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Everything you need to know about Computed Tomography (CT) & CT Scanning


IV Contrast

question1. Why do we use IV contrast material?
question2. Do you use serum creatinine levels or GFR in your practice for establishing risk prior to CT scanning?
question3. What is GFR and why is it a more accurate measure than simply getting a creatinine level?
question4. Why are GFR numbers different for Caucasians and African Americans?
question5. Are all CT scans with IV contrast done the same way?
question6. What type of IV contrast material do we use and why?
question7. At what temperature do we store IV contrast material?
question8. Why do you warm IV contrast?
question9. What is the advantage of Visipaque as written in the literature?
question10. When do you use Visipaque-320 and when Omnipaque-350?
question11. Does the concentration of contrast mean that higher concentrations are better (AKA-isn’t a higher number better)?
question12. What is the volume of IV contrast material we use?
question13. What patients are considered high risk patients for IV contrast for CIN?
question14. Do we have set cutoffs for creatinine levels and if so what are they?
question15. Can we pretreat patients who have borderline renal function? If yes then how?
question16. Should patients be NPO for CT scanning? If yes for how long?
question17. What are the common volumes of contrast used for IV injection?
question18. What kind of IV access is ideal for use for IV contrast injection?
question19. Has there been any new developments in technology that may help us high injection rates in patients who can not tolerate an 18g needle (or at times even a 20g)?
question20. Can any IV the patient has in place be used to inject the contrast material?
question21. Can we use a central line or a PICC line for injection?
question22. What about the new “purple PICC/central lines” I hear about?
question

CR Bard has developed a PICC line designed for use for CT scanning with power injection up to 5 cc/sec. These PICC lines are clearly labeled with the CT ID tag helping to prevent any errors.

For more info please go to www.powerpic.com which is the product website (note that we get no support or anything of value from C.R. Bard. This is included to be helpful to our users.)

purple PICC/central lines

Information on the purple PICC line from the Bard website


"In the ICU, peripherally inserted central catheters (PICCs) may be an alternative option to standard central venous catheters, particularly in patients with coagulation disorders or at high risk for infection. Some limits of PICCs (such as low flow rates) may be overcome with the use of power-injectable catheters."

Clinical experience with power-injectable PICCs in intensive care patients.
Pittiruti M et al.
Crit Care. 2012 Feb 4;16(1):R21.


"Power-injectable PICCs have many advantages in the ICU: they can be used as multipurpose central lines for any type of infusion including high-flow infusion, for hemodynamic monitoring, and for high-pressure injection of contrast media during radiological procedures. Their insertion is successful in 100% of cases and is not associated with significant risks, even in patients with coagulation disorders. Their maintenance is associated with an extremely low rate of infective and non-infective complications."

Clinical experience with power-injectable PICCs in intensive care patients.
Pittiruti M et al.
Crit Care. 2012 Feb 4;16(1):R21.

question23. What are some of the common normal “side effects” of IV contrast agents?
question24. Is there a relationship between patients receiving chemotherapy and CIN?
question25. Is it ok for patients to have both an MR and a CT with contrast on the same day?
question26. Have you ever seen a patient develop diffuse erythema distal to the IV injection site in the absence of extravasation?
question27. Patients often report a metallic taste in their mouth following use of IV iodinated contrast. Is there an explanation?
question28. Are there any contrast volume limitations for the use of IV contrast?
question29. Can you tell me a bit more about GFR and what it really means?

 

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