Even though I have just started as an ST1 radiologist, the assumed responsibility can be rather daunting.
Expectations arising from being a registrar involve prioritising scan requests and negotiating with fellow colleagues for a better investigation to answer a clinical question. Appropriately prioritising scans have great impacts on the care of patients, as it would facilitate earlier diagnosis and management. All hospitals have limited resources - time, scanners and of course, radiologists! As a result, inappropriate prioritisation can have devastating consequences.
Being attached to a trauma center, scenarios such as below is very common:
A young patient involved in a road traffic collision (RTC), low GCS and hypotensive.
Immediately, my thoughts were -
Is this patient well enough to be scanned? Should the patient go straight to theater without being scanned?
Discussing with my referring colleagues, I was able to elicit more clinical details regarding the haemodynamic status and airway protection (low GCS).
There have been many situations where patients crash whilst being scanned and I do wonder if they may have survived if they had gone straight to the operating theater. Furthermore, when concerned about low GCS affecting airway protection issues, an anaesthetist should always be present. What if the airway becomes compromise mid-scan? Will an airway competent clinician arrive in time to prevent hypoxic brain injury or aspirations?
As a radiologist, our role most certainly extends beyond "just looking at scans".
Ultimately, we are clinicians who make safe clinical decisions with contingency plans for patients.
This is all in being an incredible registrar in Radiology. Never compromise patient's safety.