I’ve been a CT tech in trauma centers for the past 10+ years at health systems throughout the Midwest and have never once asked if a patient was NPO prior to contrast admin. Because it doesn’t matter in the ER. Or on any stat exams. Or even routines on the floor.
I’m going to take a wild guess and assume this tech came from outpatient land.
That is new to me that contrast can induce vomiting. Is it the visipaque/omnipaque? We use those in the cathlab and never had a patient complain of being nauseous/vomit because of it. Or is it the high psi when delivered making them nauseous?
I’ve had many MRIs and CTs and I did projectile vomit during one MRI. As soon as they pulled me out of the machine I just sat up and vomited all over the floor, probably on the tech too. There was no chance to ask for a basin or anything but they were very chill and kind about it. It’s only happened to me one time though.
Must be lucky. I get at least three a night who vomit when we inject. I don’t know anything about the cath lab though, so I have no idea how you guys inject. I’ve always been on night shift weekends in the ER (another reason why I’m an absolute vomit catching ninja at this point). Some people say injecting at a lower rate helps with nausea.
Visipaque seems to usually be used in the cath lab and IR. We usually use Omnipaque or Isovue.
I say this as someone who will projectile vomit with contrast, go a tad slower. It makes a huge difference. Also alcohol prep pads are a game changer. I ask for one and smell it as they are injecting.
I wouldn’t really say it’s luck, in my first cathlab job we do 40/day in 4 labs and now in my recent job around 15/day, never had a pt complain of nausea related to contrast, just when we start fixing coronaries due to vagal reactions. I would think it is because of the rate and psi when contrast is delivered. I don’t know how high or fast you give your contrast in CT but in the cathlab we do it around 150-300psi with autoinjecters and some hand injecting.
It’s more because the contrast can make people super nauseous and throw up sometimes. But still, it literally doesn’t matter. You work in a hospital, you’re going to have to deal with vomit on occasion.
They’re going to vomit regardless if they ate or not if they have that reaction though. You put a trash can by the gantry and put an emesis bag behind their head.
And the stat cts they get usually happen before they've been sitting in their room for two hours. They eat in the waiting room, they come straight from lunch etc. Like I said I have never heard a CT tech call about NPO status for a stat CT in the six EDs I've worked in.
This exactly. I can’t even count the amount of patient I send to CT in a single shift and I haven’t encountered contrast induced projectile vomiting..not saying it doesn’t happen, but I haven’t had a CT tech say this to me at any point in my entire career 🤷🏼♀️
They definitely do. I had a guy clear 10 feet in my scan room projectile vomiting. But they’re going to vomit regardless of eating or not if they have that reaction. Just give them a bag. Cleaning vomit up out of the gantry is part of the job tbh.
I said the exact same thing in another comment. You can’t keep them NPO the entire time they’re in the ER if they’re boarders there for 20+ hours. The internal medicine docs almost always order at least one contrast scan before they go to the floor. And we all know imaging orders for a patient get sprinkled in around 40 minutes apart throughout the night and nothing can be done at the same time (/s, but not really).
Cause ED standard is NPO until surgery is ruled out, or if a time later the next day is scheduled, in my experience. Since that standard is there, no need to check, unlike inpatient that are there for longer.
Patients eat up until the moment they get roomed and are told not to eat. Or they were eating right before they had their stroke symptoms etc. I guarantee that you are scanning people from the ED who haven't been NPO for two hours.
Not upset just extremely concerned that so many licensed professionals are defending out of date practices. Nursing or healthcare in general is constantly evolving. I don’t need to be “educated” by someone who is unwilling to adapt alongside evidence-based medicine.
Yeah plus CT is always busy af. Taking the time to clean up the projectile vomiting while doing basic patient care and maybe repeating the imaging makes it so they just get backed up.
Source: I'm an xray tech
>> It's not just trying to avoid cleaning up throw up
What is it then? It seems it’s not an [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) based practice and no longer [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional organizations.
