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Regional Group.
Events
WESTERN REGIONAL
GIRSIG MEETING
A meeting of the Western Branch of GIRSIG was
held at the Post Graduate Centre, French ay Hospital, on 4th
April 2006. 22 members from the region travelled to Frenchay
from hospitals including Cardiff, Taunton, Gloucester, Cheltenham
and Weston Super Mare. Everyone enjoyed a delicious buffet
on arrival. Our thanks go to Sanochemia for their sponsorship
of the evening.
'My role as a Specialist Cancer Nurse'.
The first presentation was given by Issy Battiwalla, our Macmillan
Upper GI Specialist Nurse, entitled 'My role as a Specialist
Cancer Nurse'. Issy described her responsibilities in helping
people with upper GI cancer both within and outside of the
hospital environment.
Leaflets and booklets were handed round as examples
of reading material with which she can supply her patients
with regard to such areas as receiving care at home with advanced
cancer, and also the impact that cancer has on the important
relationships in our lives.
The cancer journey was outlined beginning with
'What is Cancer?'… going for tests, the diagnosis, and
different treatment options such as surgery, Radiotherapy,
Chemotherapy and complimentary therapy.
Ill health usually brings extra costs to the
patient, and here Issy can assist with accessing special benefits
and grants to cover extra heating bills, the installation
of a telephone and the renting of a stair lift. A Blue badge
parking ticket makes hospital visits less stressful.
The Macmillan nurse can also arrange holidays
for those who need more support or nursing care in special
holiday homes and hotels which are available.
Nutrition plays a very important part, and patients
are helped to increase their intake of protein and calories.
Many support groups are identified for these
patients, such as The Oesophageal Patients' Organisation based
in Birmingham, and others which can offer day trips and other
respite care.
All in all Issy's job is immensely varied and
is an integral part of a team, liaising with the GP and hospice
staff. We were all impressed with her great enthusiasm and
care.
'Water as an oral contrast for CT Abdomen and
Pelvis'.
Next, Louise Gibson Senior Radiographer at Frenchay Hospital
gave an inspiring presentation on 'Water as an oral contrast
for CT Abdomen and Pelvis'. Louise developed an interest after
hearing a lecture from a radiologist as part of a PGC CT course.
Early on in the evolution of the CT abdomen
it was realised that there was a need for oral and IV contrast.
A study in 1984 compared the benefits of iodine vs. barium,
and another in 1987 considered the use of corn oil emulsion
as a negative contrast agent. This study found however that
18% of patients suffered with nausea, vomiting, cramps or
diarrhoea as a result. The use of water as a negative contrast
has several benefits, including low cost, palatable taste
and good patient cooperation as it is easy to drink.
Louise cited several other studies including
one by Winter et al 1996 which found that when using water
alone for the upper abdomen it was not easy to see the stomach
wall, duodenum and proximal small bowel. Also the use of Glucagon
was required. However used in conjunction with intravenous
contrast optimal views were obtained.
A number of alternative negative contrast agents
were discussed such as Mannitol, milk and locust bean gum.
However the main adverse effect of using water was that it
could result in retention of fluid and inappropriate release
of antidiuretic hormone, but in most other aspects it was
well tolerated and cheap. Louise concluded that it is difficult
to find literature at present, and that further studies are
required with bigger sample sizes.
'The diversity and sustainability of Consultant
Radiographer practice'. Lastly, Robert Law, Consultant Radiographer
at Frenchay Hospital, gave his views on 'The diversity and
sustainability of Consultant Radiographer practice'. He discussed
the point that at present it seems to be local appointments
to fill local needs.
For the posts to be sustainable there
has to be accreditation between the Society and College of
Radiographers and the Royal College of Radiologists. Their
future may well lie in part in community hospitals which are
led by AHP Consultants and Consultant nurse practitioners,
with the support of PACS systems enabling them to communicate
with specialist radiologists working within major centres.
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YORKSHIRE REGIONAL
GIRSIG MEETING
Tuesday, 21st March 2006 at Hull Royal Infirmary
This was Hull's first local GIRSIG meeting but
hopefully a successful one and was well attended by six different
trusts.
Three 3 in-house speakers were invited to deliver
a presentation on a topic connected to the colon and we were
not disappointed by the three totally different presentations
given. The evening commenced as usual with the buffet that
was prepared by our own catering department and was extremely
tasty and also gave people chance to catch up on the gossip!!
The 3 presentations followed and then the meeting was brought
to a close with a raffle for 3 Easter eggs and I would like
to thank all those who bought a ticket.
Our first speaker was Dr. Nuala Kennan, a Consultant
Radiologist at Hull Royal Infirmary and Castle Hill Hospital
for 8 years and who specialises in body radiology. She is
one of 2 Radiologists in our Trust who reports the majority
of barium enema examinations and she spoke of how to improve
the barium enema examination as research had shown that the
right side of the colon was not always visualised optimally.
