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Venipuncture and Pharmacology for Radiologic Technologists

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Venipuncture and Pharmacology for Radiologic Technologists RTEC 93 1pm 6pm Wednesday SB 571 VENIPUNCTURE Chaptered 97-0384 Radiologic Technologic:Venipuncture SB ... – PowerPoint PPT presentation

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Title: Venipuncture and Pharmacology for Radiologic Technologists


1
Venipuncture and Pharmacology for Radiologic
Technologists
  • RTEC 93
  • 1pm 6pm Wednesday

2
SB 571 VENIPUNCTURE
  • Chaptered 97-0384
  • Radiologic TechnologicVenipuncture
  • 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
Contrast Media
  • Negative contrast
  • Radio_____
  • ____ atomic material
  • _______ on film
  • Positive contrast
  • (all others)
  • Radio_____
  • ____ atomic material
  • ______ on film

9
Contrast Media
  • Negative contrast
  • (AIR OR CO2)
  • Radiolucent
  • Low atomic material
  • Black on film
  • Positive contrast
  • (all others)
  • Radiopaque
  • High atomic material
  • White on film

10
2 BASIC TYPES OF CONTRAST
  • 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

11
Water Soluble Iodine
  • High atomic 53
  • Radiopaque
  • Used to radiograph
  • Vessels
  • Arteries
  • Veins
  • Function of internal organs

12
KVP TYPE OF CONTRAST USED DETERMINES KVP RANGE
  • IODINES 70 80 kVp
  • (Ionic / Nonionic Water or Oil)

13
IONDINATED CONTRAST
  • WATER BASED
  • INJECTED
  • VESSELS/DUCTS
  • INGESTED
  • OPEN WOUNDS
  • ISOVUE 200(41), 300(61) or 370 (76)

14
ISOVUE-M 200 OR 300 (iopamidol)
  • Intrathecal Injection
  • Myelography
  • Pediatric Myelography
  • Enhancement of CT spine images

15
IODINATED Contrast Agents
  • 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)

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
IODINE WATER BASED CONTRAST
  • IONIC
  • LESS
  • MORE REACTIONS
  • NON-IONIC
  • MORE
  • LESS REACTIONS
  • NON-IONIC PART 2
  • ISOMOLAL
  • EVEN LESS REACTIONS

20
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

21
Ionic Iodine Contrast
22
Non-ionic Contrast
23
Non-ionic Contrast Isosmolar
24
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.

25
Dose standards for intravenous contrast agents
  • Pediatrics
  • Standard of 2.0 ml/kg for pediatrics
  • Sometimes a simpler division of patients into 2
    or 3 categories is used.  (eg. small/medium/large.
    )

26
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?

27
Contrast Dose Calculation
  • 35 lbs X 0.45 15.75 kg
  • 15.75 X 2 31.5ml of contrast
  • little less than 1ml per lb

28
CALIFORNIA HEALTH AND SAFETY CODE
  • general supervision of a physician and surgeon to
    perform venipuncture
  • What does general supervision mean?
  • What else does the law specify for scope of
    practice?

29
IONDINATED CONTRAST
  • ISOVUE 200(41), 300(61) or 370 (76)
  • What does the tell
  • You?

30
Contrast Dose Calculation
  • Patient wt 60 lbs
  • How much contrast should you administer?
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