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OUT OF HOURS CT
Some emergency departments in the UK are still reluctant to implement the NICE head injury guidelines, partly because of the perceived need to call radiologists out of hours. However, some emergency physicians have confidence in their ability to interpret head CT scans sufficiently well to not require a radiologist’s opinion. An Australian study might challenge this confidence (
) . Twenty-one senior emergency physicians were put through their paces, each being given 15 scans to review. The formal radiology report was considered the gold standard. Of the 300 or so scans in total, 75 were abnormal. Emergency physician interpretation agreed with the radiology report only 67% of the time. 32 of the 75 abnormal scans were “missed”, but none were major bleeds, so it is debatable whether the “mistakes” would have resulted in significant adverse clinical effects.