Well, I didn't get a whole lot of time in CT this week and therefore didn't really see anything of great interest. I am amazed however, at how much more comfortable I am getting when working down there! For instance, I had a trauma patient last night that had a head and c-spine without and a chest/abdomen/pelvis with IV only. A few months ago I would have scared been to death to be doing it on my own but it turned out really well! Though I did see an odd mass like thing (can't think of a better word to describe it) surrounding the right kidney. I never got a chance to check the report but I'm definitely going to follow up and find out what it was!
Last week I had to do a stat AIF which was pretty interesting. The patient was 4 days post op from a left hip pinning and had diminished pulses in his left leg, the nurse was barely able to find a pulse in his foot even when using a doppler! I did the study which I thought looked a little odd and come to find out the next day after reconstructions he had almost no blood flow to his lower legs! It was a very stressful situation all around because the ordering doctor was calling and yelling because it wasn't getting done quickly enough for his liking, we were down to one scanner thanks to PM's on our other one, and it took almost 30 minutes for all of my images to cross over to synapse! I was very glad to be finished with it!
Hopefully this coming week some more interesting things will happen!
Saturday, February 14, 2009
Saturday, January 17, 2009
First Week of Clinicals
This week has flown by for me! We were extremely busy in Cat Scan every night this week and while I can't seem to remember all the cool stuff I saw, one thing sticks out in my mind.
An order for an abdomen/pelvis with contrast on a 70 something year old woman complaining of abdominal pain came across and upon taking the patient's history, I found out that she had a history of breast cancer with a left mastectomy. At the time I didn't think to ask her how long she had been cancer free but now I wish I had. Anyway, I scanned the patient and was very dismayed to see her liver. It was absolutely eaten up with what looked like mets. It was so awful to walk back into the scan room and talk to the patient like absolutely nothing was wrong. I checked the report later that night and according to the Rad, there were too many spots to even count them correctly and they were HUGE. I have never seen mets this bad before. But that wasn't even the worse part, aside from the liver, there was also question of pancreatic and uterine masses in this patient. This all happened on Wednesday night and I found out on Thursday afternoon that this same patient was scheduled for a liver biopsy the next day. I feel so horrible for that patient and her family.
I have to say that's the worst part about this job. At least I know I got a good scan and hopefully made that patient feel as comfortable as possible.
An order for an abdomen/pelvis with contrast on a 70 something year old woman complaining of abdominal pain came across and upon taking the patient's history, I found out that she had a history of breast cancer with a left mastectomy. At the time I didn't think to ask her how long she had been cancer free but now I wish I had. Anyway, I scanned the patient and was very dismayed to see her liver. It was absolutely eaten up with what looked like mets. It was so awful to walk back into the scan room and talk to the patient like absolutely nothing was wrong. I checked the report later that night and according to the Rad, there were too many spots to even count them correctly and they were HUGE. I have never seen mets this bad before. But that wasn't even the worse part, aside from the liver, there was also question of pancreatic and uterine masses in this patient. This all happened on Wednesday night and I found out on Thursday afternoon that this same patient was scheduled for a liver biopsy the next day. I feel so horrible for that patient and her family.
I have to say that's the worst part about this job. At least I know I got a good scan and hopefully made that patient feel as comfortable as possible.
Thursday, December 4, 2008
Wow
I honestly can't believe that the semester is almost over!! It seems like I just got started!!
So I've been working dayshift in CT this whole week and I'm feeling pretty good about things. The more I work, the more confidence I gain. (Duh!) Yesterday I got to do an AIF which is something that I hadn't done in probably 3 months (at least) and I remembered everything I needed to do and had a great study! Earlier in the week I did a dreaded head angio and got a compliment from the vitrea tech who does the reconstructions about how great it was! Yay me!! Today I got to do a chest angio which I think is probably my favorite exam. It's the only angio study that we get to reconstruct ourselves and I love to do it!! All the other angios are sent to the vitrea and there are only 4 people in our department trained on that equipment. Thanks goodness I'm not one of them!
We also have a new protocol that started this week concerning a soft tissue neck with contrast. We are supposed to start the scan above the ear and end it at approx. the level of the carina. Well, when I trained in CT over the summer the protocol was that the scan ended at the sternal notch. I will remember that for the rest of my days because the very first soft tissue neck I did, I did not get all the way to the sternal notch, a fact which the two techs supervising me did not notice, and our head radiologist called to point it out to me. I was so embarassed and wanted to crawl in a hole. You would have to know and work with this doctor in order to understand just how small and insignificant he can make you feel! Though technically it wasn't my fault since at the time I didn't really know what I was doing anyway! Anyway, back to the new protocol, I did a neck with contrast today and luckily just happened to get down far enough because I thought I only had to go to the sternal notch! Sternal notch is forever drilled into my head and it's gonna be hard to change! Oh well... live and learn I guess! The study was beautiful though!
I am loving dayshift because there is such a huge variety of exams being done. It seems like the last few times I worked in CT on seconds that all I ever did was stone protocols and heads! Not that I mind those, just gets a little monotonous sometimes!
Well, hope everyone has had a great semester!!! Merry Christmas and Happy Holidays!!
