Patient Preparation and Contrast Medium Key for Safe, Effective CT Scans
April 1, 2011 | Health System Risk Management
As reported in the August 2010 Risk Management Reporter, managing patients' radiation dose, particularly in the emergency department (ED), has emerged as a top patient safety concern. Two nurses writing in the November 2010 Journal of Emergency Nursing (Grossman and Vo) describe steps that ED staff can take to help ensure safe and effective computed tomography (CT) scanning for ED patients and to reduce the need for repeat scans, thereby limiting patients' overall exposure.
The authors emphasize the importance of careful patient preparation to an effective CT scan. As with any invasive procedure, patients should be positively identified using two identifiers. Similarly, clinician orders should be verified to ensure that the correct study will be performed. Laboratory work, particularly regarding renal function and pregnancy status, should be reviewed. All items containing metals, including clothing, jewelry, dentures, and hearing aids, should be removed. If the patient is sedated or otherwise nonresponsive, his or her inability to cooperate during the scan should be noted and planned for. Contrast media should be administered per the physician's order, including, if indicated, the placement of an intravenous (IV) line of appropriate size in the correct location. Finally, the patient's weight in kilograms should be recorded; it is used for...