Our second speaker was Elizabeth Beadle, a Senior
Radiographer, who trained with us, then left for 4 years but
could not keep away and so returned to work at Castle Hill
Hospital. Lizzie performs barium enema and small bowel enema
examinations and has nearly completed the Bradford GI reporting
course and delivered an adapted version of her presentation
given for her course that was the properties of barium and
the problems sometimes encountered when associated with a
barium enema examination such as flocculation.
Our final speaker was Mr. John Hartley, a Colorectal
Surgeon who has worked at Hull Royal Infirmary and Castle
Hill Hospital for 4 years and he spoke about the different
radiological investigations available for diagnosing colorectal
cancer and explained the why a particular investigation is
requested for a particular complaint, This was well received
as it helped to clarify why we needed to perform a water soluble
enema examination on a weekend or during the night!!
I would also like to thank EZ-EM and Siemens
who sponsored the evening by paying for the buffet.
Feedback from those who attended say they had
an enjoyable and interesting evening.
Sandra Pank
Senior 1 Radiographer in Fluoroscopy
Hull & East Yorkshire NHS Trust
Sandra.Pank@hey.nhs.uk
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SOUTHERN REGIONAL GIRSIG
MEETING
23rd March 2005 - Southampton General Hospital
The first meeting for over 2½ years of
the Southern Group was held at Southampton General hospital.
A small but interested number of representatives attended
from 5 different hospital trusts. Two presentations were given
by in-house speakers.
Caroline Dawson, Southampton University Hospitals
Trust colorectal specialist nurse gave a thought- provoking
presentation on the role of the team of colorectal specialist
nurses and nurse practitioners here at Southampton in supporting
the patient with colorectal cancer from diagnosis and throughout
treatment. Discussion ensued as to how to break bad news with
members sharing their own personal experiences.
Dr Brian Stedman, Radiology Interventional fellow
took us into the realms of the hepatobiliary system giving
an entertaining presentation on relevant interventional procedures
undertaken here in the Radiology department. This was of great
interest to members as not all departments perform the procedures
described (T.I.P.S.S, T.A.C.E and R.F.A interventions) His
talk gave us cause to consider personal alcohol intake!
Two case studies were presented by Southampton
radiographers. The evening ended with a short business meeting
where the main topic of discussion was whether to continue
to arrange meetings due to the small number of attendees.
All agreed that the evening had been worthwhile,
in particular for the radiographers who are the sole GI practitioners
in their hospital and feel the need for peer association and
support. Representatives from St. Mary’s Hospital, Portsmouth
volunteered to arrange the next meeting in September. A questionnaire
will be sent out to local members to ascertain the most convenient
time for the meeting.
The evening and buffet was kindly sponsored
by EZEM and Sanochemia.
Mike Collins and Ian Bell from Sanochemia were
present and contributed by providing a display and information
on their products.
Jackie Stapleton
GI Specialist Radiographer
(Southern GIRSIG Chair)
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 Originally
from County Down, I am Clinical Specialist 3 Radiographer
in charge of a three-roomed Fluoroscopy Suite room in Altnagelvin
Area Hospital, Londonderry, Northern Ireland. I qualified
from the Londonderry School of Radiography in 1977 and later
obtained the Further Education Teachers’ Certificate
and HDCR.
I perform Barium Enemas and issue informal reports.
I am responsible for
vetting most of the Fluoroscopy requests. I am part of the
Colo-Rectal Cancer Screening group which is considering piloting
screening in this area. I attend the weekly multidisciplinary
G-I Oncology meetings and have found this to be a valuable
learning experience. On a monthly basis I publish an in-house
newsletter called FluoroNews and regularly give presentations
to staff and students regarding activities and interesting
case studies.
Regionally, I recently researched the incidence
of Radiographer role development in Fluoroscopy and to date
nine sites have staff who perform DCBE, five perform Micturating
Cystograms and three Radiographers issue final DCBE reports.
Sixteen hospitals have fluoroscopy suites and the current
Diagnostic Radiographer population is approximately 513 and
the Northern Ireland population is 1.7 million. I decided
to investigate the extent of role development because it is
largely an unknown quantity.
Traditionally, Radiographers here have lagged
behind their GB counterparts. I think this was because of
the geographical distance from other staff in the UK and perhaps
the conservative nature of Northern Irish people regarding
changes in Medical Imaging departments. Role development here
seems to be gathering pace and I wanted to establish a baseline
before Agenda for Change and Colo-Rectal Cancer screening
are fully implemented. Also, the viability of establishing
a special interest group here was also a determining factor
if sufficient numbers of like–minded people could be
found.