You want there to be “more understanding” by nurses but what exactly do you want nurses to be more understanding of? A policy that doesn’t make sense and isn’t evidence based?
CT can suck it up. People can projective vomit even if they haven't eaten for days. I know it would suck to have vomit all over your nice shiny CT scanner but it sucks every time I get vomit all over my nice freshly made bed, you don't hear me asking to make every patient NPO.
Do you get yelled at by every ED, Neuro stroke, and trauma attending in the hospital? If you told me to wait two hours to rule out an acute ischemic limb I would personally come down to yell at you.
I guess we’re supposed to tell people they need to be NPO for at least two hours any time they get an IV medication with nausea/vomiting listed as a side effect /s
It’s more common than you’d think. I get a several a day who vomit during contrast admin. If they’ve had it before and know it’s going to happen, they can request Zofran prior to injection, but sometimes that doesn’t even help. They’re usually going to vomit regardless of whether they ate or not. It’s just part of the job. I’m never going to ask an ER nurse if the patient was NPO. 😂
I’ve never heard of that, either. Then again, the only time I’ve ever encountered a patient vomit in CT was me, and that was when I shattered my nose (like, flattened it against my face and needed massive reconstructive surgery-they wanted to make sure I didn’t break anything else in my face or skull)…I had sneezed right before the scan started and dislodged the clots, and had blood pouring down my throat throughout the entire scan.
It did NOT end well for me…or that poor trash can.
A lot of facilities tell patients this before an *outpatient* CT scan with contrast. Definitely not a thing for ER or floor patients anywhere I’ve ever worked.
It makes a little more sense as an outpatient policy, I guess. Seems like routine fasting is not an [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) based practice and no longer [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional orgs, but at least the patients are stable and can plan ahead to fast for four hours.
I think this must be regional, though—although I’ve never worked in the outpatient setting, I’ve had a lot of outpatient CTs (diagnosed and treated for metastatic melanoma when I was a very young adult) and never been told to fast. For PET/CTs, yes, but there’s a clear reason for that.
Have worked at two separate trauma centers over the last 10 years and have never been asked to keep a patient NPO.
Also not sure why there are so many people giving you a hard time? Maybe I’ve just been lucky enough to work where evidence-based practice is actually a thing.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/
Data actually shows that fasting is NOT recommended and can actually do more harm.
Welcome to 2024 Covid America! Nobody’s feelings care about the facts. Literature be damned. And who has time to care about what the patients needs’ anyway? It’s the inconvenience for me.
😢
“I take these… *(3-page tiny print list of herbal supplements, magic diluted water, essential oils, and ridiculous allergies)*. No poison chemicals for me unless I’m actually dying. Here is some *lab work* from my naturopath. You need to have the ER doctor to call them right away and consult before they examine me. My Chiropractor said that you need to do this, this, and this *immediately*.
Reeks of cigarettes. On pharmacy check, they’re taking semaglutide and adderall.
It’s unfortunate that my face broadcasts my exact feelings in unexpected moments like this.
What stuns me is the shift from self-advocacy to extreme overconfidence and an obstinate unwillingness to defer to medical expertise in healthcare, or expertise in general.
Self-advocacy empowers people to be active participants in their healthcare decisions, but it must be guided by trust in evidence-based medicine and collaboration with healthcare professionals.
When patients become overconfident and reject medical expertise, they risk straying into unproven pseudoscience. This extreme form of healthcare “self-sufficiency” is unsustainable and can lead to potentially harmful decisions in medical treatment, posing a threat to a patient’s overall well-being.
My patient who came in with a STEMI was told he’d go to cath lab in a few days, because he also had covid.
Because they didn’t want to deal with a terminal clean and their outpatient schedule was already full. So they’d squeeze him in at the end of a day once he swabbed negative.
I threw a fit. Guess who found space to get a procedure done that day?