So I've been working dayshift in CT this whole week and I'm feeling pretty good about things. The more I work, the more confidence I gain. (Duh!) Yesterday I got to do an AIF which is something that I hadn't done in probably 3 months (at least) and I remembered everything I needed to do and had a great study! Earlier in the week I did a dreaded head angio and got a compliment from the vitrea tech who does the reconstructions about how great it was! Yay me!! Today I got to do a chest angio which I think is probably my favorite exam. It's the only angio study that we get to reconstruct ourselves and I love to do it!! All the other angios are sent to the vitrea and there are only 4 people in our department trained on that equipment. Thanks goodness I'm not one of them!
We also have a new protocol that started this week concerning a soft tissue neck with contrast. We are supposed to start the scan above the ear and end it at approx. the level of the carina. Well, when I trained in CT over the summer the protocol was that the scan ended at the sternal notch. I will remember that for the rest of my days because the very first soft tissue neck I did, I did not get all the way to the sternal notch, a fact which the two techs supervising me did not notice, and our head radiologist called to point it out to me. I was so embarassed and wanted to crawl in a hole. You would have to know and work with this doctor in order to understand just how small and insignificant he can make you feel! Though technically it wasn't my fault since at the time I didn't really know what I was doing anyway! Anyway, back to the new protocol, I did a neck with contrast today and luckily just happened to get down far enough because I thought I only had to go to the sternal notch! Sternal notch is forever drilled into my head and it's gonna be hard to change! Oh well... live and learn I guess! The study was beautiful though!
I am loving dayshift because there is such a huge variety of exams being done. It seems like the last few times I worked in CT on seconds that all I ever did was stone protocols and heads! Not that I mind those, just gets a little monotonous sometimes!
Well, hope everyone has had a great semester!!! Merry Christmas and Happy Holidays!!
Wednesday, November 19, 2008
Dayshift!!! Yay!!
So I just found out yesterday that for the next month or so I'm going to be working some dayshift!!! Yay!! I'm a full time second shifter but thanks to someone on first shift having surgery I get to fill in AND be in CT full time!! Well, for a little while anyway!! I don't care though... I'll take what I can get! And I'll get to finish up my clinical time without having to stay late!
By the way, I ROCKED a head angio tonight!! They still make me super nervous and I almost threw up after I finished it but everything turned out great!! I'm getting more and more confident which is great! I still sometimes feel like I have mush for brains when I leave work because I'm thinking so much!! But it's great... I'm really glad I let my supervisor talk me into cross training!
By the way, I ROCKED a head angio tonight!! They still make me super nervous and I almost threw up after I finished it but everything turned out great!! I'm getting more and more confident which is great! I still sometimes feel like I have mush for brains when I leave work because I'm thinking so much!! But it's great... I'm really glad I let my supervisor talk me into cross training!
Wednesday, November 12, 2008
Not too exciting...
So it's been a while since I've posted anything new and that's only because I haven't done anything too interesting in quite some time. I did have a patient that I had to chase down through the hospital and into the parking lot because his IV had not been removed! It was pretty interesting to say the least!
It seems like the only exams I've done in the past few weeks or so are heads and abdomens! I had just gotten really comfortable with chest angios and now it's probably been a month since I've done one! Oh well. I'm getting ready to get a lot of time down there because the regular 2nd shift CT tech is going on vacation and I'm filling in for her. Yay! Sometimes I feel like I'm going to drive someone crazy asking a million questions but I guess I would rather do that than screw something up!
I'll write again soon when I have more interesting things to talk about!
It seems like the only exams I've done in the past few weeks or so are heads and abdomens! I had just gotten really comfortable with chest angios and now it's probably been a month since I've done one! Oh well. I'm getting ready to get a lot of time down there because the regular 2nd shift CT tech is going on vacation and I'm filling in for her. Yay! Sometimes I feel like I'm going to drive someone crazy asking a million questions but I guess I would rather do that than screw something up!
I'll write again soon when I have more interesting things to talk about!
Friday, October 24, 2008
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!
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!
Friday, October 10, 2008
This Week
I saw something I'd never seen before last night and thought it was worth mentioning. I went to get a patient for a chest without last night. It was ordered on a 30 something year old woman in the ER who hadn't even had a chest x-ray yet so I was a little curious as to why we were doing the exam in the first place. Her history only said shortness of breath. I don't know how it is at other facilities but MOST of the time at ours, a chest x-ray is the first step. Well, it turns out the exam was actually ordered on the wrong person! This happens at least once a day in our ER and we techs spend a lot of extra time hunting down correct patients and orders!
Anyway, it turns out the exam was actually supposed to be ordered on a 50 something year old man who was complaining of pain in the center of his chest. He had in fact had a chest x-ray prior to the ordering of the CT and the report mentioned a peritracheal and hilar fullness and recommended a CT chest with contrast. It turns out the patient was allergic to contrast! When I finally got the correct patient scanned I saw a pericardial effusion! It looked huge to me!! I have never seen one before! The CT report stated that it should be checked again in 3 months so I assume it wasn't too bad... but I think that explains why the patient's chest was hurting so much!
Anyway, it turns out the exam was actually supposed to be ordered on a 50 something year old man who was complaining of pain in the center of his chest. He had in fact had a chest x-ray prior to the ordering of the CT and the report mentioned a peritracheal and hilar fullness and recommended a CT chest with contrast. It turns out the patient was allergic to contrast! When I finally got the correct patient scanned I saw a pericardial effusion! It looked huge to me!! I have never seen one before! The CT report stated that it should be checked again in 3 months so I assume it wasn't too bad... but I think that explains why the patient's chest was hurting so much!
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