Patient Preparation For Radiology Examinations
Patient Preparation For Radiology Examinations
Patient Preparation For Radiology Examinations
PATIENT PREPARATION
Galway (Sligo)
Airport
Western
Galway
Quality Inn
Hotel N18
FOR RADIOLOGY EXAMINATIONS
Clinic N6
Motors
N6
N6 Martin
Roundabout
To Galway City To Oranmore
To Galway City
Coast Road
USEFUL NUMBERS
REPORTS & IMAGES - 091 785628
APPOINTMENTS - 091 785601
MRI APPOINTMENTS - 091 785554
RADIOLOGY NURSE - 091 785644
Dear ward staff and referring physicians, we have drawn up this document so
Introduction 3 that you can become more familiar with the range of tests and services offered
within radiology here in The Galway Clinic. We have included important
Requesting an examination in the Radiology Department 3 information on contrast reactions and pregnancy protocols. We endeavor to
respond to your requests for radiology imaging as soon as is possible. We hope
Request card minimum criteria 3 this can be used to explain to patients what tests they are going for and how
Other Considerations 4 best to prepare for their exam. Included are commonly required phone numbers.
Please feel free to call us if you have any questions about either the service in
Considerations prior to administration of contrast 4 general or regarding specific patients.
Patient Preparation for Interventional All complete Radiology Request forms should be sent to the department for
review/scheduling. Verbal,faxed and emailed requests by referring physicians may
Procedures in Radiology 18 be accepted by the relevant Clinical Specialist Radiographer, but must be
Appendix 1 - MRI Questionnaire 19 followed by a fully completed original request form before or at the time of
exam.
2 3
OTHER CONSIDERATIONS:
TO REQUEST A REFERRAL PAD PLEASE CALL 091 785554
The patients pregnancy status (if they are female and between 12 and 55
they must adhere to the 10-day rule, see page 6).
If there is an infection risk, e.g. is the patient M.R.S.A. positive? In these
circumstances the Co-ordinating Radiographer should be contacted directly on
091-785423 (or Ext 5423). GALWAY CLINIC
When the radiographer receives a complete request form for a ward patient, they
will decide on an appropriate time to call the patient down to the department and
they will communicate this with the ward.
Our policy is to call for patients continually throughout the day.
Doughiska, Galway, Ireland
Phone: + 353 (0)91 785000/5601 Fax: + 353 (0)91 785604
CONSIDERATIONS PRIOR TO ADMINISTRATION OF CONTRAST E-Mail: [email protected] Web: www.galwayclinic.com
SAMPLE REQUEST
4 5
FEMALE PATIENTS THE 10 DAY RULE FLUOROSCOPIC PROCEDURES AND PATIENT PREPARATION
One major consideration for female patients between 12 and 55 requiring x-rays is Barium Swallow:
whether a possibility of pregnancy exists. The pregnancy policy in the radiology This is a fluoroscopic examination to visualize the oesphagus and its function.The
department states that all x-ray examination of below the diaphragm and above the patient will be asked to swallow a cup of barium sulphate, which is a radio-opaque
pubis must adhere to the 10-day rule. contrast agent. Using the fluoroscopy machine, the radiologist will study the transit of
the barium through the G.I. upper tract as far as the stomach.
The 10-day rule states that female patients of child-
bearing age can only be x-rayed during the first 10 Preparation:
days of the patients menstrual cycle. The patient is required to be fasting for 8 hours prior to their exam.
Female patients must adhere to the 10-day rule (see page 5).
If the patients menstrual cycle is outside of these dates
and the x-ray required is urgent then a pregnancy test Barium Meal:
should be ordered on the ward and a hard copy of the This is a fluoroscopic examination of the stomach following administration of barium
results given to the radiographer/xray reception. sulphate (a radio-opaque contrast agent) using the fluoroscopy machine.
Preparation:
The patient is required to be fasting for 8 hours prior to their exam.
