Investigations
| Centre | Investigations available | Pathways available | ||||
| Eccleshill ISTC
01274 623060 (main office) fax number 01274 623065 |
Plain films (Digital x-ray) contrast x-ray Gastroscopy Colonoscopy fluoroscopy (Ba enemas) Ultrasound CT scanning MRI
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FAST TRACK SERVICES: ►Rectal bleeding ►Haemoptysis ►Persistent cough ►Persistent hoarseness ROUTINE SERVICES AVAILABLE ►Inguinal swelling – if suitable for daycase ►Right upper quadrant pain – routine imaging – refer to ISTC for daycase surgery if suitable ►Dyspepsia – follow local guidelines – endoscopy at ISTC if required ●If case is urgent they will be seen within one week. ●Non urgent cases will be seen within two weeks.
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Click here to see how the referral flow to Eccleshill ISTC works
Which BLOOD Investigations? Examples of How NOT to Over Investigate
| Blood Investigations | What is really Needed? | Notes |
| U&E | If your looking at renal function, just ask for urea and creatinine | Avoids Na, K results that you simply don't need |
| TFTs | ask for TSH | T3 and T4 are hardly ever needed for those on thyroxine replacement. Dose adjustment depends on the TSH level |
| Cholesterol | if patient already on
statin, ask for cholesterol not lipid profile If new patient being assessed for CHD risk, then ask for a one off Lipid Profile with HDL/LDL ratio |
avoids unnecessary ratio measurements |
Who Needs Gastroscopy?
Which X-ray Investigations? Examples of Symptom Referral
| X-Ray/USS | MRI | CT Scan |
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Soft Tissue Damage? X-ray, ultrasound at radiologists discretion, ?MRI |
Rapidly deteriorating hip | TIA carotid dopplers or atrial fibrillation = GP discretion for CT |
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Boney Damage? X-ray |
Deep soft tissue eg joint, spine | ?Hairline fracture CT test for boney pathology (arthritis) |
| Myeloma x-ray = radiologist discretion | CVA = CT scan within 24h (NICE guidance) | |
| Reoeat
follow-up requests from Lodestone arthroscopy
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Headache: no vomiting + no stiffness -send to hospital Only 2% have investigations |
Notes
If a patient requests a PSA test:
 | He should first be provided with information about the advantages and disadvantages of PSA testing; |
| He should be offered the opportunity to discuss his interpretation of the information, using the more detailed information contained in: |
 | One of the leaflets that are available; |
| Frequently Asked Questions about Prostatic Cancer and the PSA Test; |
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| The National electronic Library for Prostate Cancer (part of the National electronic Library for Cancers); |
| If the patient wishes to have the PSA test, it should only be arranged with a laboratory participating in the National External Quality Assurance Scheme (NEQAS) scheme; |
The patient whose test result indicates the need for further investigation should be referred to a urologist; he should be given more information about treatment options, including the opportunities to enter randomised controlled trials.