The Role of the Radiologist with On Site Presence in the Night Shift in a Central Hospital

Abstract

Introduction: The goal of this study was to understand the role of the on-site radiologist during the night at the emergency department of a central hospital, through the analysis of the impact of the ultrasonography exams on the management of patients, namely if they made it possible to eliminate the need for computed tomography.

Methods: Observational and retrospective study that analyzed the ultrasonography exams of 300 patients that came to the emergency department between 8 p.m. and 8 a.m., from 1 to 17 of November of 2023. The following variables were considered: sex, age, date of admission, reason of emergency department visit, triage, referral from another hospital, reason for performing ultrasonography, type of ultrasonography, ultrasonography diagnosis, time between the exam request and its performance, time between exam performance and 8 a.m., management after ultrasonography, other imaging exams, final diagnosis, final management of the patient, emergency department readmission.

Results: 384 ultrasonography exams were performed, which allowed to manage or to successfully exclude pathology in 91,7% of the patients. The rest of the patients had to be subjected to computed tomography for a better clarification of the clinical picture, in a total of 29 exams. A readmission rate of 7,5% was observed, considering patients that were only subjected to ultrasonography evaluation on their first admission at the emergency department.

Conclusion: The performance of a considerable number of computed tomography scans was avoided, due to access to ultrasonography examinations during the night, which allowed to expedite the management of patients and minimized unnecessary risks, such as high doses of ionizing radiation and potential adverse reactions to the contrast medium utilized.