into CT for the CTA/CTP with the TPA drip running. The advanced imaging is only to triage for intervention, not to diagnose the stroke.
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Thanks. Your answer is most likely correct. We are a community center. I guess my main frustration is that it disrupts the workflow and I sense it is overused. And the delay is really minimal.
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Quote from jimbob899
Thanks. Your answer is most likely correct. We are a community center. I guess my main frustration is that it disrupts the workflow and I sense it is overused. And the delay is really minimal.
Our ER docs carry cellphones and are waiting for the call. If there is a systemic delay in them being reachable, address that problem with the head of your stroke program. Btw. if your argument is ‘this causes an increase in the door to CT metric’, you are more likely to get a response than if your argument is ‘this is annoying and disrupts my cash flow’.
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We use a messaging app called qliqconnect, there are boatload of these…. I just have a prepopulated message that I can select that says (initial head CT images on the code stroke are negative) and it notifies me that they responded…. super quick and easy. Then when I have the final in VR with powerscribe, there is another prepopulated message that says final report avaialable… Obviously, if anything bad, will call them immediately
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I’ve thought about this too. Call only for positives. Seems like a hassle at times. Dial the phone, wait for it, ask to speak to so and so, wait, speak to them doc. etc.. When it could just be texted or assume it is normal unless called upon.
But I’m sure someone is going to point out some rare case where this could cause trouble.
