X

X-rays: Emergent films

X-ray films may be ordered “Routine” as are morning films to follow a pulmonary condition. Most NICU films are ordered “Urgent” for admissions, line placements, a change in a patient’s condition, etc. Radiology’s intent is to respond to “Urgent” call within 30 minutes. Although the radiology technicians will come to an Urgent NICU call as quickly as they possibly can, they are also needed in the PICU for the care of critically ill patients and the request for an Urgent NICU film must be placed in the queue.

In the event that an X-ray must be obtained IMMEDIATELY (a life or death situation/code event; for ex. to rule out pneumothorax or pneumopericardium or to diagnose CDH in a patient failing to respond to resuscitation in the delivery room), the NICU can page the X-ray technician to the nursery using the code 911 “Emergent.” In this case the technician will come immediately to the nursery postponing all other patient responsibilities.

Since the institution of this policy, this privilege has, on occasion, been misused. Physicians should not order “Emergent” films unless there is a true life or death emergency. Nurses should not order “Emergent” films unless physician-specified. The medical receptionists must understand that “Urgent” films (for line placements, etc.) DO NOT mean “Emergent” and they MUST NOT page 911 unless physician-specified.

Announced at the Collaborative Pathways Committee meeting 11/28/01. Revisited 8/10/02.