It is important for CCT medics to have a strong understanding of basic x-ray interpretation, specifically that of chest x-rays.
A large number of interfacility transfers involve very sick patients who have undergone invasive procedures prior to our arrival. Rather than just taking the word of our fellow health care providers, it is helpful if we can look at an X-ray to confirm things for ourselves visually as well. We are all human, and mistakes happen. For instance, if we have a fairly good understanding of chest x-ray interpretation, we can visualize endotracheal tube placement. On top of that, we can check chest tube placement prior to departing with the patient. We can even look for lung injuries such as pneumothorax, atelectasis, infiltrates, etc.
We don’t have a great deal of time to spend looking at images at the sending facility. So, we shouldn’t feel uncomfortable asking for such visual confirmation. This is especially true if we have any doubts about the patient’s condition or invasive tube placement. With regards to chest tube placement, there are a number of complications that can occur during placement. Some of these complications do not immediately present in the patient. A chest x-ray can help to confirm that the thoracotomy tube was properly placed. While most of the time, the radiologist report in itself should be able to confirm this, it is just one more step in assurance if we look at the x-ray ourselves as well.
So just food for thought, the more we familiarize ourselves with chest x-ray interpretation, the more confident we can be in our transfers of critical patients with invasive lines and tubes.
Tara Reed, EMS Educator Critical Care