CT scans and how long to wait?

[TexNurse]

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!

[cherryscion]

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.

We have rapid CTs also on our traumas, but then we really don't have to wait for official reads on those.....the trauma surgeons generally do the read while the patient is on the table. We're just trying to figure out what all the glitches are on the medical CTs. Even our CT heads without contrast are now taking over an hour and a half (in general) to get an official read. A fair part of the problem is a rad-tech staffing issue, I think......but you know how it is.....nothing gets fixed without the documentation to back it up.

[veetach]

We have rapid CTs also on our traumas, but then we really don't have to wait for official reads on those.....the trauma surgeons generally do the read while the patient is on the table. We're just trying to figure out what all the glitches are on the medical CTs. Even our CT heads without contrast are now taking over an hour and a half (in general) to get an official read. A fair part of the problem is a rad-tech staffing issue, I think......but you know how it is.....nothing gets fixed without the documentation to back it up.

I work night shift and all of our CTs are read by Rads in Australia, but they usually get the readings to us fairly quickly. In my opinion, 90 minutes for a head CT is preposterous! Especially if the pt has a head bleed! Are there not enough rad techs to handle the flow of the dept? Does this happen on every shift or one in particular?

I know at our facility, night shift in radiology is staffed very thin. In fact the CT tech is on an on-call basis. They ALWAYS get called in, I dont know why they dont just staff the position on nights instead of paying all of that call back pay... but we cant complain about turn around time on scans.... good luck! Do you have any kind of computerized system that can track turn around times? that might be a good way to document your problem.

[DC.Bs,Ms ARRT,R,CT]

Nurses

My point of view is different than yours. Having run scanners for 21 years, I have had the opportunity to see the pharmaceutical improvements and trust me they are significant. I, we in Imaging appreciate that the time it takes to prep the patient for a scan takes up time and a bed. If throughput and numbers are the item of interest in your ED, you have lost focus. Ex..a patient presents to your ED with non specific abdomen pain, inconclusive labs and assessment. AH HA send to CT. Do we know the patients normal bowel transit time? Then the patient is sedintary. It is no small wonder the oral contrast does not navigate the colon expeditiously. But there are several options and I hope your CT techs have the skill set to present them to the doctor. One is instead of using say a 3% Gastro try a hypermolar of 5%. If you use barium add 15cc of Gastro( tricks of the trade) And there are several new orals on the market. Oral-C we used it in Deleware. Drink the 800cc and you have to scan within 15 min. Just a suggestion. In conclussion I as a technolgist do not like the wait time because it ties up my couch 2 hours and if your ED is as busy as the ones I have worked you NEVER know what is coming throug the door two hours ahead. Thank you DC:redbeathe:yeah: