Questions about head CT that I had yesterday!

**RosesrReder, BSN, MSN, RN** · Aug 10, 2005

hello and welcome to the family of allnurses. enjoy your stay and good luck!

Editorial Team / Admin · Aug 11, 2005

(I think Jessica's post was supposed to be on the welcome thread. :))

For background info: I worked 21 yr in a Radiology Dept, and one of our nursing responsibilities was starting all the out-pt IVs for the CT scans and IVPs, remaining in the room during the injection, and monitoring the pts for contrast reactions. The last 8 yr or so, we ran two rooms, scans every half-hour, which meant we could start 20+ IVs per day. Any-hoo:

1) I don't know why veins "collapse," they just do sometimes. Possibly dehydration . . . Sometimes the pts are on prednisone or are post-chemo and their veins are fragile; sometimes they're just friable veins, depending on the person. I used to give blood a lot, and one time the needle insertion hurt horribly, and continued to hurt throughout the whole donation (have never felt that since that time, though). I have my own theory, from starting many, many IVs: I think veins sometimes spasm (although arteries are MUCH more prone to do this, and as I recall, I was taught that only arteries will spasm) and this causes the pain. Just my own theory, not evidence-based.

In your case, blood and/or contrast may have seeped out around the insertion when the contrast was injected, and that will cause pain until it's absorbed (which will happen). Did they use a power injector or drip it or inject by hand? Power injector simply pushes the contrast in at a controlled rate, and supposedly at a low psi, although it may have been high enuf psi to cause some leakage.

If the person who started the IV nicked the back wall of the vein with the needle, contrast and/or blood may have leaked out. Also, if they used Conray (one of the older agents) instead of Omnipaque or Visipaque, and some of it extravasated, that will cause pain at the site, until it's absorbed by the body.

I have no experience with anyone reporting prolonged fatigue after a contrast-enhanced CT. The contrast should be totally out of your body in 8 hr or so. Perhaps you were dehydrated before the scan, and this has persisted, as the contrast agents act as a mild diuretic. Perhaps the anticipation of going thru the CT and waiting for (and wondering about) results has fatigued you. Can't be sure . . .

I hope you drank lots of fluids post-CT, to hydrate yourself and help your kidneys "flush" the contrast out. :)

I do hope your PCP can help you with your migraines. I don't feel I have totally answered all your questions; they may have no fully satisfactory answers, after all. PM me if you have any more questions. Good luck, and good healing.