Female patients must adhere to the 10-day rule (see page 5).
Barium Enema:
This examination of the large intestine uses barium sulphate. A plastic tube is inserted
into the patients back passage. From this the barium runs through the tube into the
large intestine. Some air is also inserted into the colon which helps to expand and
visualize the colon fully.
Preparation:
It is essential that all patients use a bowel cleanser 24 hours before their
examination
Fleet Phospho-soda should be given to the patient the morning before their Barium
Enema appointment (assuming they have a morning appointment)
All instructions are provided in the box and should be followed but if you have any
questions please call the radiographer at 5423
If for some reason the patient has been unable to take the Fleet preparation, please
inform the radiographer
Female patients must adhere to the 10-day rule (see page 5).
After any of the above examinations, the patient can eat and drink as normal, unless
the doctor has specified otherwise.
If you have any questions, please do not hesitate to call the Fluoroscopy
Radiographer at 5423.
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PATIENT PREPARATION FOR A MAMMOGRAM PATIENT PREPARATION FOR A C.T. SCAN
All mammogram request forms should be sent down to the Computed Tomography is a method of imaging which uses ionizing radiation to acquire
radiology department. The Mammographer will then find a cross sectional images of the body. As C.T. uses a high radiation dose technique, it is
suitable appointment time for the patient and let the ward imperative to enforce the 10 day rule (see page 5 ). Any female patients referred for a
know when to send the patient down. Several views may be C.T. scan should have had the first day of their menstrual period no longer than 10 days
acquired during the procedure. Patients who have had previous before the date of the scan. If this is not the case, they will be rescheduled for another
mammograms should bring the x-rays with them for date. Otherwise the referring clinician will have to sign a clinical waiver and accept
comparison. Old x-rays can be requested from the department responsibility.
where the images were taken.
All C.T. scans:
Preparation: As the majority of C.T. scans involve an injection of contrast media, it would be helpful
Patients should not wear deodorant on the day of their if all patients could be cannulated before attending the C.T. department. A 20G cannula
examination and when possible, they should wear a gown and something on is sufficient for most C.T. procedures except for C.T.P.A. and Angiography scans which
their lower half (i.e. a trousers or skirt). require an 18G cannula. The line should be flushed to ensure patency prior to the
patient leaving the ward. Creatinine levels must be checked for all patients who will be
If you have any questions, please do not hesitate to call the given a contrast medium.
Mammographer at 5619
Chest/Abdomen/Pelvis:
The patient is required to fast for 4 hours prior to their C.T. scan.
Oral contrast (15mls of gastrograffin in 1litre of water) must be given to the patient to
drink before attending the C.T. department. This should be taken slowly over a period
of one hour, i.e. the patient should drink approximately one cup every 10 minutes.
8 9
CT CONTRAINDICATIONS INCLUDE: PATIENT PREPARATION FOR ULTRASOUND EXAMINATIONS
History of allergies to drugs Ultrasound is a diagnostic medical imaging technique used to visualize muscles,
Previous reaction to contrast media tendons, and many internal organs, their size, structure and any pathological lesions.
Asthma It does not use ionizing radiation.
Renal failure or cardiac problems
Pregnancy or breast feeding For many ultrasound examinations no preparation is required.
Diabetes*
This includes examinations such as thyroid, breast, testes, musculoskeletal, vascular and
* If the patient is diabetic it is important to establish if they are taking cardiac. In certain situations simple preparatory measures are required as follows:
Glucophage/Metformin. These patients are at risk of lactic acidosis following the
administration of IV contrast media. Renal function should be assessed prior to the Renal Ultrasound:
injection and the following steps taken: No fasting is required.
