Head Angios

Okay, so I'm not sure how everyone else feels about them, but basically, I LOATHE head angios. I know, I know, they are a relatively short exam to performed but for some reason, I just don't like them. Here's my reasoning behind this.

Two weeks ago on a Friday night, it's about 10 p.m., almost time for me to go home and a Head Angio pops up. Okay, so I haven't done one of these since I was still in training which had been more than two months prior to this night. Well, I got the patient, started the exam, everything was fine. I don't know how everyone else was trained but I was taught to set my ROI tracker in the ascending aorta and set my HU to 120 and let the scan start on it's own when the contrast reaches this point. Well, I did this and for some reason, I don't know if it was because the woman was absolutely tiny or what the but tracker actually read some streak artifact from the contrast that I think was actually in the vena cava and started the scan waaaaaayyyyy too early. There was absolutely no contrast whatsoever anywhere in the brain. The only thing I could do was restart the scan. There was probably about a 15 second timespan between the end of the first scan and the start of the second one but it was enough that the entire scan was contaminated. I was very disappointed. Though I didn't receive a call from the radiologist and the girl who did the recons the next day said it was fine. I was still mad because it wasn't an ideal scan. Oh well.

So, needless to say after that experience, I was none to keen on doing any head angio that popped up. Well, low and behold, Tuesday night an ER doctor orders one!! EEEKKK!! I had the other CT tech that was with me, who I graduated from x-ray school with, show me how she does them. Instead of using the tracker system, she sets the ROI between C3-C4 and watches for the internal carotids to blush. Once this happens, you manually start the scan. So this is what I did and after a few seconds of panic when I didn't see the blush as quickly as I thought I should, I got a beautiful scan! Yay!!

I still hate them though!! About the only angio study I feel fairly secure in doing is a chest!! I guess that just comes with time!