- 0Nov 19, '04 by CraigB-RNWould anyone have any competencies that they would share. My facility has just added a CT and the radiology department wants to start their own IV's and administer contrast.
- 0Nov 19, '04 by dianah, ADN Senior ModeratorI have no competencies but I'd certainly strongly recommend the techs be required to take an official IV certification class, demonstrate the requisite number of "practice sticks," and as part of the yearly competency (at first, at least), document X number of IVs started yearly (Chief Tech or RN or Radiologists determine what number is acceptable). The last part may be discontinued if it turns out the techs are ALL starting many IVs per day, and thus maintain their skills.
What happens in case of a reaction? Do the techs know what to watch for ("reaction resembling allergy," cf true "allergy?") and how to respond, based on the presentation and progression of the s/sx? Is the Radiologist in the room or just around the corner, in case of a reaction? Who will push meds and observe the pts with mild/moderate reactions afterwards? What printed instructions will the pts receive post-reaction and who will document the reaction in the pt chart? The techs should all have a yearly inservice on Contrast administration, as it's not just allergic reactions that are the danger here, it's the potential renal problems, problems with pts on Metformin (when was the last dose?), brittle diabetics who've been NPO for the CT, and whose sugar may bottom out while waiting (delays do happen!), etc etc.
All the techs BLS-trained? Do they know how to administer O2 and set up/use suction? How to put on a BP cuff and take VS? Just as important: WHEN to take VS?
PM me if you like. As you can tell, it's hard for me to give a succinct answer without more info. -- Diana
- 0Nov 20, '04 by actioncatI think it would be a wonderful idea, helping to save the nurses' time. I see no reason that radiological technologists could not learn to start IVs. If they took a special course, that would be more than I got in my BSN program!
Radiologic technologists have two and four year degrees, just like nurses. I would think that those working in CT are probably well versed in contrast allergies-- after all it is one of the more common allergies and important to screen for. I assume that radiologic technologists have BLS. Cripes, even the unit clerks have to have BLS, so why wouldn't rad techs. Probably most rad tech programs require students to learn some patient care skills too.
- 0Nov 20, '04 by dianah, ADN Senior ModeratorI agree, actioncat, and there should be taining, documentation and demonstration of competence. Yes they SHOULD have lots of experience w/contrast reactions-- our CT techs (and it IS "technologist!") were VERY good at independently recognizing and acting, if we RNs weren't able to be in the control area for every injection. Granted, too, there are far and away, FEWER problems with the nonionic contrast agents -- but not every facility uses them exclusively, due to cost constraints. And they aren't a guarantee against anaphylactic reactions.
The CT depts I've seen where the techs DO start all the IVs, work well. I'm just saying, if you're starting this (OP said they're just opening a CT dept), you need to make sure there is an MD NEARBY at all times, reasonable protocols are in place, and everyone is 1)trained, 2)competent, and 3)document such ----- and never assume. That's all.Last edit by dianah on Nov 20, '04