Radiology
The Radiology Department of Rotunda Hospital provides the following imaging facilities:
1. General Radiography
2. Mobile Radiography
3. Fluoroscopy (This is the system used to undertake Hysterosalpinogram , HSG exams)
4. Ultrasound
The hospital is annually issued a No.L 0283-04 by the EPA for the to carry out the practice(s) listed below using the Radiation Sources/Accelerators. The department caters for adult and paediatric (neonatal) diagnostic imaging.
Times of service for the department are:
Monday to Thursday 09.00 – 17.00, 0900-1630 hrs Fridays
Outpatient Ultrasound Lists run Daily and two HSG lists run weekly. Radiographers are available for all imaging in Neo Natal Intensive Care Unit (NICU).
The radiology department in the Rotunda Hospital is located in the outpatients department on the ground floor in the Orange Zone of the hospital. All paediatric ultrasounds will occur in this area.
Adult Outpatient Ultrasounds are undertaken in the Rotunda Gynaecology Building located in the Green Zone of the hospital.
In-Patient Access to Service:
Imaging referrals for in-patients are accepted from medical staff only.
Outpatient Access to Service:
Imaging referrals are accepted for patients attending the hospital’s outpatient and emergency department.
3 Referral Process
The Radiology Department does not accept GP referrals for any adult or paediatric patients.
All referrals for Ultrasound (Paediatric and Adults), Plain Film and Fluoroscopy are accepted from Rotunda Consultants and their respective teams via paediatric and gynaecological clinics.
Private Clinic referrals are accepted via the RIS Ordering System or direct communication with Consultant Radiologist.
All referrals (inpatient and outpatient) are vetted by either a Clinical Specialist Radiographer (CSR) or Consultant Radiologist for justification of examination.
Reporting of X-Rays:
Written report of findings is sent to referring doctor as promptly as possible. Urgent findings may be telephoned to referring physician and added to Peervue (National System for recording Urgent Clinical Findings). Orthopaedic Referrals to CHI at Temple Street are managed with Radiology Admin.
Appointments, Prioritisation and Cancellation:
An appointment system is in place for all ultrasound, fluoroscopic and specific radiography procedures. Patients are prioritised based on the urgency of the request as assessed from the clinical information provided on the request. HSG referrals are added to IPIMS waiting list and prioritised based on menstrual cycle and length of time waiting.
On occasion, an appointment may be cancelled due to unforeseen circumstances in the radiology department such as equipment failure, illness or bereavement/emergency leave. In this case, care is taken to give as much notice as possible to the patient/parent/legal guardian and an alternative arrangement is made as soon as possible.
Self-Cancelled or Did Not Attend (DNA)Paediatrics:
• Patients who fail to attend for a paediatric ultrasound examination in the radiology department which has been scheduled on 2 consecutive occasions are deemed Did Not Attend (DNA). Self-cancellation is offered a new appointment in the appropriate timeframe.
• Adult Patients who do not attend on first appointment are returned to their referring consultant. If the patient cancels first appointment they are given a new appointment within an appropriate time interval.
Following (1 or 2 depending on adult/paediatric) failure to attend, the appointment is cancelled and the referrer is notified of this cancellation.
Escorting Patients Cancellation:
In accordance with the policy of Rotunda all patients attending the radiology department must be accompanied by a parent/legal guardian/nurse/healthcare assistant.
If parents/legal guardian bring along a patient’s sibling (s) to the radiology department, they must provide for their proper supervision. Failure to do this will result in their examination being cancelled.
For routine examinations it is appropriate for the parent/legal guardian/nurse/healthcare assistant to remain with the baby during the examination where practicable.
Staff
The Radiology staff is comprised of Radiologists and Diagnostic Radiographers and Radiology Admin.
Investigations undertaken on babies
Chest x-ray
We usually obtain one view of the chest while the baby is lying on his/her back. The arms are held out of the way of the chest and the image is taken when the baby has taken a deep breath. The midwife or parent wearing a lead apron may be asked to hold the baby in position while the images are taken. No preparation is needed before this examination.
Abdominal x-ray
This may consist of one view of the abdomen while the baby is lying flat on the incubator or x-ray table, or two views, depending on the clinical situation. The second view is taken while the baby is lying on his or her left side or while the baby is held upright. No preparation is needed before this examination. The midwife or parent wearing a lead apron may be asked to hold the baby in position while the images are taken.
Skull x-ray
Two x-rays of the skull are taken while the baby is lying on the incubator or x-ray table. The skull has lots of complex bony anatomy so getting the right angle for the diagnosis is often a challenging task for the radiographer. No preparation is needed before this examination.
X-ray of the arm or leg
An x-ray of an arm or leg or other part of the body may be needed when there is concern about an injured bone, or other problem of bone. Usually two or more x-rays are taken of the body part being examined. No preparation is needed before this examination.
Barium swallow or meal
The baby swallows contrast (dye) from a bottle or has the contrast put into a tube already in the baby’s stomach. The radiologist can see how well the baby swallows and if there is any problem with the oesophagus, the stomach or the first part of the small bowel. Usually, the baby is lying on the x-ray table for this examination. Certain images are taken by the radiologist, using the x-ray camera, during the study. Sometimes extra x-rays are taken after the contrast has moved further into the bowel. The baby must be fasting (nothing to eat or drink) for 3 hours before this examination.
Barium or contrast enema
This study requires coating the inside wall of the colon (bowel) with barium or other type of contrast (usually clear liquid that contains iodine which can be seen on x-ray images). Contrast (dye) is injected in through a tube in the rectum (back passage) into the colon. The baby is placed in several different positions for the images so that the contrast can coat and outline the entire colon. In neonates, where obstruction is usually the problem, there is no preparation needed.
Ultrasound scans
The scans are usually done when the baby is lying down. The midwife or parent can stay with the baby while the scan is performed. A special gel is put on the baby’s skin. Ultrasound scans are very safe and do not hurt but the baby may respond to the cold gel or to the probe as it is moved gently over the skin.
Ultrasound scans are particularly useful in the neonatal unit for imaging the newborn’s brain through the anterior fontanelle (soft spot of the skull), the liver, kidneys, pancreas and spleen and for investigating certain problems of the hips and spine. The range of ultrasounds performed in the Rotunda requires no preparation.
Investigations undertaken on adults
Hysterosalpingography (HSG):
HSG is an x-ray examination of a woman’s uterus (womb) and fallopian tubes, where a special contrast (dye) is injected through the neck of the uterus. When the uterus and fallopian tubes are filled with contrast the radiologist is able to view the anatomy and function of the uterus and fallopian tubes.
Preparation
1. To make certain that you are not pregnant during the HSG, it is best performed during the first 10 days of your cycle, once the menstrual bleeding has stopped.
2. It is not necessary to fast prior to the HSG.
Chest x-ray
For adults, we usually obtain one view of the chest while the patient is standing. If the patient is too ill to stand, we sit the patient on a chair or lay the patient on the x-ray table. The arms are held out of the way of the chest and the image is taken when the patient has taken a deep breath. No preparation is needed prior to this examination.
Abdominal x-ray
This usually consists of one view of the abdomen while the patient is lying on the x-ray table, or two views, depending on the clinical situation. The second view may be taken while the patient is standing up.