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Venipuncture and Pharmacology for Radiologic Technologists

Venipuncture and Pharmacology for Radiologic Technologists. RTEC 93 10:30am- 12:40pm Monday 1pm – 3:10pm Wednesday. SB 571 VENIPUNCTURE. Chaptered 97-0384 Radiologic Technologic:Venipuncture

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Venipuncture and Pharmacology for Radiologic Technologists

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  1. Venipuncture and Pharmacology for Radiologic Technologists RTEC 93 10:30am- 12:40pm Monday 1pm – 3:10pm Wednesday

  2. SB 571 VENIPUNCTURE • Chaptered 97-0384 • Radiologic Technologic:Venipuncture • SB 571 authorizes a radiologic technologist, under the general supervision of a physician and surgeon to perform venipuncture in an upper extremity to administer contrast materials manually or by using a mechanical injector if the radiologic technologist has received specified training and education and has been issued a certificate from an approved school of radiologic technology or an instructor indicating satisfactory completion of the required training.

  3. Central Line Injections by RT • The California Law does not address arterial injection by RT • Employers policies • Saline flush

  4. CALIFORNIA HEALTH AND SAFETY CODEHEALTH AND SAFETY CODE SECTION 106955-107111

  5. ECC CONTRAST MEDIA INJECTION POLICY • "STUDENT RADIOLOGIC TECHNOLOGISTS MAY NOT, UNDER ANY CIRCUMSTANCES INJECT CONTRAST MEDIA". • HEALTH AND SAFETY CODE CHAPTER 554 STATUTES OF 1995 SENATE BILL #1334

  6. SENATE BILL #1334 • The above mentioned senate bill as of January 1996 allows TECHNOLOGISTS to complete the injection of a contrast media which was started by Authorized personnel. This bill did not address and was not meant to include STUDENT Radiologic Technologists. • Students who violate this policy shall be immediately suspended for two days and possible further action.

  7. CONTRAST MEDIA • CONTRAST • X-RAY “DYE” • COLORLESS OR WHITE

  8. Negative contrast (AIR OR CO2) Radiolucent Low atomic # material Black on film Positive contrast (all others) Radiopaque High atomic # material White on film Contrast Media

  9. BARIUM Z# 56 NON WATER SOLUABLE GI TRACT ONLY INGESTED OR RECTALLY KVP 90 – 120* IODINE Z# 53 WATER SOLUABLE POWDER LIQUID INTRAVENOUS OR GI TRACT KVP BELOW 90* 2 BASIC TYPES OF CONTRAST

  10. Water Soluble Iodine • High atomic # 53 • Radiopaque • Used to radiograph • Vessels • Arteries • Veins • Function of internal organs

  11. KVPTYPE OF CONTRAST USED DETERMINES KVP RANGE IODINES 70 – 80 kVp (Ionic / Nonionic Water or Oil)

  12. IONDINATED CONTRAST • WATER BASED • INJECTED • VESSELS/DUCTS • INGESTED • OPEN WOUNDS • ISOVUE 200(41%), 300(61%) or 370 (76%)

  13. ISOVUE-M 200 OR 300 (iopamidol) • Intrathecal Injection • Myelography • Pediatric Myelography • Enhancement of CT spine images

  14. IONIC LESS $$$ MORE REACTIONS NON-IONIC MORE $$$ LESS REACTIONS *NON-IONIC PART 2 ISOMOLAL EVEN LESS REACTIONS IODINE WATER BASED CONTRAST

  15. IONIC High Osmolality (Higher risk of complications) Diatrizoate sodium (Hypaque) Iothalamate meglumine (Conray) NON-IONIC Low Osmolality (Lower risk of complications) Gadodiamide (Omniscan) Iodixanol (Visipaque) Iopamidol (Isovue) Iopromide (Ultravist) Ioversol (Optiray) IODINATED Contrast Agents

  16. Shell fish allergies… Too bad for the patient… Not important in Radiology!

  17. Adverse Reactions • Caused By: Osmolality of the Media • Osmolality = The number of particles when in a solution form. • The more particles in solution the more water is drawn toward the molecule. This causes a change in the electrolyte balance in the body beginning the adverse reaction

  18. Iodine Contrast Material • Ionic Iodine Contrast • Anion - • Cation + • More patient allergic reactions • Non-Ionic Contrast • Less patient allergic reactions

  19. Visipaque (iodixanol) • Isosmolar, Non-ionic • Water-soluble • Addition of electrolytes • Not to be used for intrathecal injection • 270 (49%) or 320 (63%) • Better for patients with renal problems

  20. Ionic Iodine Contrast

  21. Non-ionic Contrast

  22. Non-ionic Contrast: Isosmolar

  23. Dose standards for intravenous contrast agents • Adults • Typically 100ml to 150ml is used for all patients regardless of body weight • 200 ml used for angiography or CT angiography • Maximum of 200 ml can be used in one day… must test BUN & Creat again prior to next contrast injection.

  24. Dose standards for intravenous contrast agents • Pediatrics • Standard of 2.0 ml/kgfor pediatrics • Sometimes a simpler division of patients into 2 or 3 categories is used.  (eg. small/medium/large.)

  25. Converting Pounds to Kilograms • 1 pound (lbs) ~ 0.45 kilograms • 1 kg ~ 2.2 lbs (pounds) • Patient wt 35 lbs • How much contrast do you give?

  26. Contrast Dose Calculation • 35 lbs X 0.45 = 15.75 kg • 15.75 X 2 = 31.5ml of contrast

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