BLOGS: Postings

Physician/Technologist Interaction

When I worked in nuclear medicine, I was privileged to work with many wonderful and supportive physicians. Because they respected what I did, I was motivated to excel at my job and search for ways to improve my techniques, providing the physicians with as much information as possible, to help them with their diagnostic interpretation. Although I have never met a physician as arrogant and dismissive as the one portrayed in the TV program "House", I have had the occasion to observe some physicians who treat their technologists or nurses like underlings, placing little value on their expertise. Although the physician as dictator makes for good television, in real life it is more likely to negatively impact patient care. I feel that patients are best served when everyone in the medical establishment collaborates on their care. I remember several occasions when the eventual diagnosis of the patient was helped by...

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Neonates in MRI

Are you monitoring temperatures for neonates having MRI scans? Neonates are especially vulnerable to heat loss and special care should be taken to monitor temperatures for these patients. At Children's Healthcare of Atlanta, we are currently working on a protocol to monitor and intervene when necessary as well as take additional steps to keep infants warm during a scan. Current recommendations include pre-scan temperatures, turning off the fan inside the scanner, warm packs, warm blankets and frequent temperature monitoring. The length of the scan is a factor and longer scans need careful monitoring and interventions. Neonates under general anesthesia or sedation are also at higher risk for hypothermia. Paying extra attention to these details will help patients maintain temperature during MRI scans. - Nancy Dennehy, Assistant Manager Nursing Radiology-Sedation, Children's Healthcare of Atlanta at Scottish Rite

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Ultrasound: Searching for the “Right” System

Within the past two years, the Ultrasound Department at Children's Healthcare of Atlanta at Egleston has utilized eight ultrasound machines to replace systems at the end of production life. The first two systems purchased were a modification of current systems. Unfortunately, it did not take long before errors became present in the boot-up process. As the company tried to fix the systems, we relied on two loaner systems before it was determined that the systems required replacement. We were offered two systems from a newer generation, ones the company believed would be the standard and platform for all of their future ultrasound machines. Those systems proved complicated and not user friendly, often adding 15 to 20 minutes to an ultrasound procedure. This turned out to be the final event that would end a 20+ year relationship. Today, we have a new vendor and two new systems, which have yielded technology...

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Nuclear Medicine Isotope Shortage: When Will It End?

Nuclear Medicine has been experiencing Tc99m shortages for a couple of years now, but it has never been as bad as it is now. The root of the issue is a shortage of molybdenum, a byproduct of nuclear fission. Molybdenum is then placed in containers called "generators" which, over a two week period, deliver a supply of Technetium-99m. Tc99m is used in more than 16 million nuclear imaging procedures per year nationwide. Due to the shortage, clinicians have adopted a range of strategies over the past few months, trying to use the available isotopes frugally by utilizing other modalities. Below is a brief history on what caused this shortage: 1. Canada's National Research Universal facility (NRU): Repair started May 2009 and is projected to last at least until August 2010. NRU produced 40% of the world's supply before the reactor went down. 2. Holland's Petten Reactor: Shut down for 6...

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Clinical Strategies – Pain Series

Do you live your life in pain or know someone who does? Pain is a common symptom and pain at its core is suffering and its persistence can be vexing to those who help the sick and often at a burdensome cost to society. Pain is a warning system and feedback mechanism that influences how we adapt to our environment. The causes of pain are innumerable and exist within the full spectrum of human diseases. The diagnosis of pain is often problematic due to its connection to both benign and life-threatening conditions. The Learning Center is offering a "Buy 1, Get 1 Free" special with the purchase of one of the tutorials in the 'Clinical Strategies – Pain Series" by Ashley Davidoff, M.D. Log into the Learning Center and click on 'My Account – My Discount Code' and enter 39169181. This offer is valid until June 30, 2010.

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On the Road at The Leading Edge Ultrasound Conference

There's just something energizing about attending a conference and having an opportunity to network with clinicians and chat with the readers of rt image. Last week's Leading Edge in Diagnostic Ultrasound 2010 gave the rt image staff a perfect opportunity to hit the road for a day and head down to Atlantic City's Borgata Hotel Casino and Spa. It was well worth the couple hour drive from our suburban Philadelphia headquarters to absorb the educational sessions and spend time in our exhibit hall booth meeting and greeting the approximately 1,200 attendees. With the casino serving as a backdrop, you had to pass by the glitz, bells, whistles, blinking lights and sensory overload from the slot machines and gaming tables on the way to the escalator that led to the conference. The headlines pretty much write themselves: "Leading Edge hits the Jackpot," "Full House at Annual Conference," "Ultrasound is on a...

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Mock Scanner Helps Lower Sedation Rates in Pediatric Patients

Children's Healthcare of Atlanta recently received a new addition to its Radiology department. Through the generosity of donors, Children's now has a "mock" scanner to assist staff in preparing children for MR procedures by affording a "dry" run of the exam without compromising staff member's schedules or tying up a scanner with a child who may not need sedation when given the opportunity to try without sedation first. The "mock", as we call it at Children's, looks just like a standard closed bore MR unit. It has a moving table, faux cage-style head coil, and even makes sounds similar to that of the real thing. The new "toy" has already yielded great success, and we are hopeful that the sedation rate for patients aged 5 to 10 will continue to decline! Scott Weisel RT(R)(CT)(MR) MRI Team leader Children's Healthcare of Atlanta at Scottish Rite

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So What Exactly Do Those Nuclear Medicine Folks Do?

