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Labs and non-invasive imaging
So I decided long ago that my limit in terms of what I would or won't do ends at skin. We're essentially doing complicated piercings. I don't think anyone would construe the stuff I do as practicing medicine. However, I am interested in what comes next. I don't see the medical industry suddenly becoming interested helping us..
Two things we don't have but would be required if someone was going to go all the way and play underground surgeon are imageing and labs. Prior to any surgery, people always get some basic labs done. These usually include a CBC, CMP, and a PT/INR. Modern hematological labs run samples through various machines which pretty much do everything. They're pricey and pretty much out of our reach. But, a lot of these tests can be done manually. For example, you can spin down blood and determine hgb hct based on how thick the layers are. PT/ptt can be determined by literally timing how long blood takes to clot. I think it would be interesting to figure out what we can and can't do.
Along these lines, can we do imaging? It probably wouldn't be too hard to make an x-ray.. but I'm not really interested. There's good reason for caution.. but what about ultrasound? Or even MRI? These are considered to be not invasive. I know there's a lot you can do with ultrasound that we don't because x-rays are easy. But I'd be willing to use ultrasound and not xray. Just thinking here, but anyone have any thoughts?
Comments
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(Just so everyone’s aware: I’m going on rotations next year so this may not be accurate).
As far as I am aware ultrasound can be a bit of hit-and-miss and takes experience to interpret, and sometimes even then it can get subjective (heck, the little bit of ultrasound makes me go “huh?” all the time) except for really high end stuff which you don’t see often. It’s not MRI or CT (the former is pretty expensive, and latter radiation problems).
Furthermore, again, you need to know the anatomy to be able to interpret what you’re seeing for any imaging anyway (much harder for ultrasound).
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Sure. Which is why a simple chest x-ray is standard. But that's a matter of experience. I know techs who can tell you that the gall bladder be needs to come out long before a radiologist even sees the results. Ultrasound is more difficult to interpret but it's used for many things.. for example if we were trying to access the peritoneum or part of the thoracic cavity us guidance would be very helpful. Plus.. there are more and more us based treatments being found.
Ultrasound is cheap and doesn't require contrast or radiation. I think it's at least worth exploring personally.. but yeah.. I agree that I'd take a good CT with and without contrast any day. -
If anyone is wondering about what Ivo is taking about in terms of interpretation.. take a look at these.
Vs.
https://upload.wikimedia.org/wikipedia/commons/8/83/Chest_X-ray_2346.jpg
As you can see, there's a world of difference. X-rays are so much easier to interpret... But they're great for looking at soft structures like arteries and veins.
