Patient Care and Safety
Patient Care and Safety in CT tests whether you can screen patients, choose contrast safely, protect from unnecessary radiation, and manage events during and after injection. The emphasis is practical: what you do before the scan, what you monitor, and what you document.
Core rules
- Justify every scan and limit the scan range to the clinical question. Use AEC/tube current modulation and pediatric protocols; avoid multiphase scans without indication.
- Check eGFR (not creatinine alone), prior iodinated contrast reaction, pregnancy, and IV access. A 20–22 G catheter is typical for power injection; follow institutional flow limits.
- For extravasation: stop injection, remove IV, elevate limb, apply cold or warm compress per protocol, document volume/concentration, and notify the radiologist.
Worked example
A 70-kg patient with eGFR 25 mL/min/1.73 m² needs contrast-enhanced abdominal CT. You do not automatically cancel. You check hydration status, medication (including metformin), and the indication; the radiologist may choose a reduced-volume protocol, an alternative study, or prehydration. Document the risk-benefit discussion. If the patient has a prior moderate reaction, premedication follows the site protocol.
Traps
- Shellfish allergy is not a proven predictor of iodinated contrast reaction.
- A normal creatinine can still accompany a low eGFR in small or elderly patients.
- Bismuth shielding placed inside the scan field can increase dose and create artifact.
- Stopping metformin is not automatic for every patient; follow eGFR-based policy.