When you think of Radiology, most people think of X-rays, CTs and maybe even MRI or Ultrasound. Those of us who work in this field know something about Nuclear Medicine, but the average person may not even know it exists, and that we are actually a part of Radiology. I've heard things like, "Hmm, nuclear medicine, what exactly is that? I've never heard of that, is that like an X-ray?" I did an in-service for Radiology nurses that I have worked with for the last 8.5 years, and to my surprise, they were glued to my presentation as if it was a new and emerging modality! I thought they would be bored to pieces hearing information about a modality they work around every day. I learned that even though we had been working together for a long time, and that they had some knowledge about my department, there was still...

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May is National Stroke Awareness Month

National Stroke Awareness month is a time to educate everyone about stroke and managing risk factors. It is important for healthcare professionals to recognize stroke symptoms and be able to respond. For National Stroke Awareness Month, the Philips Learning Center is offering the tutorial "Stroke: Treatments, Clinical Trials, and Imaging Technologies", worth 1.5 CE, free-of-charge for the month of May. The 100% discount will be applied at checkout. This offer is valid from May 1 – 31, 2010. Log onto the Learning Center and click on "My Account - 'My Discount Code' and enter 19615178.

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RFAs Not Just for Adults

As I sat here reading the blog posts on this site, I noticed an article on the left side of the page titled "Radiofrequency Ablation Safe and Effective for Reducing Pain From Bone Metastases Working in Interventional Radiology." This spurred my interest of the article since this is a procedure that we perform at Children's Healthcare of Atlanta. While reading the article I stopped to think about how beneficial this procedure is. The article mentions a study that was performed and the outcome of the procedures on the patients observed. It does not specify the ages of the patients, but in the pediatric hospital setting RFAs have been a blessing for children and their families. In regards to pediatrics, an RFA is a minimally invasive procedure, with quick results, and a quick recovery time. RFAs allow children to have the lesion that is causing them pain treated and allow them...

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Continuing Education

The Philips Learning Center provides continuing education (CE) approved and/or accredited self-directed learning activities by Recognized Continuing Education Evaluation Mechanisms (RCEEMs). Our education offerings are supported by the industry's leading academic institutions and accreditation organizations. That's why more than 250,000 medical professionals use the Learning Center for their continuing education needs. Visit the Learning Center to see our extensive Course Catalog with monthly specials and new offerings.

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Children's to Receive Philips Interventional Lab this Summer

Big things are ahead in Interventional Radiology at Children's Healthcare of Atlanta at Egleston. Children's will install a new Philips Interventional lab this summer, which is BIG news for us and our patients. This equipment will greatly improve image quality. Two Children's Radiology staff members will take the Interventional Registry this year to solidify their skills as IR technologists. Children's outpatient procedures have grown to include Radiofrequency Ablation and Venous Embolizations, which provide an alternative to open operations. I am celebrating my five-year anniversary in October, and I still love what I do and who I work for. Children's is a great place to work and, especially with the additions on the horizon for this summer, it's a great place to grow as an IR technologist. Mike Bryant, RT(R)CV Children's Healthcare of Atlanta at Egleston

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March is Colon Cancer Awareness Month

Colorectal cancer is the second leading cancer killer in the United States after lung cancer and is one of the most preventable cancers. Many colorectal cancer deaths could be avoided if people over 50 went for the recommended screening tests. The majority of colorectal cancers are adenocarcinomas but begin as polyps. This cancer develops from the lining of the large intestine and rectum. Colorectal cancer grows slowly and often does not cause symptoms for quite some time. As the cancer grows, it invades the wall of the large bowel. Often nearby lymph nodes are invaded. Blood from the wall of the intestine is carried to the liver; colorectal cancer easily spreads or metastasizes to the liver soon after spreading to the lymph nodes. Are you interested in learning more about colorectal cancer, tumor types, staging and the unique information that each imaging modality, clinical exam, or test provides to reach...

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Children's Welcomes Portable CT

Children's Healthcare of Atlanta at Egleston recently added a portable CT scanner to further improve care for critically ill patients. The scanner is called a CereTom and it was developed by NeuroLogica. The purchase of the portable CT scanner was made possible through donor funds. Children's staff members are able to take the portable CT to ICUs to care for critically ill patients that might otherwise not be able to be transported to radiology, such as patients with dangerously high intracranial pressure or patients on ECMO. Children's averages seven portable exams each month. The scanner is an 8-slice scanner, and produces images of the same quality as a non-mobile unit. A task force of critical care physicians, radiologists, and CT technologists worked together to establish guidelines for determining which cases will most benefit from the use of the portable scanner. An assessment of the acuity of the patient dictates whether...

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Children's Healthcare of Atlanta's Ultrasound Department: Pediatric Emergency Studies

At Children's Healthcare of Atlanta, the ultrasound department realizes that its staff makes a difference in a child's life every day. One way is by utlilizing emergent ultrasounds. The thin body habitus of a child is especially suited to ultrasound evaluation. What emergent ultrasound exams are done on the pediatric patient? The most common is to evaluate for the acute abdominal condition. Abdominal studies look for obstructions such as intusseption and pyloric stenosis. Abdominal ultrasound also evaluates the abdomen for gallstones, kidney stones or abscess or fluid collections. Pelvic ultrasounds are performed for ovarian torsion, hemorrhagic ovarian cysts, or fluid collections and abscesses. Scrotal ultrasounds are used to diagnose testicular torsion. Children's performs everything from deep vein thrombosis Doppler studies to hip ultrasound for effusions. Superficial foreign bodies can be seen on ultrasound that may not be seen by diagnostic radiography. More and more, the emergency department requests ultrasound studies....

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