Transcript blood work - El Camino College

CONTRAST MEDIA
Venipuncture
& Tomography
Brief Review of Contrast - More detail in RT 93
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BLOOD WORK
LAB TESTS to check function of kidneys
prior to injection of contrast
• BUN = BLOOD UREA NITROGEN – ______
always check with RAD when level above ___
• CREATININE levels range__________
always check with RAD when level above ______
Why are these important to check?
What is the name of the other test now done?
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BLOOD WORK
LAB TESTS to check function of kidneys
prior to injection of contrast
WATCH THE UPPER LIMITS
• BUN = BLOOD UREA NITROGEN – 8 to 20
always check with RAD when level above 20
• CREATININE levels range: 0.6 - 1.2 (1.5)
always check with RAD when level above 1.2
• Indicates function of kidneys
• Diseases / dehydration / kidney failure
• New test: GFR glomerular filtration rate
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estimates the amount of blood per minute that passes through the small filters in the kidney
Shows how well the kidneys are working to filter out waste products.
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Contrast Induced
NEPHROPATHY
• ANGIOS
• CT SCAN (includes urography)
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30 % MORTALITY
MORE THAN JUST BUN & CREATININE
LAB WILL DO ANALYSIS
Should be taken with last month –
Most over 50 need blood work before contrast
injection
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• Requirements for CREATININE testing prior to iodinated
contrast media injections (for the purpose of reducing the
chance of contrast-induced renal failure):
• Patients > 50 years of age are to have a recent (within 30
days) serum creatinine prior to contrast injection.
• Patients < 50 years of age do not require labs, UNLESS the
patient has one or more of the following:
• An underlying medical condition that impairs the renal system
• Cancer
• Recently (within 30 days) had chemotherapy
• History of renal disease.
• Diabetes mellitus
• Receiving treatment with potentially nephrotoxic drugs
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Guidelines from UCSD
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Important Conditions to be Aware of……
• Level of Consciousness:
ALOC
– Altered Level Of
Consciousness
• Anaphylatic Shock:
vasogenic shock
• Hypoglycemic/
• Hyperglycemia
– NPO – Nothing by
Mouth
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FEAR
Needles?
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Have emesis basin
Towels
Wet cloth available
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Become familiar with………..
• In your work environment:
– Emergency assistance protocol (how to get
help)
– Emergency Cart/Crash Cart Location
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KNOW WHERE YOUR CRASH CART
AND DRUG TRAYS ARE LOCATED
And HOW to CALL FOR HELP
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Patient Assessment Check List
• Information update !!
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INJECTABLE
IODINE - NONIONIC
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Supplies for Venipuncture
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Disposable gloves
Alcohol Swabs
Tourniquet
Needle
– Butterfly or
Angiocath
Tape
2X2 or 4X4
Contrast & Syringes
Saline
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Venipuncture Anatomy
• Most Common sites
for IV introduction in
Radiology
– Anticubital space
– Anterior forearm
– Dorsum of the hand
– Radial wrist (ouch)
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Standard Precautions
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Principles of Drug Administration
• “The golden rules of drug administration”
• The five rights of drug administration
• Right drug
• Right patient
• Right route
Right amount
Right time
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Extravasation of Contrast
into soft tissue of arm
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TOMOGRAPHY (historical)
taken between 1 – 5 min images
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TOMOGRAPHY
• PURPOSE:
• TO BLUR OUT
ANATOMY ABOVE AND
BELOW THE PLAIN OF
INTEREST
• USUALLY 1CM FOR
KIDNEYS
CHANGE FULCRUM
LEVEL FOR EACH EXPOSURE
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Note level of kidneys to spine
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Tomogram – “PREPPED”
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Tomography = blurs out anatomy above and below
selected level
Long
exposure
Times
At least
1 second
Must
reduce mA
Increase
time
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tomogram
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nephrotomogram
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Why is this blurry?
Why taken?
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Must mark cm levels
“fulcrum “ also remember
to change levels in
between exposures!
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