This was my first week back on placement. I was at Crosshouse hospital and in Computed Tomography (CT). It was quite nerve racking being back and in my final year. It was also intimidating to be placed in CT on my first week back as I knew I was expected to perform five CT head examinations in order to prove my CT competency.
On the first day after the summer break I expected to be gently eased into the environment, however I was mistaken. As usual in any CT environment it was fast paced and on this occasion, as with my last CT placement, there was a shortage of staff. I had previously undergone a week in CT in another hospital which was also extremely busy and with a shortage of staff and this affected my confidence of achieving my required competencies.
Throughout the morning the staff explained what procedures and examinations they were performing, and it was not long before I was carrying out patient ID checks and safety checks for the administration of intravenous (IV) contrast. By early afternoon I was being talked through setting up examinations for head CT scans and by the end of the first day I had performed my first solo CT head examination. Patient ID checks are IRMER regulation and all patients under going any examination which involves ionising radiation needs to be identified by, name, address, date of birth and examination to be carried out.
Throughout the week my confidence grew, and the staff helped me relax, it felt easy to fit into the department. By the end of the week, I had performed eight CT head examinations and two abdomen/pelvis examinations. There are many reasons that head CT scans are performed. A few of the more common reasons are to detect brain injuries through trauma such as fractures of the skull or bleeds in the brain, another common referral for head CT examination are to detect bleeding due to a ruptured aneurysm or blood clots in the event of strokes.
I found utilising CT to look for pathologies extremely interesting although, due to its fast pace, there is limited amount of time to examine and study the images carefully. I also felt that, unless you were able to canulate patients and administer IV contrast, CT scanning could become very repetitive. It has very clear advantages from the patients’ point of view, the speed and ease of the examination enables patients to tolerate examination even through pain and discomfort. Even though some patients are on beds and may need to be manually transferred with the use of a PAT slide on to the CT table top, overall CT examinations seem to be well tolerated.
Throughout the week there were many examinations which required IV contrast. Contrast agents (which are usually an iodine compound) used in CT are available in several different forms, some of the more common contrast agents used are, Iodine, Barium, Barium sulfate and Gastrografin. These can be administered in different ways; intravenous injection, oral administration and rectal administration. IV contrast is used in CT is to help highlight blood vessels and to enhance the tissue structure of various organs such as the brain, spine, liver and kidneys.
Patients requiring any contrast agent for examinations require safety checks to be carried out. This is to determine any conditions such as diabetes, asthma or any allergic reactions they may have experienced in the past. They are then required to sign an “informed consent form” prior to having their contrast administered and CT exam. This form outlines the potential side effects of the contrast. Some patients experience mild side effects from the contrast agent such as a warm or hot “flush” during the actual injection, a “metallic” taste in the mouth, which usually lasts less than a minute and a sensation like they have to urinate. The patients are told about these potential side-effects and are reassured that these sensations quickly subside. Experiences vary depending on the type of contrast used, the rate at which it is administered and individual patient sensitivity. Milder reactions that may take place following the administration of contrast is itching over various parts of the body with hives, lasting from several minutes to several hours after the injection. This type of reaction is usually treated with medication. A more serious reaction, although much less likely, may include breathing difficulty, swelling of the throat, or swelling of other parts of the body. These reactions can be more serious if not treated immediately.
Overall my week in CT was interesting and very fast paced. I am extremely happy to have achieved my competences and enjoyed learning on new equipment. Attached to this piece of reflection is an image of a CT brain taken from, http://www.radiologyinfo.org.

 

 

 Images taken from; http://www.e-radiography.net/index.htm, showing various contrast used in CT imaging.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

contrast for CT

This entry was posted on Tuesday, January 4th, 2011 at 7:04 pm and is filed under Reflectives. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.