Ictal SPECT Testing

[csegismundo]

Hello everyone,

I am currently working on an evidence-based practice project investigating the best practices for ictal SPECT testing for pediatric patients with intractable epilepsy in the Epilepsy Monitoring Unit. If your facility offers SPECT testing, do you have any policies/procedures or care guidelines to share? Thank you for your time!

[Surprised1, MSN, RN]

Hello,

Can you elaborate on which angle you're coming from? Do you want to know the nurses' role and best practices, or the nuc med tech's? Or something else?

[KelRN215, BSN, RN]

When I worked in the hospital, the SPECT set-up was done by the night nurse. Nuclear medicine brought the isotope up the floor at 8am. The isotope degraded over time- depending on the brand, sometimes it was good until 2pm, sometimes noon. They left a piece of paper with how much isotope to inject if the seizure occurred from 8am-9am, 9am-10am, 10am-11am, etc. Originally, the policy was that the clamp on the tubing was open to the isotope but then one time it automatically injected so that was changed to clamps to isotope and saline flush closed. Children that would need sedation for the scan were NPO all day. If the child also needed an interictal SPECT, on day 1, they were injected with the isotope at either 2pm or noon (depending on which isotope we had at the time) by the bedside RN if they didn't seize. If they seized and got their ictal SPECT on day 1, Nuclear Medicine did the injection for the interictal SPECT the next day.