Patient must drink 1.5 litres of water 1hr before their appointment time and not
If the creatinine level is normal (i.e. 65-115) then Glucophage should be empty their bladder
suspended for 48 hours after injection and only resumed if serum creatinine A full bladder is necessary to examine the complete renal tract. Insufficient filling of
levels remain unchanged. the bladder will give appearances of thickening or a trabeculated bladder, making it
impossible to exclude a bladder lesion
If the creatinine level is abnormal, Glucophage should be suspended for 48 hours
prior to and after the examination and only resumed if the serum creatinine levels Abdominal Ultrasound:
remain unchanged. Adequate hydration should be given to the patient prior to the The patient should be fasting for 12 hours.
C.T. scan (i.e. NaCl infusion to be given to the patient prior to administration of Optimum conditions for the ultrasound examination of the abdominal organs require a
contrast medium). The patient must be well hydrated after the scan also. fluid-filled gallbladder and as little gas in the gastrointestinal tract as possible.
If the renal function is unknown, the physician should evaluate the risk/benefit of * If the patient is a diabetic, he/she may be accommodated by receiving an early
the contrast media and precautions should be implemented. Glucophage should be appointment time.
suspended, patients hydrated and renal function monitored.
Pelvis Ultrasound:
Patient must drink 1.5 litres of water 1hr before the scan and not empty their bladder.
To optimally visualize the pelvic contents, bowel gas must be displaced. This is
accomplished by filling the bladder to full capacity.
10 11
PATIENT PREPARATION FOR AN M.R.I. SCAN PATIENT PREPARATION FOR A NUCLEAR MEDICINE SCAN
Magnetic Resonance Imaging is a non-ionizing method of imaging the body. It uses a A nuclear medicine scan is a test in which radioactive material is injected into the
magnetic field to acquire cross-sectional images of the body. In the M.R.I. department, body and is used to create an image of a specific organ or bone using a gamma
M.R.A. (Magnetic Resonance Angiography) scans are also performed. Owing to the camera. This test can provide information about the structure and function of
strength of the magnet, patient safety is of utmost importance. It is essential that the specific parts of the body.
M.R.I. Patient Safety Questionnaire and the M.R.I. Safety Memorandum (see page and
19 ) should be discussed with the patient before all scans. Isotope Bone Scans (IBS):
Procedure
This is the only patient preparation necessary before an M.R.I. scan with the 1 Intravenous administration of radiopharmaceutical. This may be
following exceptions: immediately followed by 5-10 minutes of imaging depending on the
indications for the procedure.
M.R.I. Abdomen: 2 Uptake Time. The patient will then return to the ward for a minimum of 2
The patient is required to fast for 7 hours prior to the scan. hours (more often 3). This is known as the uptake time and is necessary on
An IV cannula is not necessary. order to allow the radiopharmaceutical to be absorbed by bone. During this
time the patient may eat normally and is encouraged to drink approx. 2 pints
M.R.C.P: of any liquid. If the patient is unable to do so, they can be given IV fluids
Magnetic Resonance Cholangiopancreatography examines the gall bladder and bile under the direction of the RMO or referring clinician. These instructions and
ducts. The patient is required to fast for 7 hours prior to the scan. the return time will be given to the patient before they leave the Nuclear
An IV cannula is not necessary. Medicine Department.
3 Delayed Phase. Patients are asked to void immediately prior to imaging.
M.R.I. Pelvis: This phase takes approx. 30-45 min. During this time the patient is generally
The patient is required to fast for 4 hours prior to the scan. lying supine with the gamma cameras moving around them.
An IV cannula is not necessary. 4 Patients may eat and drink as normal following the procedure.