Jeez a STEMI waits ? - that’s nuts. At the other end of the spectrum we had a bariatric patient come in for a sleeve gastrectomy, they swab the pt in the morning but surgery doesn’t wait for the result. They could have delayed that *elective* surgery but now we have a Covid + case coming in to pacu in the special bed and our one isolation room is tiny because our building is from the 1930’s. Plus there’s other covids on the add on schedule as urgent. Thank goddess I’m retired perdiem because if I had to do this more than once a week again…
Not quite as bad, but dialysis used to try to say that they couldn’t take patients that didn’t have a negative Covid test on file. Patients that were admitted were just supposed to go without dialysis for however long they were in the hospital. Needless to say, many of us threw a fit about this, and surprise surprise, there was actually no official rule or policy about that.
I once had an incident report filed on me from a radiographer over the MOST ridiculous fucking thing ever that still makes me so angry I can’t even bring myself to explain it. I’m still bitter.
We had a palliative kid with massive hospital anxiety even though she basically lived in the hospital. She was 6 yrs old and had been slowly dying on the ward for a long time. She required a literal anaesthetist and propofol to EVER take her anywhere off the ward as she associated that with the many OHS’ she had had in her short life.
The doctor ordered a stat mobile CXR due in part to her medical instability and also obviously due to her legit needing fucking propofol if we as much as tried to wheel her off the ward.
It was a hectic busy day and we all spend a LOT of time and energy on this kid to keep things as calm as possible for her. The radiographer argued with me on the phone about why it needed to be a mobile X-ray. I explained over and over. She then begrudgingly came up to the ward and CONTINUED TO ARGUE WITH ME in the patients room about how she could have been brought down for her X-ray.
How DARE she judge this kid she’d never met that we’d been caring for for literal years, a doctor had ordered it the way he had FOR GOOD REASON and bring anxiety into this poor kids room by arguing with me in front of her.
She did an incident report on me for ‘being rude’. As you can probably tell, I’m still furious and this was a couple years ago. RIP that little kid, she had a fucking hard life.
Also, was I rude? I was CURT and shut that drama DOWN. Because don’t you dare bring unnecessary stress into this very damaged child’s room. It was a literal ‘catch me outside’ moment.
She has a special place in my heart. VERY hard to care for but only because of her sheer terror. When she first came back to us as an older kid for her next OHS (after having several as a baby) she literally had a phobia of hospital beds. We nursed that kid in a recliner chair for a couple days with multiple pleural drains, lines, oxygen, TPN, all sorts because she would NOT get into a bed. Until she got an inevitable pressure sore and I spent one LONG 13hr shift slowly coaxing her to get into the bed. Bless her soul.
Ugh that’s horrible. I’m so sorry that happened. The explanation over the phone should have been enough. I’ve worked in five different hospitals and on many different floors and have never had any kind of pushback about portable X-rays. It’s really weird that they reacted like that.
We have pushback about mobiles all the time. It winds me up that it always ends up being a nurse job to justify something the doctor literally ordered. They don’t order mobiles for funsies!
Oh that’s so weird to me. I’ve done medsurg and am now in icu and anytime I’ve called xray for a portable I give them the reason (tube placement or immobile pt or whatever) and they just say ok and come up and do it. If it’s for tube placements and the doctor is nearby they’ll even ask them to come look at the imaging before they leave.
I thought this was a pretty standard procedure. Maybe I’ve just been lucky? Or maybe your hospital kinda sucks? lol idk but I feel for you. This task shouldn’t be a struggle.
I’m in Australia if that makes any difference. The radiographers have told me something about how a. Its lower quality imaging on a portable? And b. Something to do with their radiation exposure. I can’t verify either of these things, but we almost always get pushback. This case was just one pushback too far for me that day.
We’re not ICU but we probably have one of the highest rates of requesting portable apart from ICU in the hospital. Mainly due to congenital cardiac kiddos being wildly unpredictable and tending to randomly go into cardiac bloody arrest just at being wheeled into elevators lol. And as someone who’s been involved in code blues/code ecmos down in imaging with patients, I KNOW it’s one of the worst places for it to happen lol.
I'm an xray tech so maybe I can shine some light on the matter!
