Scribd Logo
Upload

Welcome to Scribd!

  • 187 views

    Radiology Request Form - CDR

    Uploaded by

    saranya
    The document provides instructions for patients undergoing various radiology procedures at a hospital. It outlines general instructions such as arriving 30 minutes early and bringing prior scans for comparison. It then gives specific instructions for CT scans, MRI scans, and ultrasounds. For CT scans, it details fasting requirements, appointment times, and post-procedure observation. For MRI scans, it notes metal restrictions and fasting rules. For ultrasounds, it specifies fasting rules for abdominal, pelvic, and other types of ultrasounds. Patients are advised to contact the radiology department with any questions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Radiology Request Form - CDR

    Uploaded by

    saranya
    187 views2 pages
    The document provides instructions for patients undergoing various radiology procedures at a hospital. It outlines general instructions such as arriving 30 minutes early and bringing prior scans for comparison. It then gives specific instructions for CT scans, MRI scans, and ultrasounds. For CT scans, it details fasting requirements, appointment times, and post-procedure observation. For MRI scans, it notes metal restrictions and fasting rules. For ultrasounds, it specifies fasting rules for abdominal, pelvic, and other types of ultrasounds. Patients are advised to contact the radiology department with any questions.

    Original Description:

    Original Title

    Radiology Request Form.cdr

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document provides instructions for patients undergoing various radiology procedures at a hospital. It outlines general instructions such as arriving 30 minutes early and bringing prior scans for comparison. It then gives specific instructions for CT scans, MRI scans, and ultrasounds. For CT scans, it details fasting requirements, appointment times, and post-procedure observation. For MRI scans, it notes metal restrictions and fasting rules. For ultrasounds, it specifies fasting rules for abdominal, pelvic, and other types of ultrasounds. Patients are advised to contact the radiology department with any questions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    187 views2 pages

    Radiology Request Form - CDR

    Uploaded by

    saranya
    The document provides instructions for patients undergoing various radiology procedures at a hospital. It outlines general instructions such as arriving 30 minutes early and bringing prior scans for comparison. It then gives specific instructions for CT scans, MRI scans, and ultrasounds. For CT scans, it details fasting requirements, appointment times, and post-procedure observation. For MRI scans, it notes metal restrictions and fasting rules. For ultrasounds, it specifies fasting rules for abdominal, pelvic, and other types of ultrasounds. Patients are advised to contact the radiology department with any questions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    RIMC/AAC/RAD/RF-006

    Patient Details (Affix Label here)


    Name:
    UHID:
    DOB: Sex:
    Consultant:

    RADIOLOGY REQUEST FORM


    Serum Creatinine (if required): Done on:

    Clinical Details / Provisional Diagnosis:

    Investigations Required:

    Signature Name Reg. No. Date Time

    Consultant

    FOR RADIOLOGY STAFF USE ONLY


    Appointment: Date: Time:

    LMP (for females below 45 years):

    Signature Name Emp. No. Date Time


    Radiology
    Staff
    GENERAL INSTRUCTIONS FOR THE PATIENTS
    Ÿ The patient has to bring the radiology request form filled by the referring consultant.
    Ÿ The patients are requested to reach the radiology department, half an hour prior to their appointment.
    Ÿ Please bring your scan reports and films, if performed previously, for comparison.
    Ÿ If there are emergency and trauma patients, your waiting time for the scan may be extended from 30
    minutes to 1 hour.

    SPECIFIC INSTRUCTIONS FOR CT SCAN


    Ÿ No fasting is required for plain studies. For contrast studies, 4 hours fasting is required, however there is no
    restriction for water intake.
    Ÿ Scan time will be 5 to 10 minutes for plain studies and 20 - 30 minutes for contrast studies.
    Ÿ For contrast studies, an attender has to accompany the patient. The patient has to bring a recent serum
    creatinine report (not more than 30 days).
    Ÿ For female patients - If you are pregnant or think you might be pregnant, please inform our Doctors /
    Technologists.
    Ÿ Radiologist will decide whether oral contrast has to be given for the patient after doing the plain scan. If oral
    contrast is needed, the patient will be asked to drink 2 litres of water mixed with contrast over a period of 2
    hours. Then the scan will be done.
    Ÿ Once the scan is done, the patient has to wait in the radiology department for 1 hr for observation.
    Ÿ If the patient develops symptoms like nausea, vomiting, itching, chills after giving contrast, kindly inform our
    technologist.

    SPECIFIC INSTRUCTIONS FOR MRI SCAN


    Ÿ Fasting is not required for MRI studies except for MRCP, which requires 6 hours fasting.
    Ÿ For plain studies, the scan time will be 45 minutes to one hour. An additional 15 to 30 minutes will be taken
    for contrast studies.
    Ÿ The patient has to remove all kinds of metals and ornaments. If the patient had previous cochlear implant,
    pacemaker or any kind of metal inside patient's body, kindly inform our technologist.
    Ÿ For contrast studies, the patient has to bring a recent serum creatinine report (not more than 30 days).
    Ÿ Children and non co-operative patients may require sedation / anaesthesia.

    SPECIFIC INSTRUCTIONS FOR ULTRASOUND SCAN


    Ÿ For abdominal ultrasound, fasting of at least 4 hours before the examination is required. For ultrasound
    pelvis, KUB and Obstetric scans, no fasting is required.
    Ÿ For pelvis examination, the patient will be asked to drink four to six glasses of water to fill the urinary
    bladder. This will enable the radiologist to evaluate the pelvic organs clearly.
    Ÿ No fasting is required for Doppler(except renal), Neck, Thyroid, Scrotum and Breast ultrasound. Renal
    Doppler requires overnight fasting or at least 6 hours fasting prior to examination.

    For any queries / appointments, kindly contact 044 6666 7721

    You might also like