Abd CT : PO contrast vs IV contrast

[saphyre]

Pt has no allergies. Md writes an order for Abd CT with PO contrast to R/O obstruction. Would you have both contrasts used in the test? Would it be a problem if IV contrast was not used?

Thanks.

[FireStarterRN, BSN, RN]

I would assume that the physician wants PO contrast since he wrote for PO contrast. That would be the best for R/O a bowel obstruction anyways.

[recoveringcory]

Sometimes they don't use IV contrast. In most instances in the ER, the Docs almost always used PO and IV contrast. The IV contrast should help identify within the bowel and surrounding that there is adequate blood flow, and there isn't ischemic or necrotic bowel...

Cory

[WalkieTalkie, RN]

Was the patient's creatinine high?

[saphyre]

No, pt's Creat was fine. HH low, PT INR sky high. Pt on Coumadin for Afib at home. Huge belly.

There were many things going on with the pt, I was just worried that I did not put the order in properly for the Abd CT scan as the last I heard he was going down for a repeat later that same day.

[mcubed45]

awhile back our hospital introduced some "generic" orders for CT. that way the MD can just order "CT Abdomen" rather than having to specify with, without, or with/without and PO vs IV. it made things a lot easier b/c in the past if a MD ordered "ct abdomen with contrast" and radiology determined that contrast really isnt' necessary for what we're diagnosing, we'd have to go through the whole process of contacting the md and having them write a new order. this was happening for about 75% of our exams and we'd have our scheduled outpatients literally waiting around for hours while we try to get a new order.

[interleukin]

No, pt's Creat was fine. HH low, PT INR sky high. Pt on Coumadin for Afib at home. Huge belly.

There were many things going on with the pt, I was just worried that I did not put the order in properly for the Abd CT scan as the last I heard he was going down for a repeat later that same day.

Why are nurses putting in orders?

[WalkieTalkie, RN]

Why are nurses putting in orders?

LOL, we don't have the technology to allow the docs to put in orders at our hospital yet, and I work at a large, major teaching facility.

[interleukin]

We do, and docs still want nurse to put in orders...like we have nothing else to do.

Problem is, some nurses do and that perpetuates this ongoing issue.

Some nurses think it's a popularity contest.

[dorimar, BSN, RN]

Why are nurses putting in orders?

Are ya kidden me??????!?

[dorimar, BSN, RN]

What planet do you nurse on?

[BroadwayRN, ASN, RN]

In the ED the docs order CT abdomen with oral contrast only, the gastrographin illuminates the entire colon. If a severe blockage is found they frequently go back and repeat the CT with IV contrast witch illuminates circulation in the bowels.