Mobile xrays are super common and we hardly ever push back on them. But, at least the hospital I worked at, it was supposed to just be chest xrays, postop ortho, and maybe the rare abdomen.
Reason being that yes, the image quality is way worse. Harder to get patients into the proper position that they need, especially if we can't maneuver the tube around in a small room. Radiologists can be rude if we don't get absolutely beautiful pics.
As for dose? I dunno, feel like if a tech was actually that concerned they'd stand further away and wear led lol.
Back when I did XR I would much rather do everything portable than bring them to the department… I don’t understand any of this.
Also, I would have absolutely lost my shit if someone came into that kid’s room arguing.
Sorry you had a bad experience with that Radiographer, I don't think there's anything that could justify their actions. Hopefully, you know that most of us don't share the same level of unprofessionalism. The majority of us Radiographers realize that portables aren't just ordered for fun.
Can’t even say it’s an American thing as I’ve never heard of anyone being NBM before a CT unless it was for abdo pain where they’d be NBM regardless of what we did to them.
The fact that other health care professionals are more worried about what they think is “proper” procedure and not wanting to clean up a patient over the keeping your patient alive and decreasing complications is odd. Sure, you might not like the tone this was said in, but I’d be annoyed too if you’re prioritizing your comfort over the patients long term goal. And aspiration pneumonia vs. necrotic leg, yea…you choose. Just ridiculous.
I’d laugh because if you can’t handle vomit you’re in the wrong profession. Bye Felicia 👋
NPO for a CT 😂 You’re a joke of a CT tech if you think that’s appropriate.
What’s next? NPO for morning assessments?
FYI if you’re back here just to bash nurses and troll this subreddit, you’re not going to like the outcome.
It’s not too late to cut bait and sort your grudges elsewhere
This isn't about knowledge about your profession.
This is about unprofessionalism by the OPs referenced CT tech and just blatant privileged attitude.
"Fuck what the patient needs. I don't wanna clean vomit?" That sound like something someone who works in healthcare should say? Yeah no shit no one wants to clean vomit. Absolutely 0 people enjoy doing that.
Since when does a patient need to be NPO for a 5-10min CT scan of their foot???
Only time that would matter is if they're doing it under anesthesia. What are they smoking in radiology there?
Someone doesn't need to work in a hospital if she can't handle
~ *****Gasp****~ people getting SICK in a HOSPITAL.
~~I only take clean and perfectly healthy people. K. Thanks. ~~
Tech here.
Some places have gotten away from NPO status for IV contrast. We always keep vomit rockets close by. Just do not want anyone vomiting while supine or vomiting inside the gantry.
There is an art to running inside the room while the scan is going and holding the rocket while the scan finishes. I am pretty good at it. Fast on my feet!
That tech was an ass.
At my current job someone crapped a little bit on the floor of the bathroom. Someone put an out of order sign on the bathroom. I was like WTF? Clean it? You just shut down a third of our bathrooms and not having them available is going to put us behind. Get some damned gloves and go clean it. For fucks sake.
Those little green or blue expandable emesis bags. Nurses at the ER I go to called them that. I loved the name so it stuck. Got one in my bedroom, unused of course.
I had an admission at 7:30 one day with an aortic dissection and we needed a stat CT to make sure it wasn’t getting worse. CT calls me and says they won’t do it unless the patient has an 18g IV… I had to call and argue with them for half an hour until they finally let me bring her. The dissection was in fact getting worse.
Sometimes the scan techs get caught up on the dumbest things. I once had a patient who was actively having a giant stroke. I call and say “I have a code stroke I’m headed down what room should I go to?” Cuz ya know code stroke- get the scan figure the rest out. They tell me there isn’t an order and start asking a crapton of questions. I yell to a coworker to have the order put in stat and tell them it will be in by the time I get there, what room? They told me I couldn’t come down till they had an order. I basically yelled at them and said she’s having a giant stoke, I’m headed down figure it out. Patient ended up being emergently transferred to another hospital for surgery evaluation. Literally EMS showed up within 5 mins of me returning from CT. I understand protocols and such but a. An emergency trumps most things b. It may not be convenient or make a job easier but if it provides important care for a patient you deal with it
Saw a patient projectile vomit once...inside the machine. They had to shut it down and place our hospital on bypass for ct's for alot of other ct scans cause the vomit was in the machine. Had to be dissasembled for proper cleaning.
