Congress:
EuroSafe Imaging 2021
Keywords:
Obstetrics (Pregnancy / birth / postnatal period), Pulmonary vessels, Radioprotection / Radiation dose, CT, Plain radiographic studies, Ultrasound, Audit and standards, Education, Radiation safety, Education and training, Embolism / Thrombosis, Obstetrics
Authors:
K. V. Harries, H. T. V. Sivashankar, S. Syed, I. Syed, N. Balaji
DOI:
10.26044/esi2021/ESI-12385
Results or findings
All pregnant women admitted to our District-general-hospital with suspected VTE, over a 4 month period, were retrospectively audited.
A questionnaire was distributed to the junior doctors, to gauge familiarity with the RCOG diagnostic pathway.
The utilisation of diagnostic imaging; Chest Radiographs, Doppler Ultrasound, CT Pulmonary Angiograms and Ventilation-Perfusion scans, was reviewed. In addition to this, the patient notes were analysed to see whether the risks of these scans were explained to the patient and whether consent was documented.
Initial results of the questionnaire
- The questionnaire established 42% of doctors chose initial correct imaging
- Only 22% felt confident explaining the risks and safety measures used for suspected VTE in pregnancy (Figure 1a)
Results of our analysis of Diagnostic imaging usage and Consenting
- 81% of patients had a chest radiograph, the remaining refused due to fear of radiation.
- 50% of Ultrasound Dopplers were inappropriate
- Only 32% of patients had radiation risks explained
- Only 36% had documented consent
These findings demonstrated that the RCOG guidelines for suspected VTE are poorly adhered to. In order to educate and inform junior doctor colleagues, a poster with an imaging flow chart was displayed in common areas (Figure 2). Furthermore, an easy-to-use patient leaflet was distributed, which explained the imaging pathway and risks associated with radiation exposure(4,5) (Figure 3).
After the intervention, 94% identified appropriate imaging modalities, and 91% felt confident explaining the risks (Figure 1b).