12 13
Preparation Isotope Thyroid Scan
IT IS NOT NECESSARY FOR PATIENTS TO FAST PRIOR TO RENOGRAMS Procedure
Patients should be well hydrated before attending for Renograms (approx.1 1 Radiopharmaceutical is administered through IV cannula
litre of fluid orally). 2 Patient is asked to drink 1 glass of water over the following 15 minutes
IV access: Peripheral IV cannula in-situ 3 Imaging is carried out 20 minutes following radiopharmaceutical
LMP: Female patients aged 14 55 must be imaged within 10 days of the administration.
first day of their most recent period (10-day rule). If it is not suitable to 4 Imaging lasts for approx.20 minutes. During this time the patient is supine
schedule the procedure for this time a clinical waiver must be signed by the with the gamma camera directly above their head and neck.
referring clinician. 5 Patient may eat and drink as normal following procedure.
Breast feeding must be discontinued for 48hrs following administration of 6 Patient may resume any medications immediately following procedure.
the radiopharmaceutical.
Renograms should not be carried out on the same day as surgical Preparation
procedures. All other diagnostic and therapeutic procedures should be IT IS NOT NECESSARY FOR PATIENTS TO FAST PRIOR TO ISOTOPE THYROID
scheduled before radiopharmaceutical administration. SCANS.
For patients who have recently received X-ray contrast agent, have taken
DMSA thyroid medications or have taken alternative seaweed based remedies or
Procedure foods please discuss with the Nuclear Medicine department before booking
1 IV administration of radiopharmaceutical. procedure.
2. Patients may return to the ward following administration of DMSA. They can IV access: Peripheral IV cannula in-situ
eat normally and are asked to increase fluid intake (approx.1litre over 120 LMP: Female patients aged 14 55 must be imaged within 10 days of the
minutes) first day of their most recent period (10-day rule). If it is not suitable to
3 Patient returns to the Nuclear Medicine department not less than 90 minutes schedule the procedure for this time a clinical waiver must be signed by the
post radiopharmaceutical for imaging. referring clinician.
4 During imaging patient lies supine and the gamma cameras are moved Breast feeding must be discontinued for 24hrs following administration of
around their abdomen. the radiopharmaceutical.
5 Imaging takes approx 45 minutes. Isotope Thyroid scans should not be carried out on the same day as surgical
6 Following imaging patient may eat and drink as normal. procedures. All other diagnostic and therapeutic procedures should be
scheduled before radiopharmaceutical administration.
Preparation
IT IS NOT NECESSARY FOR PATIENTS TO FAST PRIOR TO DMSA scans.
Patients should be well hydrated before attending for (approx. 1 litre of fluid
orally).
IV access: Peripheral IV cannula in-situ
LMP: Female patients aged 14 55 must be imaged within 10 days of the
first day of their most recent period (10-day rule). If it is not suitable to
schedule the procedure for this time a clinical waiver must be signed by the
referring clinician.
Breast feeding must be discontinued for 48hrs following administration of
the radiopharmaceutical.
DMSA scans should not be carried out on the same day as surgical
procedures. All other diagnostic and therapeutic procedures should be
scheduled before radiopharmaceutical administration.
14 15
Parathyroid PATIENT PREPARATION FOR A P.E.T. SCAN
(Parathyroid scans are NOT connected to isotope thyroid scans).
Procedure P.E.T. C.T. is a complex
1 Radiopharmaceutical (Sestamibi) is injected through peripheral cannula. procedure which has quite
2 Patient is asked to drink 1 glass of water during the following 15 minutes. specific patient preparations. If
3 The first image is acquired 20 minutes following injection and the remainder a patient in your care requires
at intervals of approx. 45 minutes over the following 3 hours. Further a P.E.T. C.T. scan we would
delayed images may be necessary. recommend that you contact
4 Patients may eat and drink as normal during intervals between images. the Radiographer directly at
5 Patients may eat and drink as normal following procedure. 5626 for advice and
information.
Preparation
IT IS NOT NECESSARY FOR PATIENTS TO FAST PRIOR TO PARATHYROID
procedures
It is not necessary for patients to stop any medications (including thyroid
medications) prior to Parathyroid scans.