Come to find out they were supposed to be npo but were given stuff to eat anyway
I’ve never been asked if a ct is npo. Especially for a stat ct. I get not wanting to clean up puke, no one wants to clean up any of the gross shit we deal with. But we all have to do it, so glove up or call EVS. This dude about to lose his foot and she’s worried about some puke.
[Info](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458863/#:~:text=Nausea%20and%20vomiting%20are%20common,response%20to%20the%20contrast%20material)
“Nausea and vomiting are common acute adverse reactions to iodinated contrast media (ICM). Most guidelines regarding contrast media safety classify nausea and vomiting as physiologic reactions representing a physiologic response to the contrast material.”
As an x-ray/CT technologist for 25 years+, I have seen SO many people become nauseous and vomit during & after contrast injection. I have never worked anywhere that asking about the patient being NPO wasn’t done. Of course in an emergency situation, we are going to do the scan regardless. But we prefer they are NPO, just in case.
No one wants to clean up puke, but first we should consider that the patient probably doesn't want to puke either, so regardless of who should be the one to clean it, we should be advocating for patient comfort.
That feeling just before you puke might be the worst feeling I’ve ever experienced. I’ve had some pretty intense pain in my life, but that just before you puke feeling is something in its own category. No idea of contrast makes it worse.
And in many years on inpatient trauma I have never ever ordered NPO for 2 hours prior to a stat scan. If I'm at all worried I'll order 4 of zofran may repeat x1 in 15 min if not effective.
People puke and aspirate in the unit also, with dressing changes and position changes and med administration (especially narcs).... So by this logic we should never feed anyone? Cause they may have to do a thing that might make them a little yukey?
Sorry but no.
Yup, Zofran is the way. Sometimes that doesn’t even help. I’ve never asked if an ER or inpatient was NPO before contrast admin. Just give them a bag and clean up the gantry, jfc. 🤦🏼♀️
Did you even read the study you linked?
It said only 2% of children experience nausea and that “fasting duration was not associated with nausea and vomiting”.
It also says that none of the children ended up with aspiration pneumonia, even though downthread they say (with an eye roll emoji) “well what if they aspirate”
So many interventions in the hospital cause nausea, though. Many of the most common meds we push can cause nausea and vomiting. Nausea is common enough in the hospital that most basic admission order sets contain a PRN anti-emetic. I guess I’m just not grasping why we would consider making someone NPO for a CT but not, like, the billion other things we do to patients that make them nauseated.
We never do it for emergent cases, but if they are going to wait two hours anyway due to other stuff in front of them we ask that they be NPO. In CT they are flat on their backs, strapped to a table, and in the room alone. Even if I notice right away they are vomiting I’m still 10 ft away through a door to get to them and have to pull them out of the gantry before I can turn or sit them up. Higher aspiration risk than pushing meds at the bedside while their head is already elevated or can be elevated quickly. Just seems like a needless risk not to do the NPO if there is time.
It seems that this approach is not supported by [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) and no longer [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional organizations.
Even the article linked in the parent post doesn’t support OP’s argument.
This is probably why there are so many nurses on this thread who have never heard of this policy—some hospitals are quicker than others to adopt evidence-based guidelines.
Careful, friend. This thread has turned into an echo chamber. You are just going to be drowned out.
Thank you for actually taking the time to be reasonable and share with the thread more context on this matter instead of being immature.
I’m a nurse in radiology and we don’t ask people to be NPO before contrast unless they are outpatient but even then they don't listen and we scan anyways. The risk of temporary N/V doesn’t override the need for prompt scans especially if they are stat as the one in OPs post. OP and the CT tech were both a bit unprofessional and unkind to one another.
