Tweet
If something happens outside the norm in the course of patient care, we're supposed to report it. I've filled out two within the last week.
Yes there is prep for this
Had a lady last week in for a test she needed to be NPO for. She had coffee. Apparently neither the dr's office nor the scheduling department mentioned any prep, which actually wouldn't surprise me at all. Even though we do a gajillion of these things.
Well, you're lucky that wasn't the problem
Floor doc writes an order for a scan 12/5 ~1725. Order shows up in our computer 12/9 ~0945. Oh, and the scan in question? A lung scan. Lung scans are ALWAYS STAT. Now some docs are nice and don't haul us in in the middle of the night if they think it can wait until morning, but that was 4 days. Neither of the people on call over the weekend got paged. If the pt had a blood clot in her lung, she'd probably be dead by now.
Other fun tales:
It's even on the order, dingus
There's this girl who works in our registration department who is really dumb. She really doesn't know her rear end from a hole in the ground. Not long ago, we dosed a pt for a thyroid scan to see if she had any thyroid cancer mets after her thyroid gland had been removed. For this test, we use I-131. A beta emitter that's pretty potent and we don't like to be around it. Standard protocol is for females (really any female, but especially one of child-bearing age) to have a pregnancy test. Even a low dose of this stuff will kill a developing fetus. You're pregnant, we're not doing it. Period.
There's a dr's office across the street that sends us most of our I-131 pts. He knows what he's doing. His orders typically have the I-131 scan, treat with a high dose if necessary, and for female pts, a pregnancy test.
So, dingus brings me back some paperwork that includes radiology's waver for the pt stating she's not pregnant. The pt in question is 23 and still has all her lady parts.
Dingus: She signed the thing and put no.
Me: That doesn't matter; I need an actual pregnancy test. It's even on the order.
Dingus: *copping an attitude* Well, then you better go talk to them cuz I tried to send them to lab but they wouldn't go.
Me: Fine.
So I take the paperwork and talk to the pt. I explain that I do need an actual pregnancy test just to be safe and the pt was totally fine with it. Besides, if it's on the order, we have to do it unless told not to by a physician. We did end up dosing the girl with a 100 mCi treatment dose (for reference, we give 5 mCi for the initial scan). You should see the lead box that thing comes in. Holy fark.
Scheduling.....
I don't even know. Somehow our outpatient availability schedule is so jacked up, no one can make sense of it. It's to the point the scheduling department is calling us to see when there are openings because they can't see any. It's a mess and none of us know how to fix it.
And #1 on my list of scans I hate to do....
Did a brain death scan on someone recently. It was a sad situation all around (obviously I can't share details due to HIPAA), but the pt was fairly young. Brain death scans are typically a formality and have to be done if someone is donating organs or there's a legal issue. In my 6 years in the field, I've only ever heard of 1 locally that wasn't positive for brain death. And I didn't see it, my classmate did. Though if I remember correctly, that person died a few days later. I hate brain death scans. I came home and cried.
Yes there is prep for this
Had a lady last week in for a test she needed to be NPO for. She had coffee. Apparently neither the dr's office nor the scheduling department mentioned any prep, which actually wouldn't surprise me at all. Even though we do a gajillion of these things.
Well, you're lucky that wasn't the problem
Floor doc writes an order for a scan 12/5 ~1725. Order shows up in our computer 12/9 ~0945. Oh, and the scan in question? A lung scan. Lung scans are ALWAYS STAT. Now some docs are nice and don't haul us in in the middle of the night if they think it can wait until morning, but that was 4 days. Neither of the people on call over the weekend got paged. If the pt had a blood clot in her lung, she'd probably be dead by now.
Other fun tales:
It's even on the order, dingus
There's this girl who works in our registration department who is really dumb. She really doesn't know her rear end from a hole in the ground. Not long ago, we dosed a pt for a thyroid scan to see if she had any thyroid cancer mets after her thyroid gland had been removed. For this test, we use I-131. A beta emitter that's pretty potent and we don't like to be around it. Standard protocol is for females (really any female, but especially one of child-bearing age) to have a pregnancy test. Even a low dose of this stuff will kill a developing fetus. You're pregnant, we're not doing it. Period.
There's a dr's office across the street that sends us most of our I-131 pts. He knows what he's doing. His orders typically have the I-131 scan, treat with a high dose if necessary, and for female pts, a pregnancy test.
So, dingus brings me back some paperwork that includes radiology's waver for the pt stating she's not pregnant. The pt in question is 23 and still has all her lady parts.
Dingus: She signed the thing and put no.
Me: That doesn't matter; I need an actual pregnancy test. It's even on the order.
Dingus: *copping an attitude* Well, then you better go talk to them cuz I tried to send them to lab but they wouldn't go.
Me: Fine.
So I take the paperwork and talk to the pt. I explain that I do need an actual pregnancy test just to be safe and the pt was totally fine with it. Besides, if it's on the order, we have to do it unless told not to by a physician. We did end up dosing the girl with a 100 mCi treatment dose (for reference, we give 5 mCi for the initial scan). You should see the lead box that thing comes in. Holy fark.
Scheduling.....
I don't even know. Somehow our outpatient availability schedule is so jacked up, no one can make sense of it. It's to the point the scheduling department is calling us to see when there are openings because they can't see any. It's a mess and none of us know how to fix it.
And #1 on my list of scans I hate to do....
Did a brain death scan on someone recently. It was a sad situation all around (obviously I can't share details due to HIPAA), but the pt was fairly young. Brain death scans are typically a formality and have to be done if someone is donating organs or there's a legal issue. In my 6 years in the field, I've only ever heard of 1 locally that wasn't positive for brain death. And I didn't see it, my classmate did. Though if I remember correctly, that person died a few days later. I hate brain death scans. I came home and cried.
seriously issues if that pt had died from a thrown PE and the lung scan still had 3 days to go.
Comment