UCSD Musculoskeletal Radiology
bonepit.com
New Critical results|
|
UCSD Musculoskeletal Radiology bonepit.com New Critical results |
TESTING AREA:
·
Radiology
1.
RED
CATEGORY CONDITIONS : COMPLETE ALERT WITHIN 1 HOUR
2.
ORANGE
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
3.
YELLOW
CATEGORY CONDITIONS: COMPLETE ALERT
WITHIN 2 DAYS
ANATOMICAL AREA
o
CNS
o
RED
CATEGORY CONDITIONS : COMPLETE ALERT WITHIN 1 HOUR
·
New Cerebral hemorrhage/hematoma
·
New intracranial mass effect with impending
herniation
·
New Acute Stroke
·
New Acute obstructive hydrocephalus
·
New Spinal cord compression (non-degenerative)
o
ORANGE
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
·
New Cerebral aneurysm without hemorrhage
(unruptured)
·
New brain abscess or tumor
·
New Spinal cord compression (degenerative)
o
NECK
o
RED
CATEGORY CONDITIONS: COMPLETE
ALERT WITHIN 1 HOUR
·
Epiglotitis
·
New Carotid or vertebral artery dissection
·
New retropharyngeal abscess
·
Suspected septic arthritis or osteomyelitis
o
ORANGE
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
·
New Critical carotid stenosis (>90 %) seen on CT,
MR, DSA
o
BREAST
o
ORANGE
CATEGORY CONDITIONS: COMPLETE
ALERT WITHIN 4 HOURS
·
Breast Abscess
o
CHEST
o
RED
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
·
Tension pneumothorax
·
Ruptured aneurysm or impending rupture
·
New Central or large Pulmonary embolism
o
ORANGE
CATEGORY CONDITIONS: COMPLETE
ALERT WITHIN 4 HOURS
·
New pneumothorax
·
Aortic dissection (new or changed)
·
New pneumonia
·
New evidence of TB
o
ABDOMEN
o
RED
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
·
Free Air in abdomen (if no recent surgeries
within seven days)
·
Active bleeding/extravasation, whether from
laceration, AAA, retroperitoneal bleed, etc.
o
URO-
GENITAL
o
RED
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
·
Ruptured Ectopic pregnancy
o
ORANGE
CATEGORY CONDITIONS: COMPLETE ALERT
WITHIN 4 HOURS
·
New Large Placental abruption (more than 50%) (2nd
or 3rd trimester)
·
Testicular or ovarian Torsion
o
VASCULAR
o
ORANGE
CATEGORY CONDITIONS: COMPLETE ALERT
WITHIN 4 HOURS
·
New DVT or extremity vascular occlusion
o
BONE
o
RED
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
·
Any new spinal fracture threatening mechanical or
neurological stability
·
Suspected septic arthritis or osteomyelitis, not
including those in the diabetic foot
·
Any new spinal tumor affecting mechanical or
neurological stability
·
New Joint dislocation
o
ORANGE
CATEGORY CONDITIONS: COMPLETE ALERT
WITHIN 4 HOURS
·
Any new fracture or dislocation not otherwise
specified
o
GENERAL
o
RED
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
·
Significant Line/or Tube misplacement (e.g.
feeding tube in airway)
·
Any significant test re-read, resulting in a red
condition diagnosis
o
YELLOW
CATEGORY CONDITIONS: COMPLETE
ALERT WITHIN 2 DAYS
·
New finding highly suggestive of malignancy (e.g.
new nodule on CXR, diffuse lymphadenopathy on abdominal CT)
o
NUCLEAR
MED
o
RED
CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
·
Acute gastrointestinal blood loss imaging
·
Pulmonary perfusion imaging with aerosol
ventilation imaging with “intermediate” or “high” probability findings
·
Brain imaging vascular flow
(for brain death)
·
Kidney imaging with vascular flow and function
(Renal Transplant Evaluation)-with acute abnormality
o
ORANGE
CATEGORY CONDITIONS: COMPLETE ALERT
WITHIN 4 HOURS
·
Three Phase bone scan showing “osteomyelitis
pattern”
·
Myocardial perfusion imaging tomographic (SPECT)
suggestive of ischemia
·
Radiopharmaceutical localization of infectious
process (WBC scan)
·
Liver function study with HIDA agents, showing
“acute cholecystitis” or “bile leak”
o
YELLOW
CATEGORY CONDITIONS: COMPLETE
ALERT WITHIN 2 DAYS
·
Bone scan showing “potential for pathologic
fracture”
Radiologists only
need to treat these conditions as “critical” if:
I: There is a high
degree of certainty that the patient has one of these conditions, and
II: There is a
reasonable chance that the ordering provider was not aware of the condition when
the test was ordered.
