Patient Care & Radiation Safety Flashcards
Hematocrit (HCT)
35% - 50%
Males are generally higher
Hemoglobin (Hgb)
Males 14 - 17 g/dL
Females 12-15 g/dL
Platelets (Plt)
140,000 - 440,000 platelets per microliter
Prothrombin Time (PT)
12 - 15 sec
Partial Thromboplastin Time (PTT)
25 - 35 sec
International Normalized Ratio (INR)
0.8 - 1.2
Body Temperature
- 7 - 99.5 deg F
36. 5 - 37.5 deg C
Pulse
60 - 100 bpm
Blood Pressure
Systolic 100 - 120 mm Hg
Diastolic 60 - 80 mm Hg
Respirations
12 - 20 breaths/min
Pulse Oximetry
95% - 100%
P wave
Electrical activity through the atria (atrial systole)
QRS complex
Movement of electrical impulses through the ventricles (ventricular systole)
ST segment
When ventricle is contracting but no electricity is flowing through it
T wave
When the ventricles are resetting electrically and preparing for the next muscle contraction (complete diastole)
Blood Urea Nitrogen (BUN)
7 - 25 mg/dL
Creatinine
0.5 - 1.5 mg/dL
eGFR
90 - 120 mL/min
Radiation in Air - Exposure
C/kg or R
Ability of x-rays to ionize a volume of air
Radiation in Air - Air Kerma
mGy
Amount of radiation absorbed in a quantity of air
Absorbed Dose (D)
D = Joules/kilogram
Gy or mGy
Equivalent Dose (EqD)
EqD = D x Wr
Sv or mSv
Effective Dose (EfD)
EfD = D x Wr x Wt
Sv or mSv
CTDI
mGy
DLP (Helical)
CTDI x scan length
mGy-cm
Patient appears drowsy but can be aroused
Lethargic
Patient is in a more depressed level of consciousness and may not easily be aroused from a state of confusion
Obtunded
State of near unresponsiveness (semicomatose)
Stupor
Patient is completely unresponsive to stimuli
Coma
Pulse rate for children
70 - 120 bpm
Preferred bpm for optimal heart imaging
65 bpm
Ataxia
Loss of muscle coordination
Respirations for children
20 - 30 breaths/min
Nasal cannula / Mask
1 - 5 LPM / +6 LPM
BUN / creatinine ratio
6:1 to 22:1
GFR
70 +- 14 mL/min/m2 for men
60 +- 10 mL/min/m2 for women
Medical reconciliation
Process of reviewing patient’s medical record at all points of care
Medication record should include:
Name, dosage, frequency, and route
Warfarin (Coumadin)
Anticoagulant
Metformin (Glucophage)
Should not take before and up to 2 days after exam
RCM through GI tract
30 - 90 min
Neutral contrast agent
Volumen
Serum iodine concentration
2 - 8 mg/mL
Filtration
6 - 9 mm aluminum (Al) or equivalent
Ability of the detector to capture transmitted x-ray quanta and produce the appropriate response
Inherent absorption efficiency
The spatial arrangement of detector elements, including the amount of interspace material required between adjacent elements
Geometric efficiency
Section of patient exposed to radiation
Dose profile
CTDIvol
CTDIw / pitch
MSAD (Axial)
T/I x CTDI
MSAD (Helical)
CTDI / pitch
DLP (Axial)
MSAD x slice width (cm) x number of slices in scan volume
Medication for sedation (anxiolytic)
Benzodiazepines
- Midazolam
- Diazepam
- Lorazepam
- Clonazepam
Selective serotonine inhibitors
- Paroxetine
- Seratraline
- Fluoxetine
- Escitalopram
Medication for analgesia
- Fentanyl
- Hydromorphone
- Morphine
Ionic contrast media
- Iothalamate meglumine
- Diatrizoate sodium
- Metrizoate
- Ioxaglate
Nonionic contrast media
- Iohexol
- Iopamidol
- Iopromide
- Iodixanol
- Ioversol
Overranging or z-axis overscanning
Applying radiation dose before and after the acquisition volume to ensure sufficient data collection for the interpolation algorithms of helical CT reconstruction
Mild reactions to contrast
- Mild urticaria (hives)
- Mild cutaneous edema (swelling)
- Nasal stuffiness/sneezing
- Scratchy/itchy throat
- Nausea/vomiting
- Pronounced sensation of warmth and/or flushing
- Sweats/chills
- Anxiety
- Altered taste
- Mild hypertension
- Transient vasovagal reaction
Moderate reactions to contrast
- Moderate to severe urticaria
- Diffuse erythema
- Facial edema
- Tightening throat, hoarse voice
- Wheezing
- Moderate to severe nausea and vomiting
- Vasovagal response requiring treatment
- Tachycardia from hypotension
- Chest pain
Severe reactions to contrast
- Facial, laryngeal, and/or PE
- Anaphylactic shock
- Severe erythema
- Profound hypotension
- Severe wheezing and/or bronchospasm
- Cardiac arrhythmia
- Seizure
- Severe hypertension
- Cardiopulmonary arrest
- Death
Common delayed reactions to contrast
- Urticaria (hives)
- Pruritus (itchiness)
- Nausea/vomiting
- Drowsiness
- Headache
- Fever/chills
(Cutaneous reactions are most common and can occur within 3 hours to 7 days after contrast)
Risk factors for CIN
- Preexisting renal function and hydration level
- Diabetes
- Myeloma
- Advanced age
- Cardiovascular disease
Risk factors for adverse reaction to iodinated contrast
- Asthma
- Environmental and/or food allergies
- Renal disease
- Multiple myeloma
- Diabetes mellitus
- Pheochromocytoma
- Sickle cell disease
- Hyperthyroidism
- Significant cardiac disease
- Anxiety
Contraindications to IV iodinated contrast
- Allergy to iodine
- Prior severe allergic reaction to an iodinated contrast agent
- Renal insufficiency/failure
Parenteral routes
- Intramuscular
- Intravenous
- Intradermal
- Subcutaneous
Used for bradycardia during vagal reaction
Atropine
Bronchodilator
Epinephrine (Adrenalin)
Medicine for severe anaphylactoid reactions
Epinephrine and Diphenhydramine
INR is calculated to standardize:
PT
Inherent filtration of x-ray tube used in a CT system typically amounts to equivalent thickness of:
3 mm Al