CLINICAL UPDATE ACUTE DEMAND PLAIN FILM XRAYS

20.08.20 CLINICAL UPDATE CONCERNING ACUTE DEMAND PLAIN FILM XRAYS

Please note that because we remain at Level 2 for Covid-19 the following processes are in place for patients being referred to Bay Radiology or Medex.

When Acute Demand receives a referral request for CXR & other plain film the referral will be forwarded directly to the Radiology provider (Bay Radiology (includes Katikati) or Medex (which includes the site at The Doctors Tauranga). The patient will be contacted and given an appointment time to attend. TO LOCATE THE RADIOLOGY THE PATIENT IS BEING SENT PLEASE READ THE NOTES UNDER THE CPO COMMENTS TAB.

IMPORTANT Please ask the patient all the relevant COVID questions to make the process faster for Radiology.

Make sure all relevant clinical information is included (temp etc, SOB etc) and if the patient has had a previous COVID test.

CT KUB and DVT USS Please keep the patient at the practice as the turn around for getting an appointment time is very quick. This will avoid the referral being cancelled if I am not able to get hold of the patient.

Acute Demand Service – Community Acquired Pneumonia Key purpose/benefit The Acute Demand Service for Community Acquired Pneumonia currently acknowledges the Adult Pneumonia Pathway on Bay Navigator but once developed this will be found on Midland Health Pathways. A key component of the pathway is the use of a CRB-65 score to determine the severity of Community Acquired Pneumonia for appropriate management in primary care.

Chest X-Ray A chest x-ray may be requested but is not routinely recommended in a community setting. A chest x-ray may be appropriate when the diagnosis is unclear, where there is dullness to percussion or other signs of an effusion or collapse, or when the likelihood of malignancy is

increased, such as in a smoker over 50 years. Use the current Best Practice Acute Demand Radiology Referral for a chest x-ray request.

Eligibility criteria The Patient must reside within the Western Bay of Plenty It is preferred the patient is enrolled and funded through a WBOP PHO general practice Follow-Up funding If a follow-up is required within 48-72 hours for a patient with Community Acquired Pneumonia, then this can be funded under the Acute Demand Service Not eligible for follow-up funding A follow-up that does not fall within the time-frame of at least 48 or within 72 hours after first appointment as per the Bay Navigator Community Acquired Pneumonia pathway A subsequent routine 6 week follow-up CXR is not funded Please also note that all Acute Demand Services under Level 2 are still operational.

They include: Hydration Plain Film – please make sure clinical notes outline all COVID related questions.

DVT USS – keep patient at practice until an appointment has been given.

CT KUB – Always need a GP’s mobile number for Radiology ONLY Cellulitis – IV and Oral

Please contact Lizzie – Acute Demand Administrator if you require any further information on 07 571 7161 OR Email: lizzien@wboppho.org.nz.