Can a nurse obtain informed consent for a CT /MRI scan? - page 3
I overheard a physician saying how they are short staffed and wanted a nurse to obtain informed consent for CT/ MRI scans.... is this legal? From what I know it isnt.... this is in New York if it... Read More
Mar 19, '08I know what multiple myeloma is...just didn't know that with IV contrast you can cause renal failure.... that is why I asked for supporting literature... I've never even read about this on the American College of Radiologist website...
Mar 20, '08Quote from kevin88gti didn'ti know what multiple myeloma is...
didn't know that with iv contrast you can cause renal failure....
Mar 21, '08I have attached 2 journal articles that will hopefully answer your question about multiple myeloma and contrast media. Multiple myeloma is not a direct contraindication but, these patients often have some renal imparement.
If your patients are at risk of contrast induced nepropathy (CIN) this article may be of help:
This is the premedication regime that the radiologists @ my facility use for patients with prior contrast media reactions:
Americal College of Radiology (ACR) guidelines for MRI Contrast (gadolinium) safety:
ACR guidelines on Iodinated contrast media:
I hope this helps - Its all about the patient
Mar 21, '08I had no idea this requires a consent, I've sent many patients to a CT with contrast, I only have to make sure that if it is a chest CT that they have a 18 gauge anticub IV. I have accompanied critical patients down to CT and have never seen an x-ray tech get a consent either.
Mar 22, '08Consent is not required , Check with your facilities polocy and procedures. Patients should be screened to insure that the possibility of a reaction or injury is present. The screening process also has the added benefit of patient education about the procedure.
Mar 22, '08Quote from mike RTConsent is not required.
In some states (for example, in Georgia) it is the law to obtain informed consent before giving IV iodinated contrast.
Mike is absolutely right: check your hospital's policy and procedures.
And your state laws/requirements.
Mar 24, '08mike RT thanks for the info...luckily at my facility we require a BUN under 32 or a Creatnine 1.5 or lower which would cover renal impairment... thanks for the info though...
Mar 25, '08Quote from kevin88gta bun under 32 or a creatnine 1.5 or lower does not cover renal impairment. i've seen a creatnine of 1.1 and after calculating the gfr it was below 50. it depends on the patients age and race. the bun is of no consequence when considering ct contrast.mike rt thanks for the info...luckily at my facility we require a bun under 32 or a creatnine 1.5 or lower which would cover renal impairment... thanks for the info though...
a gfr needs to be calculated and needs to be under 60 for ct contrast to be considered renal safe, followed by 80 ounces of caffeine-free fluids the day of and day after the contrast infusion.
a gfr of 30-60 requires mucomyst x 3 plus a 250 cc 0.45%/sodium bicarb iv infusion pre and post contrast.
a gfr of less than 30 requires an order from a nephrologist.Last edit by DutchgirlRN on Mar 25, '08
Mar 25, '08Quote from mike rtthanks mike! there's always something new to be learnedhttp://radiology.rsnajnls.org/cgi/reprint/183/2/519.pdf
if your patients are at risk of contrast induced nepropathy (cin) this article may be of help:
this is the premedication regime that the radiologists @ my facility use for patients with prior contrast media reactions:
americal college of radiology (acr) guidelines for mri contrast (gadolinium) safety:
acr guidelines on iodinated contrast media:
i hope this helps - its all about the patient
Oct 20, '11Informed consent is required for essentially any procedure which carries risks of complications unless those complications are minor or extremely rare. While I am not familiar with all state law, I do know that California requires the physician who will be performing the procedure to expain the rationale for the procedure, the risks, benefits and options and must obtain the patient's consent. A nurse may not obtain informed consent because the likihood of risks/benefits and other medical options are outside of nursing scope of practice and the nurse is not the one performing the procedure. While a nurse may be able to explain the procedure, answer questions, etc., it is fundamentally a physician's duty to obtain informed consent (at least in California). This should be distinguished from having a patient sign a piece of paper stating that the risks and benefits have been explained to them and they consent to the procedure (after the physician has already obtained informed consent and documented such consent in the medical record.)