Deaconess Update

We've had a very busy start to our work week...or at least it felt that way! Our scanner went down overnight and today was a bit chaotic to start. It turns out that we've had some air conditioning problems in our VCT room. This is our 64 slice scanner and it puts some heat out! We use it all the time and it just doesn't really get a break, even at night. So, we had to call engineering and maintenance and get it taken care of. Apparently, the ducts had not been cleaned out for quite some time causing the air conditioning to not work the best. But, by 1030 am we were all cooled down and running smoothly again!!!

Clinicals Update

We've been really busy the past few weeks in the CT department at Main and Gateway. Yesterday we were hopping from the ER all day! We had a gentleman with a history of a fall come over for a CT chest, abdomen and pelvis. Of course, we were looking for trauma related pathology, but unfortunately, the patient ended up with an abnormal lesion in his chest. The fall of course is bad, but it could have saved his life! He was asymptomatic and had no cancer history. The radiologist recommended a biopsy so I am sure that we will be seeing him back in a few weeks once he has healed up from his fall.

Clinical Update

Hello all! I hope everyone is having a great semester. Things are moving along for me. Our hospital is beginning to ramp up for our HFAP survey. HFAP is a hospital accreditation similar to JCAHO. Many hospitals are moving to this type of survey. Right now we are really working hard on our Stroke Indicators. With our Stroke Certification we must do alot of PI (performance indicators) to show what our turn around times are. I am given a list of patients that coded out as a stroke and then must audit their charts for their CT head or CTA head results and then also their CXR's. We are supposed to have results to the ordering physician in 45 minutes. For the most part, we are very good at what we do. CT is a well-oiled machine in most cases. Of course, there are always an outlier or two that needs a little research. It helps alot that I still go back and watch staff and scan. It is a huge help to get buy in from staff and also to develop policies that actually work.

Hello All

Happy Clinicals! My name is Susan Brumley for those who may not know me. I am the department manager for Deaconess Hospital, Gateway Hospital, and Deaconess Clinic. I have been a CT technologist for about 13 years now. I passed my boards finally last April...just decided I needed to do it! I can't expect my CT staff to take a board exam if I don't.

I am running a bit late this semester! We've had a busy past few weeks at Deaconess in managment and staffing. We had a routine unnannounced inspection from the Indiana State Board of Health. I am happy to say that the Radiology department passed with flying colors! The surveyors complimented our staff on how helpful and knowledgeable they were. Then, as that was drawing to a close, the NRC walked in! Boy, was I nervous. I had not gone through this type of rigorous inspection before and our previous RSO had taken a new job not two months previous. So, needless to say I was nervous about how things would play out. But, again, our staff did a tremendous job. The surveyor was extremely detailed and interviewed every technologist and team leader including myself. But, we did a wonderful job and there were no citations or recommendations. This was a real test in leadership for me, and I feel like if I can go through an NRC and State inpection on the same day...I can probably handle anything!

Update to Clinicals

Well...this has been a crazy week, to say the least! CT at both Main and Gateway have been extremely busy. Thursday we had a code called at the Main campus in CT. He was a 72 year-old gentleman from a regular medical telemetry bed. He was getting a CT Head without contrast due to altered mental status. We noticed he was very uneasy and unsettled while we were transferring him to the table. He then just wouldn't hold still, but after repeating the first axial group, we got what we needed after we shortened the scan time. As we entered the room, we noticed he had turned gray and was not breathing. We knew that the family down here were discussing his code status, but with no official changes in the chart, we called the code. Immediately, we had much help. Due to the fact we had an ICU patient down in another room, the ICU nurse jumped right and started compressions. I think everyone was glad that she happened to be there! After some work, the team got him back and transferred him to ICU. As we were completing this...the trauma pager went off. I guess when it rains, it pours. The trauma was a 20 year old who was cutting limbs and a limb came back and hit him in the face and then knocked him off the ladder...he did some major damage to his face and caused a SDH.

Friday, our scanner at Gateway went down again. So, I went over there to help with any issues with the ER and to make sure service was on it. It went down during a bone biopsy, but luckily the needle wasn't placed. We had to move him and then work on the 6 ER orders that we had before we could get the biopsy going again.

The biopsy patient was a 56 year old male with hepatocellular carcinoma with metatstatic disease. He now presented with terrible pain and CT showed that the disease had infiltrated his bone. The radiologist was asked to perform a right iliac wing bone biopsy. Believe it or not, it went very well. He made 3 passes in to the bone and the pathologist said that we had an excellent specimen. I've included an image that shows the needle location while we were passing through.

Update to Clinicals

Well, thankfully, the pregnancy season is closely coming to an end in the CT department. We have had 4 maternity leaves all spaced about 3 weeks apart. The second technologist returned this past week and I have one more returning on April 5th. While it is stressful for all involved, it is nice to stay closely in tune with the department. CT at Main and Gateway are two of the busiest departments in the Radiology department. We average about 4000-4500 scans per month, and to be honest, that is down a little bit from last year. I worked this past Friday evening to give some relief to my Team Leader. As we all know CT dose is a hot topic. I had an OP present to the department for a CT stone protocol. When I went in to look at his record I noticed that he'd had 3 separate scans in the past 5 weeks. I thought that was odd that a urologist would order yet another scan only a week later. So, I phoned the physician. It puts the technologist in a precarious position to actually ask the practioner..."Are you sure you really want this?", but this patient was only 35 so I figured it was better to err on the side of caution. It turned out that the patient was scheduled in error. He was supposed to get it in 30 days after his lithotripsy! So, I was glad that I put a little time into it and saved the guy $2,000 and unnecessary radiation.

Clinicals Update

Here at Deaconess Hospital we have a Level II trauma certification. We had a category II come in while I was working. Category I activations are the most severe activations that require alot of accurate QA documentation. Category II's are a little lower level of trauma activation. Above are some images from a recent category II. This patient was a 70 year-old female who was a restrained passenger. The car was T-boned. She was airlifted to Deaconess from Illinois on March 1st.

She had multiple displaced rib fractures, a large right pneumothorax, and a hematoma to her RLQ anteriorly. She also had a Grade I liver laceration. Luckily, she had no head injuries or spinal injuries. The patient had chest tubes placed in the ER and was transferred to Trauma ICU. Her liver laceration was monitored while in the ICU as it was not deemed surgical at the time of admission.