The clinical and imaging team in the ICU

Patient care in the ICU is optimized when the clinical and imaging departments function as a team. Co-operation should begin at the design stage for the purchase and deployment of new imaging equipment and carried through to where and when the clinical and imaging teams meet in consultation. The simple task of properly noting pertinent clinical information with the radiological request can enormously benefit the patient's care as well as reduce the cost of these services. Co-ordination of the routine morning portable examination times so that the images and interpretation are available for morning clinical rounds should be standard. The radiological technologist should understand enough about patient care to co-operate with the nursing staff in consistently obtaining high-quality radiographs in these often difficult patients, and the nursing staff should understand enough of the technologist's duties to be able to help, particularly in stabilizing multiple catheters and monitors, so that the vital clinical function of these devices is not interrupted as the patient is positioned for radiography. The technologists should be trained in the basics of film and processor quality assurance. Each film should be reviewed as it is developed, not only for quality but also for any medical problems requiring immediate attention. Not only should the radiologist be prepared to contact the clinical team immediately with verbal reports of such findings, but the clinical team should be readily available to receive such reports.

One of the great advantages and, paradoxically, one of the great dangers inherent in digital systems is the ability to obtain and simultaneously to deliver diagnostic images to the ICU as well as other diagnostic nodes. This dispersion of the medical image may inadvertently lead to the loss of vital consultation between the radiologist and the clinician, with the result that optimal patient care is jeopardized.

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