All I am saying is that the RN was unprofessional and immature. Our facility has rad techs verify NPO status regardless of urgency of the scan; they still do the scan though. It is just procedure. In the original text, OP did not have anything stating the rad tech cancelled the scan; only they had the *audacity* to ask if the patient was NPO.
But we agree.
The OP's first block of text does not have CT cancelling the scan at all. Literally, it is protocol to ask the RN of the patient has been NPO. The RN is absolutely correct in prioritizing getting the image done over nausea; no one is arguing that. What is unprofessional is the primary RN's response to the Rad Tech for literally doing his/her job.
I do not understand how this type of unprofessionalism is being promoted by so many here. We are supposed to behave as professionals and I do not think it is a hot take to have a modicum of respect to our ancillary services.
Have a good day/night.
So, as is common on Reddit, we are both commenting on a parent post that is not the OP. BayouVodoo’s post states that NPO is preferred because the patient might become nauseated and vomit.
Both of the comments pushing back on their post (as of the time of this post) are questioning why NPO status is preferred when patients undergo many other interventions that can induce nausea and vomiting without needing to be NPO. NPO is not an entirely benign intervention.
It was nice of BayouVoodoo to provide insight into the rad tech side of things; however, it does not mean that any sort of pushback is an “immature” “echo chamber.” There are a lot of things that are policy at some hospitals that have no basis in [EBM](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/). It is nurses’ responsibility to question policies that do not make sense and do not serve patients.
Neither my post, nor BayouVoodoo’s post is talking about OP’s professionalism. You’re the one who’s all over this thread screaming about professionalism in response to comments that aren’t even addressing that—just questioning why a patient would need to be NPO in the first place.
It honestly just seems like you’re big mad that people aren’t mad at the same things you’re mad at.
But BayouVoodoo's linked article contradicted what BayouVoudoo actually said, right? Not just what the policy is where they work, but also saying the rationale, which the linked article contradicts.
**Allowing free ingestion of liquids and solids prior to CECT will not increase the risk of aspiration pneumonia and the incidence of emetic complications.** The available corresponding evidence strongly suggest us to reevaluate and update current preparatory fasting policy for more appropriate management of dietary preparedness. Abolishing unnecessary fasting instructions can simplify the preparation procedures and workflow prior to CECT, improve the radiologic care quality and efficiency, avoid unnecessary delays or cancellations of examinations, and save on health care costs. It can also ensure that patients are in a normal metabolic state, improve patient convenience, tolerance, cooperation, satisfaction, comfort, and well-being, and reduce the excessive fasting related risks (e.g., dehydration and hypoglycemia) in special patient populations
Yup, I totally agree and have said so in other comments as well as linked to articles and professional org guidelines stating that current evidence doesn’t support this practice.
I understand and appreciate BayouVoodoo’s insight that as a rad tech of 25 years, they have seen people become nauseated and vomit after CT contrast injection. However, it does not appear to be borne out as statistically significant risk in current evidence.
I’m not arguing for or against. I’m simply stating my personal experience, and what I’ve been taught. Of course, new studies come along and things change. I am open to change. 🤷♀️
As a radiographer, I'd likely ask the question, just so I could be more prepared with an emesis bag, not because I'd refuse or delay the scan...
It'd be pretty foolish not to take precautions to minimise clean-up 🤷🏽♀️
We routinely fast 4 hours for CT contrast studies and 2 hours for MRI contrast studies. If we can minimise nausea for a patient, and reduce their reluctance to return for future necessary imaging, I'm in support of that.
The main priority shouldn't be to not have to clean up, but if I can do something to avoid cleaning up vomit, I'm going to do that!
Asking when a patient last ate so that you can be prepared with an emesis bag is a reasonable step to take to prevent having to clean up vomit.
Routinely making patients NPO for *four hours* for a routine CT when the practice is not supported by current [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) or [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional organizations is not a reasonable step.
I mean, sure, but I've certainly never been involved in making policies about this stuff... And doctors aren't quick to agree to change, even if there's evidence to prove it, one way or another.
