Interventional Radiology Consult 💉
Guide for interventional radiology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: full name, date of birth, location and MRN
- Reason for consult and urgency (e.g. abscess drain, GI bleed embolisation, nephrostomy, biliary drain, biopsy, line/port)
- Clinical story: timeline, working diagnosis, failed conservative measures so far
- Past history: bleeding disorders, contrast allergy, CKD, previous IR or surgical procedures, pregnancy status if relevant
- Medications: anticoagulants, antiplatelets, metformin; last dose and when held if applicable
- Observations: vitals, EWS, haemodynamic stability, transfusion status if bleeding
- Bloods: FBC (Hb, platelets), U&E (creatinine/eGFR), coagulation (INR, APTT), group and hold / crossmatch if bleeding
- Imaging: study type, date, and key finding that supports the request (have accession or report ready)
- What you are seeking: specific procedure, advice on feasibility/timing, or joint plan with another specialty
🔎 Investigations to Know
- Recent cross-sectional imaging (CT/US/MRI) that defines the target: size, location, safe access window
- Coagulation and platelets: many IR procedures need platelets and INR within local thresholds; confirm local protocol
- Renal function before IV contrast; note if patient already has AKI or is dialysis-dependent
- Infection markers and cultures if requesting drain for abscess or infected collection
- For bleeding: serial Hb, lactate if shocked, and whether endoscopy/surgery has already been involved
- For obstruction (urinary/biliary): creatinine, LFTs/bilirubin, and imaging confirming level of obstruction
- IV access and NPO status if sedation or procedure is likely the same day
📞 Example Script
- Hi, this is [Your Name], the intern from [Team Name]. I'm requesting an IR consult for a [Age]-year-old [M/F] on [ward] for [e.g. percutaneous drain of abdominal collection / angioembolisation / nephrostomy].
- They were admitted with [presentation]. Imaging ([CT/US date]) shows [key finding, e.g. 6 cm collection adjacent to the liver with a safe window]. They are currently [stable / tachycardic / on vasopressors].
- Bloods: Hb [ ], platelets [ ], INR [ ], creatinine [ ]. Anticoagulation: [none / held since / still on].
- We've already [e.g. started antibiotics, discussed with surgery/gastro, held anticoagulation]. We're seeking [drain insertion / embolisation / feasibility and timing].
- Happy to send the request form and imaging accession, and to clarify fasting, consent, or holding antiplatelets if needed.
📝 Tips
- IR is procedure-focused: state the exact intervention you want and why imaging supports it
- Clarify urgency early (emergency embolisation vs elective biopsy) and who else is involved (surgery, gastro, urology, oncology)
- Do not delay life-threatening bleed referral to perfect labs; say what is pending and escalate concurrently
- Know local anticoagulant/antiplatelet hold rules and whether reverse agents or products are needed
- Diagnostic imaging requests belong with radiology (see Requesting Radiology); IR consults are for image-guided procedures
- After acceptance: confirm consent pathway, NPO, bed/porter plan, and post-procedure observations
Educational reference only. Medical disclaimer