Stat CT for Ventilated Patient School Question

[kchester3]

For school we have a question regarding who to call for a patient who has an order for a stat CT. I know respiratory is needed for the transport, so they need to be called. The other half of the question is that CT says all tables are full. So then who would the nurse call an why at should she do? I always was under the impression vent patient get priority, but not sure what I would do if all tables were full with patients. Thank you for any advice given!!

[Corey Narry, MSN, RN, NP]

CT scans do not take such a long time to complete (even extensive CT scans shouldn't take more than an hour). In cases when an order for a stat scan is written and there is already a patient currently being scanned on the table, the Radiology Technician typically calls the bedside ICU RN to let them know that the patient will be next to be scanned as soon as the other patient's scan is completed. There should be a time frame for this as far as when this will happen. This gives the RN enough time to get the RT and transporter to the bedside for the trip to CT scan. Those patients whose ordered scans are not stat or are less of a priority gets bumped down the schedule.

[kchester3]

Okay, thank you for your reply!

[roser13, ASN, RN]

This seems like a strange question for school to ask. In my experience, this is a facility-specific answer that would be covered by Policies & Procedures. So your answer might reference that as well.

[heinz57]

This seems more like a critical thinking scenario for prioritizing and patience.

First you double check the order to see what is being scanned and if contrast is needed or whatever special considerations. Weight, size and special equipment like a halo or traction might be special. When you call Radiology you will get an estimated scanner availability and inform them it is a ventilator patient. This gives them time to adjust for coordinating transport if it is arranged by their department. It may keep you from waiting in the hallway also. Moving a ventilator patient safely will take time. Chances are the patient ahead of this one will be finished with their scan.

Give the time estimate to Respiratory since one RT might be covering several areas.

Make sure you are prepared. Is your IV adequate for contrast? Can you lighten the load? What prep for a bad situation is needed? Do you have enough people to push all equipment? Do you have adequate sedation orders and meds to take?

Patience. No matter how much you scream STAT, every other doctor will be screaming their patient is more STAT. You could call the CEO but that does not make another patient's emergency less urgent. Provide the urgency information calmly to the CT Scan Radiology staff. Just be sure to have all things in the previous paragraphs in order so you don't look silly in the scanner room. Nothing wastes the precious time of this patient and others waiting their turn as someone who "Oh I need a bigger or better IV?" or the staff restraining a ventilator patients while someone gets more meds. Or, the patient weighs 400 pounds and in not a candidate for this CT Scanner.

Lack of preparation defeats STAT regardless of the situation when a scanner becomes available.