Last Post for Clinicals

I hope everyone has had a great semester! I know that I am glad to get a little break for a couple of weeks!

I am attaching a CT head image after administration of 75 cc Omnipaque 350. We use a 3 minute delay for our heads. This patient, a 56 year old male, first came initially for a CT chest in March. He had been having some hemoptysis with little to no shortness of breath. The CT showed a left lung cavitary mass. We biopsied this mass in March and it came back positive for Stage IV adenocarcinoma. In April, we scanned him again and we found bone mets in his pelvis. In May, we repeated the scan and found bilateral metastatic adrenal lesions. Now, the patient presents back to us while undergoing radiation and we perform the CT head and find mets to his brain. The report reads that there is a 2.5 cm left cerebellar mass with moderate effacement of the fourth ventrile. No hydrocephalus.

This is the great thing about working in CT, and also the hardest. These patients once they keep coming over and over become like family. It's hard to see them deteriorate and then pass. But, we have such an ability to impact their last days in making more tests easier to bear. We have an opportunity to ask them about their family and fun things they would like to do. Once, one of our cancer patients brought back seashells from the beach. This trip to Florida was her last wish that her family fulfilled. It meant so much to the staff that she shared that with them. We, as healthcare workers, often don't realize how much we can impact a patient's outcome just in helping keep spirits up.

I hope everyone enjoys the rest of their classes, this is my last clinical class.

Susan Brumley

CT Radiation Dose

As everyone is aware, CT dose is a hot topic in the layperson media along the ACR and other Radiology journals. At Deaconess, we try very hard to keep up with current best practices. Recently, the CT Team Leader and myself listened in on a webinar regarding CT dose and how to reduce it. We actually realized during this national webinar, that we...in little Evansville, IN are doing what many larger institutions are doing. We've done alot surrounding radiation safety to ensure the public is safely receiving adequate CT studies.

We have done recently:

*Looked at all of our protocols-per scanner. One particular Radiologist has taken ownership and we run all of our protocols through him.

*Developed a CT Dose Audit tool. We actually take this audit tool and place it at the controls for the scanner and the technologist must record the dose from the CT Dose report that is attached to every CT exam and sent to PACS. This makes the technologist think about radiation dose as they audit.

*Radiologist helped determine "normal ranges" for the dose audits. In doing our audits, we found that our CT Sinus/Face protocol could be realistically tweaked down a bit on one particular scanner without sacrificing quality images.

*We've made a huge stride to shield as much as possible. Attached you will see an image using a breast shield. The breast shields are great and they cause very little artifact while saving the female breast tissue a huge dose.

*Radiologist is going to do a "Grand Rounds" at Deaconess for Medical Staff so that MD's are educated on CT Radiation dose and what exams are best for what diagnoses.

All of these things are actually reported out to our Radiation Safety Committee quarterly so that they know at what lengths our department is going to keep our patients safe!