4 ways radiology residents' outsized role during the pandemic reinforces the specialty's value to patient care
The pandemic has severely strained healthcare systems, forcing many to redeploy providers and trainees to the frontlines of the crisis. And with some regions still struggling and winter bearing down, researchers detailed the role radiology residents played during the outbreak and how they may help going forward.
Radiologists from New York Presbyterian Hospital—a former COVID-19 hotspot—chose four first-hand experiences in which trainees played a pivotal role in patient care, sharing them Tuesday in Clinical Imaging.
“During redeployment, imaging rounds became critical in clinical decision-making, expediting appropriate management, potentially avoiding unnecessary tests, and decreasing overall healthcare costs,” wrote Juliana Atallah and colleagues with Presbyterian’s Department of Radiology. “The redeployment experience increased the visibility of radiology and gave us an opportunity to showcase our expertise, highlighting the fundamental role of the radiologist within the field of medicine.”
Real-time imaging consults during rounds
In the first case, Atallah et al. described a 38-year-old man whose chest x-ray and subsequent CT scan revealed patterns sometimes associated with COVID-19. During rounds, residents pointed to a specific area of dense peripheral wedge-shaped consolidation, describing it as atypical for the novel virus.
This insight, paired with new clinical information, led the team to strongly consider pulmonary infarction. And thanks to reemphasizing the latter, the man’s medication and management was altered.
Quicker communication with colleagues
A second case involved a 77-year-old man who tested positive for COVID-19, with chest CT showing right heart strain and other cardiovascular abnormalities. Ultimately, he developed symptoms suggesting a massive pulmonary embolism.
Armed with clinical interventional radiology experience, Atallah et al. quickly discussed the case with colleagues and organized a discussion between the primary care, IR and critical care teams. Soon after, the patient underwent catheter-directed thrombolysis and immediately improved.
“This case highlighted our unique position and ability to expedite communication between teams to better facilitate patient care in a time-sensitive manner,” the authors wrote.
Explaining uncertain imaging findings
Radiology residents helped the medical team better understand a 79-year-old’s atypical eye exam finding, after carefully reviewing a same-day head CT. He was brought to the hospital by his family, with both chest radiograph and CT showing abnormalities associated with the novel virus.
Guiding appropriate follow-up imaging
Finally, the authors described a 53-year-old healthcare worker diagnosed with COVID-19 who developed abdominal pain and an acute drop in hemoglobin. These events prompted trainees to order an immediate CT angiography and consult with IR about the results and possible embolization.
“As radiology residents, we knew the appropriate imaging to order when the patient was decompensating, promptly placed the electronic order ourselves, and communicated with our IR colleagues, expediting patient care,” Atallah et al. explained.
The experiences not only improved patient care but also helped residents develop relationships with providers across various specialties that will likely impact their interactions going forward, the team noted.
“Ultimately, redeployment to a medical team gave us a newfound perspective on the importance of radiology within the greater healthcare system,” Atallah and colleagues concluded. “Direct communication between the radiologist and the clinical team through resident-driven clinical imaging rounds is not only beneficial for patients but can improve our diagnostic capabilities as well.”
Read more about their experiences in Clinical Imaging.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.