It's Been a While... again!

Suffice it to say that it's been a pretty interesting past few weeks for me. My CT time has been a little limited but I have managed to have some interesting experiences.

It all started when one of our machines (we have two Toshiba Acquilion 64 slice) blew it's tube! That made for an interesting night! Especially when the next day, the other machine went down for some odd reason and we had no scanner whatsoever. ER patients were being taken next door to our outpatient facility that has a machine that most of us have never used, myself included! One of our ER doctors in particular was having an absolute fit over the situation and I heard him yelling and complaining about it to anyone who would listen for over two hours! Because it was our fault you know!

Anyway, once the tube was replaced in one scanner and the other was up and running again, I had an interesting experience while doing a chest angio on a woman who was approximately 29 years old. Everything was going fine, she had great IV access and I was having no problems. I did both of my scout pictures and when I FINALLY found her pulmonaries after about 6 sure exposure pictures, my dot for my ROI was nowhere to be found!! I had no idea what to do. I tried everything I could think of. Absolutely everything. I called three different techs, only managing to get ahold of the 3rd one I tried, and found out that I was pretty much on my own and would have to manually watch the contrast in her pulmonaries and start the scan based on my own judgement. My hand were shaking so bad as I did her test injection and then as I started her contrast. Luckily, the patient was young and her body cooperated with me. Her pulmonaries lit up nice and bright, I hit the scan button, and everything was beautiful!! I have never ever had to do that before! It just goes to show me how spoiled that scanner has us all!!

The other interesting experience I had was on this past Friday night. A two year old girl had fallen approximately 5 feet from the top of a slide and was having severe pain any time her parents tried to pick her up. The ER physician had ordered a head and c-spine without and then a chest, abdomen, pelvis with IV only. Of course we're all dreading getting this patient because it's hard enough to just do a head on a child this age, let alone give them contrast and try to get them to hold still long enough for a scan of their entire body! Well the patient was great!! She was of course scared to death, but I had the mom lay on the scanning couch with her for the head and c-spine which seemed to help, and then we spun the patient around so she was feet first in the scanner and could easily see both her parent for the C/A/P scan. The patient's weight was 25 pounds so I hand injected 20mL of contrast and we started the scan. There was a little bit of respiratory motion because of course, a two year old is not going to hold her breath, but other than that we got a great scan! I didn't get to see the report because when we finished it was time for me to go home but I am interested to see if anything was wrong with her.

Bad Week

So due to a lot of people being out sick lately I've gotten a lot of time in Cat Scan. Though I have to say it has not all been good! For three days in a row I had major problems. The first day, a patient threw up all over me, the next day, contrast exploded in my face and hair, and then the day after that, as I was scanning a patient and their IV pulled completely out of their arm and contrast spewed all over the patient, the scanner, the room and me. After all of that I told the other girl I was working with that I was DONE with contrast of any type because I was tired of going home with half of it on my person!!!

I haven't really seen any interesting cases lately. Just your usual abdomen/pelvis and heads. Though on one good note, I did do another head angio by myself and it turned out great!! Still doesn't mean I like them though!!

My Week

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!

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.

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!!

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!

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!