MCCCD Official Course Competencies:

ICE265  2005 Summer I – 2009 Fall

Computed Tomography Procedure Protocols

1.

Explain the choice of correct patient and room preparations. (I)

2.

Select the correct protocol for specific structures, symptoms, pathology. (II, III)

3.

Describe patient pre-procedure instructions. (IV)

4.

List and describe correct scan parameters. (V)

5.

Describe methods for choosing the appropriate contrast. (VI)

6.

Identify contrast requirements. (VI)

7.

Describe adaptations to atypical situations. (VII)

8.

Explain the steps of post exam processing. (VIII)

9.

Explain post procedure patient instructions. (IX)

10.

Explain computed tomography (CT) image filming and archiving. (X)

MCCCD Official Course Outline:

ICE265  2005 Summer I – 2009 Fall

Computed Tomography Procedure Protocols

I. Scan Preparation

A. Room preparation

B. Previous exams/reports

C. Patient preparation

1. Indications for exam (scanner and patient limitations)

2. Verify order

3. Contraindications for exam (pregnancy, allergy, barium, Neutropenic precautions)

4. Contrast Media

a. Intravenous (types)

b. Oral (types and routes of administration)

5. Patient assessment and monitoring

a. Current History and Physical

b. Chief complaint

c. Current medications

d. History of present illness

II. Exam Protocols

A. Patient Symptoms

B. Patient Pathology

C. Patient Preparation (oral, Intravenous (IV), angio, etc)

III. Specific Exam Protocols

A. Adult Neuro

1. Head

2. Facial bones

3. Orbits

4. Paranasal sinuses

5. Internal Auditory Canal (IACS)/temporal bones

6. Soft tissue neck

7. Cervical spine

8. Thoracic spine

9. Lumbar spine

10. Neurovascular

11. Myelogram

B. Adult Body Protocols

1. Chest

2. Abdomen

3. Pelvis

4. Upper extremity

5. Lower extremity

6. Vascular

C. Pediatric Neuro Protocols

1. Head

2. Facial bones

3. Orbits

4. Paranasal sinuses

5. Internal Auditory Canal (IACS)/temporal bones

6. Soft tissue neck

7. Cervical spine

8. Thoracic spine

9. Lumbar spine

10. Neurovascular

D. Pediatric Body Protocols

1. Chest

2. Abdomen

3. Pelvis

4. Upper extremity

5. Lower extremity

6. Vascular

E. Interventional Protocols

1. Biopsy/Drainages

2. Tube placements

3. Ablations

F. Non-routine Procedures

1. Emergency Department Exams/Emergency Room Trauma

2. Oncology

3. Computed Tomography (CT) Guided Surgical Localizations

IV. Patient Education

A. General and specific exam information

B. Consent requirements

V. Scan Protocol Parameters

A. Patient parameters

1. Positioning

2. Anatomical landmarks

3. Patient information/identifiers

B. Scanner parameters

1. Scout/topogram range

2. Gantry bore size and isocenter

3. Technical factors

a. Azimuth

b. Matrix

c. Mode (helical vs. axial)

d. Algorithm

e. Pitch

f. Slice thickness

g. Slice interval

h. Scan Field of View (SFOV)

i. Display Field of View (DFOV)

j. Milliamperes (MA)

k. Kilovoltage (KV)

l. Rotation time

VI. Contrast

A. Pre administration requirements

1. Lab values

2. Medication screening

3. Patient history

4. Joint Accreditation Commission of Health Care Organizations (JACHO) Patient Safety Standards

B. Oral contrast

1. Indications/contraindications

2. Routes of administration

3. Dosages

C. Intravenous (IV) contrast

1. Indications/contraindications

2. Steroid prep protocol

3. Dosages

4. Intravenous (IV) injection parameters/catheters

5. Extravasation

6. Reactions

VII. Adapting to atypical situations

A. Patient positioning challenges and tips

B. Mode (helical vs. axial)

C. Rotation time

VIII. Post Exam Processing

A. Reconstruction of scan data

1. Algorithm

2. Display Field of View (DFOV)

3. Slice thickness/interval

B. Reformations

1. Sagittal/coronal/curved/axial

2. Maximum Intensity Projections (MIPs) vs. average

3. 3-Dimensional processing

C. Window width and level display

D. Filming format/Picture Archiving and Communications System (PACS)

IX. Post Procedure Patient Instruction

A. Discharge instructions

X. Archiving

A. Magnetic tape

B. Digital Acquisition Tape (DAT) tape

C. Optical disc

D. Compact disc (CD)

E. Laser disc

F. Digital video disc (DVD)