IV access: Peripheral IV cannula in-situ
LMP: Female patients aged 14 55 must be imaged within 10 days of the
first day of their most recent period (10-day rule). If it is not suitable to
schedule the procedure for this time a clinical waiver must be signed by the
referring clinician.
Breast feeding must be discontinued for 48 hrs following administration of
the radiopharmaceutical.
Parathyroid scans should not be carried out on the same day as surgical
procedures.
All other diagnostic and therapeutic procedures should be scheduled before
radiopharmaceutical administration.
Preparation
IT IS NOT NECESSARY FOR PATIENTS TO FAST PRIOR TO PERFUSION LUNG
SCANS
DO NOT CANULATE PATIENTS FOR PERFUSION LUNG SCANS AS THE
RADIOPHARMACEUTICAL MUST BE GIVEN BY DIRECT STICK
LMP: Female patients aged 14 55 must be imaged within 10 days of the
first day of their most recent period (10-day rule). If it is not suitable to
schedule the procedure for this time a clinical waiver must be signed by the
referring clinician.
Breast feeding must be discontinued for 48hrs following administration of
the radiopharmaceutical.
Perfusion lung scans should not be carried out on the same day as surgical
procedures. All other diagnostic and therapeutic procedures should be
scheduled before radiopharmaceutical administration.
Please inform the nuclear medicine department prior to the procedure if the
O2 sats are below 90% on room air.
16 17
PATIENT PREPARATION FOR INTERVENTIONAL PROCEDURES IN MRI QUESTIONNAIRE
RADIOLOGY
Name:
Portacath Implantation: Date of Birth:
Portacaths are implanted into the patient using fluoroscopy. The procedure is Address:
carried out by a radiologist and is assisted by the radiology nurse. The patient is Telephone:
generally sedated for the procedure.
Preparation:
The following blood tests must be performed prior to Portacath Insertion; It is important to answer the following questions fully:
FBC, U&E and COAG screen. Yes No
An IV cannula should be in situ. Have you signed the Insurance form?
The patient should be fasting from midnight prior to the procedure. X-RAYED HERE BEFORE? YEAR
Patients should be in a gown and should come down in their beds. Have you had a pacemaker or artificial heart valves?
Biopsies: Have you had any surgery to stop a bleed in the brain or elsewhere?
Biopsies are carried out using CT or Ultrasound. Have you any joint replacements or metal implants?
Have you ever worked with metal welding or cutting etc?
Preparation: Do you have any foreign bodies or shrapnel in your eyes or skin?
The following blood tests must be performed prior to biopsy; FBC, U&E and Do you have any jewellery in any part of your body?
COAG screen.
If the biopsy is of the liver, spleen, renal system or pancreas, a Group and Do you wear dentures, a dental plate or hearing aid?
Hold must also be done. Do you have an eye or ear implant?
An IV cannula should be in situ. Do you suffer from epilepsy?
The patient should be fasting from midnight prior to the procedure. Do you suffer from Diabetes?
Patients should be in a gown and should come down in their beds. Could you be claustrophobic?
Peripheral Angiography:
Peripheral Angiography is done using fluoroscopy. The procedure is carried out Female:
by a radiologist and is assisted by the radiology nurse. Could you be pregnant?
Are you breastfeeding?
Preparation:
The Radiology Nurse needs to be informed if the patient is diabetic.
The following blood tests must be performed prior to angiography; FBC, U&E Please ensure all loose metal articles are removed from your person before entering the
and COAG screen. scan room. These include: Glasses, Hearing Aid, Jewellery, Watch, Money, Keys, Credit
An IV cannula should be in situ. Cards, Hair Clips, etc.
The patient should be fasting from midnight prior to the procedure.
Patients should be in a gown and should come down in their beds. I have read and understand the questions on this consent form and agree to
be imaged.
If you have any questions, please do not hesitate to call the Radiology
Nurse at 5644.
Signature:
Witness:
Date:
SAMPLE QUESTIONNAIRE
18 19