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extravasation_policy [2010/07/02 00:46]
hyomul
extravasation_policy [2012/04/03 01:54] (current)
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 ===== 4) For all extravasations of ≥ 10cc ===== ===== 4) For all extravasations of ≥ 10cc =====
 The Technologist will complete the first page of the ‘Contrast Extravasation Quality Assurance (QA) Form,’ including patient demographics (with a contact phone number), type of CT study, peripheral IV site and gauge, personnel who placed the IV, injection rate, estimated volume of contrast extravasation,​ and the patient’s symptoms. QA forms are available here [1]. The Technologist will complete the first page of the ‘Contrast Extravasation Quality Assurance (QA) Form,’ including patient demographics (with a contact phone number), type of CT study, peripheral IV site and gauge, personnel who placed the IV, injection rate, estimated volume of contrast extravasation,​ and the patient’s symptoms. QA forms are available here [1].
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 ===== 5) The radiologist or their physician delegate ===== ===== 5) The radiologist or their physician delegate =====
- ​will ​examine the patient and document the physical findings in the electronic medical record.+Will examine the patient and document the physical findings in the electronic medical record. 
 ==== a) Notify the ordering physician or the patient’s nurse of the complication. ==== ==== a) Notify the ordering physician or the patient’s nurse of the complication. ====
 This contact information will be recorded on the QA form, page 2. This contact information will be recorded on the QA form, page 2.
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   * Increasing pain   * Increasing pain
   * Change in sensation at or distal to the site of extravasation.   * Change in sensation at or distal to the site of extravasation.
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 ===== 6) The affected extremity ===== ===== 6) The affected extremity =====
- ​will ​be elevated have ice packs applied for 10 minutes, then removed, and the extremity should be elevated for 12 hours. Ice packs can be re-applied, as desired. +Will be elevated have ice packs applied for 10 minutes, then removed, and the extremity should be elevated for 12 hours. Ice packs can be re-applied, as desired. 
-===== 7) Technologists ​===== +===== 7) Technologists completing the QA forms are responsible for turning them into the Leads on their shifts. ​=====
- completing the QA forms are responsible for turning them into the Leads on their shifts.+
   - The CT lead will distribute the QA forms to the QA folder in Angiography if the extravasation is ≥ 60 mls. and/or the LIP requests follow-up, or to the QA Coordinator if < 60 mls   - The CT lead will distribute the QA forms to the QA folder in Angiography if the extravasation is ≥ 60 mls. and/or the LIP requests follow-up, or to the QA Coordinator if < 60 mls
   - If the patient is an outpatient and the extravasation is ≥ 60 mls,, the patient will remain in the department for 2-4 hours. The affected extremity will be elevated and ice packs applied intermittently to the site, after which time, the Resident, PA, ARNP, or attending physician will re-evaluate the patient to establish clinical stability.   - If the patient is an outpatient and the extravasation is ≥ 60 mls,, the patient will remain in the department for 2-4 hours. The affected extremity will be elevated and ice packs applied intermittently to the site, after which time, the Resident, PA, ARNP, or attending physician will re-evaluate the patient to establish clinical stability.
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   - The referring physician should be notified.   - The referring physician should be notified.
   - In the event the exam has to be rescheduled due to patient characteristics,​ the radiologist will make note of the reasons in the report.   - In the event the exam has to be rescheduled due to patient characteristics,​ the radiologist will make note of the reasons in the report.
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 ===== 8) Before departing the Department of Radiology ===== ===== 8) Before departing the Department of Radiology =====
-, the patient will be given a ‘Contrast Material Extravasation Information’ card (completed by either the CT Technologist or the Radiologist) explaining the significance of a contrast material extravasation experience. A contact phone number will be provided to the patient so he/she can contact a nurse should concerning symptoms develop.+The patient will be given a ‘Contrast Material Extravasation Information’ card (completed by either the CT Technologist or the Radiologist) explaining the significance of a contrast material extravasation experience. A contact phone number will be provided to the patient so he/she can contact a nurse should concerning symptoms develop.
   - In the event the exam has to be rescheduled due to patient characteristics,​ the Radiologist will make note of the reasons in the report.   - In the event the exam has to be rescheduled due to patient characteristics,​ the Radiologist will make note of the reasons in the report.
   - The exam will be ended using a ‘reduced services’ modifier.   - The exam will be ended using a ‘reduced services’ modifier.
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   - If symptoms do not resolve, the patient will be asked to return to the Urgent Care Clinic in the morning hours for appropriate clinical evaluation of the patient.   - If symptoms do not resolve, the patient will be asked to return to the Urgent Care Clinic in the morning hours for appropriate clinical evaluation of the patient.
   - Documentation of patient contacts by the Department of Radiology nursing staff members will be made as an addendum to the physician report in the patient’s electronic chart.   - Documentation of patient contacts by the Department of Radiology nursing staff members will be made as an addendum to the physician report in the patient’s electronic chart.
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 ===== 10) In the event the exam has to be rescheduled ===== ===== 10) In the event the exam has to be rescheduled =====
- due to patient characteristics,​ the Radiologist will make note of the reasons in the report.+The Radiologist will make note of the reasons in the report.
   * a) The exam will be ended using a ‘reduced services’ modifier   * a) The exam will be ended using a ‘reduced services’ modifier
extravasation_policy.1278056818.txt.gz · Last modified: 2012/04/03 01:52 (external edit)