Paul Smyth
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Minutes of East Anglian GIRSIG
Wednesday 19th October 2005
West Suffolk Hospital, Bury St Edmunds
This meeting was well attended by 15 radiographers
from 7 hospitals. Schering kindly sponsored the meeting, giving
a short talk about their products and supplying a very tasty
lunch!
The main speaker was Daniel Welford, a part-time
clinical lecturer at Suffolk College and a part-time senior
I radiotherapy radiographer at Addenbrooke's Hospital, Cambridge.
Main entrance
of West Suffolk Hospital in Bury St Edmunds
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Daniel gave a very interesting and informative
talk about radiotherapy for carcinoma of the rectum. Topics
he covered included the patient pathway, how the radiation
is actually administered, side effects of radiotherapy and
the prognosis of rectal carcinoma following varying combinations
of radiation, chemotherapy and surgery.
A business meeting followed where agenda for
change was hotly discussed! Several hospitals are scheduled
to issue their AfC bandings in the next week or so. The radiographers
were reminded to fill in their surveys for the SoR when they
received their bandings.
Abbey gardens
and cathedral- one of the most famous landmarks
in Bury St Edmunds
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The radiographers were then informed of the
forthcoming 2006 GIRSIG conference and all were reminded how
to obtain membership to GIRSIG. Repetitive strain injuries
and the wearing of lead or Xenolite coats were also discussed.
This was followed by a discussion regarding postgraduate fluoroscopy
courses and the GIRSIG website.
Newmarket Hospital kindly volunteered to host
the next local meeting, provisionally scheduled for 1st March
2006
If anyone wishes to attend please contact Jo
or Michelle by 1st October at joanne.rudd@wsh.nhs.uk or michelle.boyle@wsh.nhs.uk
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Delegates from all over the North West arrived
at the Royal Liverpool Hospital's Education Centre on the
evening of Thursday 14th July for the regional GI radiographers
Special Interest Group meeting. After a buffet reception,
sponsored by Sanochaemia Diagnostics, they were treated to
a selection of presentations related to imaging of the small
bowel and inflammatory bowel disease.
Professor Tony Morris (Consultant Gastroenterologist
& Director of Endoscopy) began by providing an insight
into current endoscopic methods of small bowel imaging and
gave a glimpse of the future, where it appears that with the
introduction of video imaging capsules the size of a standard
tablet we could all be Dennis Quaid in the film "Inner
Space" in a few years!
Dr Mark Hughes (Consultant Radiologist) explained
how small bowel enemas are performed in Radiology, using a
dedicated pump mechanism with a naso-jejunal pressure tube.
Propelling a substance not unlike wallpaper paste (methyl-cellulose)
into the patient provides excellent double contrast images
that make diagnosing disease here much easier than using a
conventional small bowel meal or enema using a manually powered
syringe.
Dr Keith Leiper (Consultant Gastroenterologist)
then gave a medical overview of the diagnosis and treatment
of irritable bowel syndrome and its differences to inflammatory
bowel disease (IBD). The range of potential treatments surprised
a few delegates and showed how difficult it can be to appropriately
manage this group of patients.
Miss Rose Edwards followed this by giving the
patients perspective of IBD, recounting the many symptoms
and explaining how distressing and debilitating they can be
and how difficult it can be to find effective treatment with
the very large range of symptoms.
The presentations left the interested and interactive
audience with both food for thought and some new ideas to
consider in their clinical practice in their own hospitals.
Geoff Fitzgerald, co-organiser, said that
it was refreshing to have a session where the barium enema
was conspicuous by its absence, demonstrating that GI Radiographers
have both a wide range of clinical knowledge and a willingness
to learn new theories and practice.
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The East Midlands group has now been running
for over a year now, and the time has flown by. We have had
5 meetings and have settled into a small core of people attending
all meetings and others joining us when they can. The greatest
benefit has been knowing that there are others out there,
that, because you know their face are easier to talk to and
you know they are having the same problems with managers,
radiologists and loopy colons.
We have decided to alternate the meetings between
Kings Mill Hospital in Mansfield and Derby City Hospital to
allow the maximum number of people to attend at least 2 meetings
a year.
We have had meetings with radiologists showing
us films, a colorectal nurse discussing the impact the governments
initiatives are having on their service and the knock on effect
for gastro radiographers, we have also presented case studies
and unusual films - along with discussion on techniques we
use, from this we are looking to compile a list of tips and
hints entitled "what to do if". In the future we
are arranging meetings to look at the spine/pelvis and plain
abdominal radiographs as these are things we see all the time
but we decided we have little knowledge about.
So if you want to come and join us please do
so by contacting Vicki Smith-West at vswh@aol.com
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