In addition, the
radiologist must include in his/her report the name of the person contacted and
the date and time at which the contact was made.
OLD
TESTING AREA:
· Radiology
1. RED CATEGORY CONDITIONS : COMPLETE ALERT WITHIN 1 HOUR
2. ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
3. YELLOW CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 2 DAYS
ANATOMICAL AREA
o CNS
o RED CATEGORY CONDITIONS : COMPLETE ALERT WITHIN 1 HOUR
· New Cerebral hemorrhage/hematoma
· New intracranial mass effect with impending herniation
· New Acute Stroke within six hours of clinical presentation
· New Acute obstructive hydrocephalus
· New Spinal cord compression (non-degenerative)
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· New Cerebral aneurysm without hemorrhage (unruptured)
· New brain abscess or tumor
· New Spinal cord compression (degenerative)
o NECK
o RED CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
· Epiglotitis
· New Carotid or vertebral artery dissection
· New retropharyngeal abscess
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· New Critical carotid stenosis (>90 %) seen on CT, MR, DSA
o BREAST
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· Breast Abscess
o CHEST
o RED CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
· Tension pneumothorax
· Ruptured aneurysm or impending rupture
· New Central or large Pulmonary embolism
· New or Enlarging Ascending Thoracic Aortic Aneurysm > 5.5 cm
· New cardiac valvular vegetations seen on Gated CT or MR
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· New pneumothorax
· Aortic dissection (new or changed)
· New pneumonia
· New evidence of TB
o ABDOMEN
o RED CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
· Free Air in abdomen (if no recent surgeries within seven days)
· Active bleeding/extravasation, whether from laceration, AAA, retroperitoneal bleed, etc.
o URO- GENITAL
o RED CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
· Ruptured Ectopic pregnancy
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· New Large Placental abruption (more than 50%) (2nd or 3rd trimester)
· Testicular or ovarian Torsion
o VASCULAR
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· New DVT or extremity vascular occlusion
o BONE
o RED CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
· Any new spinal fracture threatening mechanical or neurological stability
· Suspected septic arthritis or osteomyelitis, not including those in the diabetic foot
· Any new spinal tumor affecting mechanical or neurological stability
· New Joint dislocation
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· Any new fracture or dislocation not otherwise specified
o GENERAL
o RED CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
· Significant Line/or Tube misplacement (e.g. feeding tube in airway)
· Any significant test re-read, resulting in a red condition diagnosis
o YELLOW CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 2 DAYS
· New finding highly suggestive of malignancy (e.g. new nodule on CXR, diffuse lymphadenopathy on abdominal CT)
o NUCLEAR MED
o RED CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 1 HOUR
· Liver function study with HIDA agents, showing “bile leak”
· Acute gastrointestinal blood loss imaging
· Pulmonary perfusion imaging with aerosol ventilation imaging with “intermediate” or “high” probability findings
· Brain imaging vascular flow (for brain death)
· Kidney imaging with vascular flow and function (Renal Transplant Evaluation)-with acute abnormality
o ORANGE CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 4 HOURS
· Three Phase bone scan showing “osteomyelitis pattern”
· Myocardial perfusion imaging tomographic (SPECT) suggestive of ischemia
· Radiopharmaceutical localization of infectious process (WBC scan)
o YELLOW CATEGORY CONDITIONS: COMPLETE ALERT WITHIN 2 DAYS
· Bone scan showing “potential for pathologic fracture”
Radiologists only need to treat these conditions as “critical” if:
I: There is a high degree of certainty that the patient has one of these conditions, and
II: There is a reasonable chance that the ordering provider was not aware of the condition when the test was ordered.
In addition, the radiologist must include in his/her report the name of the person contacted and the date and time at which the contact was made.