CT scans and how long to wait?

rjflyn, ASN, RN · May 27, 2004

Here its the oposite- Gastrografin aka Hypaque one q2hrs and scan after 5-6. Scan C aka barium 1q 1hr and scan after 3.

Rj

tiredfeetED · May 27, 2004

by using water only...are times are alot faster...usually have there person back from CT after an hour if CT is not slammed..which it usually is.. :)

akvarmit · Jun 15, 2004

Hmmmmm ...... we use gastrograffin, but the patients can drink all 3 glasses right down, then we scan in 1 hr.

We also use the Aussies to read our scans on night shift..........sounds like they got one heck of a racket going on there!

veetach · Jun 16, 2004

it DOES sound like those Aussies are making a bundle on the ER's in the states. We have a real time delay with receiving results. I think its ridiculous that we have to use them, just so our Rads can sleep??? Cant they work round the clock like we do? :chuckle :chuckle

NeuroICURN · Jun 16, 2004

I have an issue that I need help with. Our ED recently went from barium to gastrografin for CT's. Supposedly you can do a CT in less time, pt's tolerate it better, move patient's quickly. Everyone's happier. Not happening. This is what is happening now: Contrast is brought to patient, told to drink 3 glasses. Drink one every 30 minutes. (1 1/2 hours to drink). Then, the techs want to wait AT LEAST another 1 hour to scan! That is 2 1/2 hours! Average is 3 hours now from start to finish. THEN we have to wait for the scan to be sent to the radiologist, and when he/she calls back, we can dispo the patient.
I can't believe that every CT done in this country for a possible appy or whatever takes over 3 hours. We did better with barium! We originally changed because the barium is not tolerated as well, and that has proven to be true. Not nearly as many people get nauseated now. BUT! The time factor is unbearable! Please let me know your time frames, protocols, etc.! Then I can present other hospital examples..... Thank you so much for you help!

Hmmm...this got me thinking. I don't know what kind of PO contrast we use (I'll have to find out), but our patient's get it (usually down the NG tube, most of ours are intubated), it's generally about a total of 360 mL of fluid (water and contrast) and can scan in 1.5 hours.

I know it's not barium, but it's clear.....I'll find out what we use!

As for reading...ours is usually done (unofficially) by us (yes, we're taught to ready CTs) AND by the resident. Radiologist usually reads in approx. 1 hour.

mommatrauma, RN · Mar 6, 2005

We use Hypaque (gastrograffen) we do 10gms in 16 oz H20 every 30 minutes x 3 then scan 30 minutes after last dose...so ours is a 2 hour prep w/6 glasses to drink....if you see my other posts of least favorite patients....you understand why abd pain and ct scans are my least favorite...If they are nauseous we will pre-treat w/Reglan, which usu does help...traumas get no hypaque..they just go right to CT-Scan...not as optimal a study but no wait either...

rjflyn, ASN, RN · Mar 6, 2005

Heres a different protocol. Just started working as a travel nurse. In my current ER the protocol is 16oz of RediCat/ barium, 15 mins drink the second 16 oz cup. Call CT when that cup is gone. Pt goes to CT when they can take them ie its been as soon as when we tell them and the cup is gone and as long as an hour. When the get to the scanner the CT techs give the pt a hypaque enema. Do the scan, longest wait for an r/o appy CT so far was an hour and that was because they had a trauma on the table.

rj:rolleyes:

ktwlpn, LPN · Mar 6, 2005

that sounds a bit passive-aggressive on your part-as a patient i would rather not go with rectal contrast and would not appreciate it being pushed on me as a way for nursing to passively/aggressively exert control over the rad techs....if i am sick enough to need that kind of work-up i would rather wait the 4 hours and have access to pain med if needed...

mommatrauma, RN · Mar 6, 2005

Heres a different protocol. Just started working as a travel nurse. In my current ER the protocol is 16oz of RediCat/ barium, 15 mins drink the second 16 oz cup. Call CT when that cup is gone. Pt goes to CT when they can take them ie its been as soon as when we tell them and the cup is gone and as long as an hour. When the get to the scanner the CT techs give the pt a hypaque enema. Do the scan, longest wait for an r/o appy CT so far was an hour and that was because they had a trauma on the table.
rj:rolleyes:

The only problem with the barium is that if the pt is suspected to have a perfed bowel...it can cause bad peritonitis, where gastrograffen won't do that...

rjflyn, ASN, RN · Mar 7, 2005

Unfortunately is not a nurses choice. That is the radiologists protocol at this hospital. The patient can always refuse the barium and the rectal Hypaque/Gastografin- they then get explained the risk of not having a CT ie could be appendicities,could be divertiular disease, could be.... They they get informed the potential harm that can come from something not being diagnosed. The patient alway has the option just an informed one.

Personally I wouldnt want the enema either. I havent been at this hospital that long so I havent come across a pt who didnt want to procede with the test as above.

rj

That sounds a bit passive-aggressive on YOUR part-as a patient I would rather NOT go with rectal contrast and would not appreciate it being pushed on me as a way for nursing to passively/aggressively exert control over the rad techs....If I am sick enough to need that kind of work-up I would rather wait the 4 hours and have access to pain med if needed...

cherryscion · Aug 5, 2005

The problem is that I don't agree. I don't think it is good enough to say "oh well, its going to take 4 hours anyway" It doesn't have to. If you give barium, you can scan in 1 1/2 hours. If you give gastrografin you are looking at 3 hours. That is not progress. There has to be an quick, efficient way to scan these people. I can't believe that with all the progress medicine has made over the years, this is the best we can do..........

I'm interested in getting some general feedback on administering po contrast to ED patients. Do the RNs in your ED give the contrast or do the rad-techs give it? We are trying to streamline our CT flow process. Right now we have a 90 minute wait after ingestion, but it is the rad-techs who have the contrast and our average wait time from order to read is almost 3 hours. I think this could be improved if ED nurses had it available in pyxis and didn't have to wait for the rad-techs. It's just one piece of the puzzle.....but there has to be a better way to help move these patients from the EDs in a timely manner. Our system has a goal of 3 hour turnaround from door to floor......ha ha. I haven't seen that done in years....but we are trying.

veetach · Aug 5, 2005

I'm interested in getting some general feedback on administering po contrast to ED patients. Do the RNs in your ED give the contrast or do the rad-techs give it? We are trying to streamline our CT flow process. Right now we have a 90 minute wait after ingestion, but it is the rad-techs who have the contrast and our average wait time from order to read is almost 3 hours. I think this could be improved if ED nurses had it available in pyxis and didn't have to wait for the rad-techs. It's just one piece of the puzzle.....but there has to be a better way to help move these patients from the EDs in a timely manner. Our system has a goal of 3 hour turnaround from door to floor......ha ha. I haven't seen that done in years....but we are trying.

Our Rad Techs Bring over the PO contrast, but it usually only takes them a few minutes after the order is entered into the computer. Do you have a 90 minute wait on all patients? We have rapid CTs on traumas and those suspected of having a AAA.