Shamelessly copied verbatim from this post by Chris Nickson of the LITFL team.
The ‘Ten Commandments of Emergency Radiology’ according to Touquet et al (1995):
- Treat the patient, not the radiograph
- Take a history and examination before ordering a radiograph
- Request a radiograph only when necessary
- Never look at a radiograph without seeing the patient, and never see a patient without looking at the radiograph
- Look at every radiograph, the whole radiograph, and the radiograph as a whole - remember the ABCS: alignment/ adequacy, bones, cartilage (joints) and soft tissues.
- Re-examine the patient when there is an incongruity between the radiograph and the expected findings
- Remember the rule of twos - two views, two joints (above and below the injury), two sides (for comparison), two occassions (may need a follow up x-ray) and two radiographs (compare to a normal radiograph)
- Take radiographs before and after procedures
- If a radiograph does not look quite right ask and listen: there is probably something wrong.
- Ensure you are protected by fail safe mechanisms - establish a quality control system
References: Touquet R, Driscoll P, Nicholson D. Teaching in accident and emergency medicine: 10 commandments of accident and emergency radiology. BMJ. 1995 Mar 11;310(6980):642-5. PMID:7661941; PMCID: PMC2549014.
These ought to be put up prominently (engraved in stone tablets if so desired) in every Emergency and Radiology Department.