X-rays for childbearing women

Specialties Emergency

Published

Hello once again!

Another question I have for you all is about sending childbearing women for an X-ray. Before sending her to X-ray you ask her if there is any chance she is pregnant. If she says no, do you then send her to X-ray or do you always get a urine HCG just to be sure? Or do you only get a urine HCG if she says she is not sure if she is pregnant or not? I am asking this because it seems that some ER doctors take the women's word that she is not pregnant while others want to get an HCG just to make sure. We currently do not have a policy for this, and I am wondering what your ERs do regarding this situation. The ER where I work is small and not extremely busy (it has its moments though!), and I can imagine how time consuming this would be in a very busy ER and perhaps not practical to do for everyone.

Also, I find it challenging to find a way to ask a teenager this question when her parents won't leave her side. I don't think it is appropriate to ask a young girl this question in front of her parents, and I am interested in hearing ways that you find successful in asking this question to young girls.

Thanks again to all!

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In our ER the xray tech asks this question and they sign a release saying they are not pregnant. If they are not sure and tell us before they go to xray or if they tell us nothing and tell the xray tech they aren't sure then we do a urine HCG. It's more a radiology policy then ER where I work. They do the paper work.

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Specializes in M/S, Onc, PCU, ER, ICU, Nsg Sup., Neuro.

All women in child-bearing that need x-rays etc we routinely do urine HCG tesing which takes all of 3 minutes, went to this because in the past we've x-rayed those claiming to not be pregnant only to find out during the workup that they are, OOPS!!! Paul

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Specializes in ER, ICU, L&D, OR.

Howdy Yall

From deep in the heart of texas

The general rule of thumb is any female over 10 and under 90 or thereabouts gets a urine hcg. With bedside testing it takes less time to do the test than to collect it. Better safe than sorry or radiated.

keep it in the short grass yall

teeituptom

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Specializes in M/S, Onc, PCU, ER, ICU, Nsg Sup., Neuro.

We routinely do urine HCG testing on all women in child-bearing range which takes all of 3 minutes to do, prevents xraying someone who claims not to be prgnant only to find out during workup they are. OOPS!!! Paul

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Specializes in ER, PACU, OR.

if she has not had a hysterectomy, and is between the ages of 8-10 and 55, they get a serum hcg first. then we go from there!

how many times have you heard, i'm not pregnant!

i can't be pregnant............my boyfriend was sick when he was little and can't have kids...........i just had my period a few days ago........... i'm on the pill.................. we use condoms................... i haven't had sex................ boom! well then your boyfriend was misinformed or lied, and despite just having your period you are pregnant, your pills were not working, and the condom had a hole in it.............and your the virgin mary right? :chuckle

me :)

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When I interviewed teens that we were going to need to rule out pregnancy concerns OR do an XRay I would walk them to the BR (when feasible) and ask them the question there away from momma's ears. I would ask them LMP in the room, but I would ask them if they were sexually active or having sex or if they had ever had sex (whatever stuck me at the moment).

I always said I would do a pregnancy test on Mother Teresa if she were of child-bearing age and had pain below the belly button.

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Still in the dark ages , off to the lab with urines and somed eves it takes forever. If I have a teen in triage with a parent, I will finish triage and send them off, then call the kid back with a I forget to weigh you and then ask them personal questions.

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Originally posted by flaerman

We routinely do urine HCG testing on all women in child-bearing range which takes all of 3 minutes to do, prevents xraying someone who claims not to be prgnant only to find out during workup they are. OOPS!!! Paul

My insurance recently refused to pay for a urine HGC done pre-xray...my triage and assessment sheet both indicated a TAH w/ USO in 1996 (was done at the same hospital but I know they don't have time to pull and review charts) and the ER did it any way as a matter of policy. I was not told it had been done until I got the bill.

It may only take 3 minutes but it costs $100. Hospital billing refuses to back down...the insurance company is now fighting on my behalf.

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Doesn't it depend on what kind of xray they are getting in your facilities? I know for many pt's if they are getting a foot or hand or something like that then you shield them and be done with it. The only time we do ucg's (because we do have to send them to lab) is if it is an xray where it isn't possible to shield. But also in a lot of those cases the patient needs blood work and get a serum pregnancy test anyway.

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Specializes in M/S, Onc, PCU, ER, ICU, Nsg Sup., Neuro.

NO, our policy is to do urine hcg on all child-bearing age women, this was set up by both the ER and the radiology dept, with the blessing of our risk management people as well. If there's major stink over not being paid by insurance they will deal with that individually and sometimes drop that cost. It's better than a lawsuit over fetal damage. Paul

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Our xray techs have women read and sign the release....Routine HCG's i trust more..but like ikimiwi stated...some evenings our lab is so slow the pt could get her self pregnant by the time the results came back.... :kiss :chair:

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