A HIDA (gallbladder function test) order came down from the floor this morning. When we called the floor, we found out the patient had pain meds. Heavy-duty pain meds screw with the test and if you really want to know the technical reason, I'll gladly explain. So we'll just wait a few hours and do the scan in the afternoon.
A V/Q lung order came down. Same patient. Another call up to the floor to see which one they really wanted cuz we can't do both today. The tracers interfere with each other. The floor decided to do the V/Q first and see about the HIDA tomorrow afternoon if the V/Q tracer has washed out by then (I kinda doubt it will, but whatever).
A Gallium order came down. Yup. Same patient. Now I'm wondering if this doc got his degree from a Cracker Jack box (more likely it's multiple docs on the same floor who obviously don't read the chart). Yet another call up to the floor to see WTF is going on. If they want both, fine, but we can't do them at the same time. And because Gallium's half-life is 78 hrs (as opposed to the 6-hour half-life of the Technetium-based V/Q and HIDA stuff), we will HAVE to do the HIDA first.
Not only is the floor ordering every Nuc Med scan they can think of, but the patient has also had several regular X-rays and CT scans. I for one am really not comfortable exposing the patient to so much radiation in so short a time. Yes, she is really sick and they don't know why. But that much radiation can't be good for her.
Then there was another patient who had a stress test today and the floor ordered a V/Q. Again, folks, we can't do them the same day! Really, we're not trying to be difficult or duck out of doing our jobs; the tracers interfere with each other and we can't see lungs when the heart is lit up. Inevitably, there's a bowel loop sitting right under the heart and/or over a lung. And since the liver and bowel suck up so much of the excess tracers, we can't see through that until it washes out. And since this patient's had upwards of 45mCi of Cardiolite, that might take a couple days.
A V/Q lung order came down. Same patient. Another call up to the floor to see which one they really wanted cuz we can't do both today. The tracers interfere with each other. The floor decided to do the V/Q first and see about the HIDA tomorrow afternoon if the V/Q tracer has washed out by then (I kinda doubt it will, but whatever).
A Gallium order came down. Yup. Same patient. Now I'm wondering if this doc got his degree from a Cracker Jack box (more likely it's multiple docs on the same floor who obviously don't read the chart). Yet another call up to the floor to see WTF is going on. If they want both, fine, but we can't do them at the same time. And because Gallium's half-life is 78 hrs (as opposed to the 6-hour half-life of the Technetium-based V/Q and HIDA stuff), we will HAVE to do the HIDA first.
Not only is the floor ordering every Nuc Med scan they can think of, but the patient has also had several regular X-rays and CT scans. I for one am really not comfortable exposing the patient to so much radiation in so short a time. Yes, she is really sick and they don't know why. But that much radiation can't be good for her.
Then there was another patient who had a stress test today and the floor ordered a V/Q. Again, folks, we can't do them the same day! Really, we're not trying to be difficult or duck out of doing our jobs; the tracers interfere with each other and we can't see lungs when the heart is lit up. Inevitably, there's a bowel loop sitting right under the heart and/or over a lung. And since the liver and bowel suck up so much of the excess tracers, we can't see through that until it washes out. And since this patient's had upwards of 45mCi of Cardiolite, that might take a couple days.
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