Wow, time flies, I hadn't realized that I haven't written anything on here in like a month. Things have been super busy for me lately.
CT wise it's been interesting at OMHS... We are testing out a new protocol for patient's with Crohn's, among other disorders which I can't remember right now where we inject the contrast at 4 mL/sec as opposed to 2 mL/sec like a normal. I'm still not sure the purpose of this as I have yet to do one but according to our medical director it makes a "huge" difference! Oh well, I don't pretend to understand why our protocols change so much... it's better just to go with the flow!
We're having trouble with one of our scanners causing artifact on all head scans. This has been an intermittent problem with this same scanner ever since we got it. What's weird is that it always seems to show up after we get a software upgrade. Also strange is that our other scanner which is exactly the same as the one with the artifact only 2 year newer has never had this issue. Supposedly it's fixed now but two weeks of only being able to do head scans on one scanner was getting really really old!
I haven't had any interesting cases lately... I did do another head angio (ICK!!!!) the other night. I was not proud of it at all. Ever since my bad experience with setting an ROI in the ascending aorta I do a manual scan where I watch the carotids blush and most of the time this works out well for me. Well this time for whatever reason when I hit "next scan" there was like a 5 second delay. Well as those of you that do CT know, this is a huge deal when it comes to angios, especially head angios! I still hate them... I would rather do just about any other exam! Other than one that involved rectal contrast I guess!!
Saturday, June 27, 2009
Wednesday, May 27, 2009
Summer Clinicals
Wow, it's hard to believe this is my last semester!! I'll officially have my Bachelor's Degree in August!
In other news, my husband and I are expecting our first baby in October! School really couldn't be ending at a better time!! I am so glad I decided to do this.
Things in CT at OMHS are pretty much the same. I am still working 1 or 2 days a week in CT and spending the rest of my time in x-ray. I think that's pretty much how I would like for it to stay!
Anyway, I recently saw a very interesting case, that's what the images above are from. I had a patient come in who was complaining of pain in her left pelvic area. No symptoms other than that. When I was getting the patient's history she told me that she had just had an ultrasound in which they had found a cyst on her right ovary. Well, I didn't think anything about it since this is fairly common for most women. I did her scan, abdomen/pelvis with, and sent her back to the ER. As I was looking over the scan before sending it to the doctor I was surprised by what I saw, the cyst was taking up almost her entire pelvic cavity and her bladder was completely compressed by it. I have never seen anything like it. I can't remember the reading exactly but the gist was that it was way too big to be a simple cyst and was probably some sort of neoplasm. I found out later that week that the patient ended up having a completely hysterectomy the next day. Crazy! I just hope that she's okay!
Well, hope clinicals are going well for everyone else! I have another cool case that I want to get some images of on here but I haven't gotten the chance to do it yet. I'll save it for next time!
Sunday, April 19, 2009
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.
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.
Thursday, March 19, 2009
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!!
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!!
Saturday, February 14, 2009
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!
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, 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!!
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