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BMJ Qual Saf doi:10.1136/bmjqs-2012-000817
  • Editorial

Medical emergencies in medical imaging

  1. Donald A Redelmeier1,2,3,4
  1. 1Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
  2. 2Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  3. 3Clinical Epidemiology Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
  4. 4Centre for Leading Injury Prevention Practice Education & Research, Toronto, Ontario, Canada
  1. Correspondence to Dr Donald A Redelmeier, Sunnybrook Health Sciences Centre, G-151, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada; dar{at}ices.on.ca

Sending inpatients to the medical imaging department is sometimes tantamount to discharging them from hospital for hours at a time. Consider, for example, a patient with an unexplained acute abdomen where an urgent CT scan is indicated. Patient transport, logistical delays and the procedure itself may lead to gaps in monitoring vital signs, providing intravenous fluids and administering medications (eg, antibiotics, antianginals and analgesics). For stable patients, even basic tasks such as eating, toileting, physical therapy, family meetings and discharge planning can be problematic while undergoing medical imaging. Ironically, the gaps in general medical care for inpatients in a medical imaging department may occur in full view of healthy outpatients awaiting elective imaging procedures.

This issue of the journal contains a descriptive study by Ott and colleagues that highlights how medical emergencies in medical imaging departments are neither rare nor benign.1 The study examined life-threatening changes in patient status occurring in the medical imaging department of one large American hospital over a 2-year period. The overall frequency averaged about one event per week. Forty per cent of patients originated from critical care wards and about half of the events occurred on the patient's first day of admission. No single physiologic change was responsible for more than a …

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