Ask the Fish

Ask the Fish Forum => CT Scan Protocols => Topic started by: CharPatton on August 01, 2019, 02:43:29 pm

Title: Oral Contrast for CT: 2 Questions
Post by: CharPatton on August 01, 2019, 02:43:29 pm
1) Are you still holding the line at requiring/recommending oral contrast for CT in non-trauma settings?

- Most every administrator in the hospital, and many of the clinicians, are telling us that we don’t need to give it. We feel that patients benefit barring extenuating circumstances, but it’s an uphill battle to promote continued PO contrast in CT.   
- There was a 2019 Radiology article from Harvard that said, “Current oncology and American College of Radiology guidelines advocate the use of positive OCM, despite its influence on workflow”.   

2) If you are still giving PO contrast, what volume of contrast and what specific instructions do you give patients about drink timing prior to the CT scan?

- There was a 2019 AJR article from UCSF that said: “Our use of a 45- to 60-minute scanning delay after initiation of drinking of oral contrast material is common for the use of oral CT contrast material and has been our institutional protocol for decades. Nevertheless, we found incomplete opacification of the small bowel when using this protocol regardless of which type of oral contrast agent was used. “

As always, thank you so much!!!
Title: Re: Oral Contrast for CT: 2 Questions
Post by: Elliot K. Fishman, MD on August 05, 2019, 09:55:47 am
we need oral contrast to prevent misdiagnosis.
use 500-1000 cc of Oral Omnipaue or 500-1000cc of water depending on the situation.
this is a quality of care issue
Elliot
Title: Re: Oral Contrast for CT: 2 Questions
Post by: CharPatton on August 05, 2019, 02:44:42 pm
Preaching to the choir, but thank you very much for sharing your expertise and maintaining such a wonderful and useful site!!!

Given the UCSF paper, what kind of time delay to you use at JHU between ingestion and scanning? Our practice is similar to the UCSF quote, but it would sure be nice to get a longer delay in there to opacify distal SB loops.
Title: Re: Oral Contrast for CT: 2 Questions
Post by: Elliot K. Fishman, MD on August 05, 2019, 03:47:15 pm
the era of delay is over
if u get 15-20m minutes "praise the Lord"
Title: Re: Oral Contrast for CT: 2 Questions
Post by: CharPatton on August 05, 2019, 04:41:33 pm
 :) :) :)
Title: Oral Contrast for CT 2 Questions
Post by: BeJimmiediony on September 04, 2019, 03:38:22 pm
I teach adults in a college in Brazil. The most difficult for me its to make them to participate in an oral class. Do have a tip about how can I do to have an effective oral class for absolute beginners? What kind of material would you sugeest?

Luciana