Unstable patients to MRI or CT?

[frankwalker]

Hey everyone,

I have a question about sending ICU patients down for diagnostic procedures. I'm a former ICU RN who transfered down to imaging and got tasked with helping come up with a policy for who and who is not appropriate to come down for procedures. At this facility ICU patients come down for procedures like: CT, MRI, US, PICC placemet, lumbar punctures, nuclear medicine scans, para's and thoras. Some patients have not done well while out of the unit prompting this task. I feel all proceedures should be done bedside with the exception of emergent CT or MRI's. I've spoken to a few local facilities and they have no written policy and leave it to the discretion of the intensivist.

Do any of you have policies at your facilities?

Any input would be appreciated.

Thanks.

[pricklypear]

The only things our patients leave the unit for are CT and MRI and nuclear med. All the rest is done at the bedside. Radiologist inserted PICCs have to go to radiology. If the patient is unstable, we would just do a central line at the bedside and not bother with a PICC. Most of our PICCs are put in by nurses, anyway. We don't have any written policies that I am aware of, that's just how we do things.

[christianRN]

Like Prickly Pear, our pts don't leave except to go to CT, MRI, or nuc med. Since we don't have an MRI in-house, they don't go to MRI unless they're on their way out of ICU.

We don't have written policies, but we do use our judgement when a pt is too unstable to leave the unit. A code in CT is no fun at all!

[Teachchildren123]

Same for us. We now have a MRI mobile, coming M-W-F. I never had to go there yet, but they say that it is very cold in the winter (being in a truck) and if your pt codes, you have to pull him out of there first, because it is just big enough for one pt.

I usually bring my emergency drugs, flushes and Ativan IV in transport, you know, just to wear off the "diablo"! :angryfire

So far, my pt never coded in CT and they never pulled out their triple!

Oops! I forgot! Yeah, that pt with Munchausen, she did it, pull her triple lumen while sitting on the commode at shift change. She did herself too! That truly confirmed our suspicions. Diagnosed too late! :smackingf