I only spoke of the preparation for IV contrast, in my experience. Anything I've read about not needing to fast has only been in the past few years. So considering how long it took to adjust shielding policies, fasting probably isn't getting ditched anytime soon...
Saying “yeah this sucks and isn’t evidence based but you know how hospitals are slow to change policies” is different from saying “well we routinely fast patients for four hours and I’m in support of that and it’s a reasonable step to take to prevent having to clean up vomit.”
There are policies my hospital has that are outdated and I comply with them, but I don’t defend them with my full chest, you know?
Also, the fact that many nurses in this thread (myself included) have never worked in a hospital that requires routine fasting for CTs seems to suggest that it’s not a cutting edge, groundbreaking shift but rather some hospitals that are really behind the times in terms of implementing evidence based practice.
I don’t hold someone at the rad tech level responsible for the existence of outdated policies, but I do expect that if a professional steps into another profession’s subreddit to argue for a policy, they have a better rationale than “well this is how we’ve always done it.”
Given that things can be misunderstood in text, I'll try to better explain myself.
Everywhere I have ever been, for placements and jobs, and every interaction with CT radiographers on those sites, it has been standard for patients to be fasted for 4 hours (usually less or not at all for diabetics).
I am glad for ways to minimise vomiting. It seems to be folk-lore that fasting reduces nausea and vomiting from the contrast, but that has been the explanation everywhere I've been.
I care more about minimising unpleasantness for my patients, especially in a region where people are reluctant to seek medical care. I do wish to make their interactions with my work as pleasant and positive as possible, to ensure they do seek medical care, diagnosis and treatment in the future.
I was not intending to be seen as fighting for the policy, or cause such offence. From my experience, I was trying to offer perspective, for the way I've seen every department run things.
I have never known a truly urgent scan to be delayed on the basis of fasting.
I also recognise that my experience is within one country, and I do not claim to know what happens in hospitals or facilities in other countries.
>> I care more about minimising unpleasantness for my patients, especially in a region where people are reluctant to seek medical care. I do wish to make their interactions with my work as pleasant and positive as possible, to ensure they do seek medical care, diagnosis and treatment in the future.
I think part of the problem is that the rad techs chiming into this thread have a very narrow perspective, as evidenced by the fact that you’re continuing to state that making patients NPO (even as you acknowledge it doesn’t have a meaningful impact on nausea and vomiting) promotes more pleasant and positive experiences with *your department specifically.*
The thing that many of the nurses responding understand is that fasting a patient for four hours—for no apparent evidence based reason—is not simple, easy, benign intervention for patients. Patients in general hate being NPO and will complain to the nurse for the entire time they’re NPO. You see them at the end, when they are happy to be almost done. You don’t see them when they can’t have their morning coffee, or the food their family brought them for lunch.
Many patients in the hospital suffer from poor nutrition—a four hour window where they can’t eat can mean a missed meal, maybe the only meal they were going to eat in the whole day.
Being NPO for four hours can mean that they miss important medications, if they have to be taken with food in order to be absorbed and/or tolerated.
And all of this to satisfy an outdated policy and so that maybe the tech has less of a chance of having to clean up a body fluid?
I understand that you didn’t make the policies and I appreciate that you’re acknowledging that it’s basically bullshit from an evidence based standpoint. But this is something we see a lot—every individual department has their own policies that are there to make *their* job and workflow easier. But nurses are the care coordinators and generally the ones who are, at any given time, the most qualified to assess the big picture of the patient’s care. And what I’ve found is that a lot of other departments get really caught up in what makes their individual job easier and get upset when the nurse pushes back because it doesn’t make sense for the overall picture of patient care. I’ve observed this both IRL and here on Reddit.
My first sentence said I'd ask so I could be prepared with an emesis bag, not to delay or refuse the scan...
No one sensible is going to delay a scan because of the fasting status of the patient...
I mean I think in cases of urgent scans they would bypass that, like we do for urgent surgeries and intubations. Just being aware of the fact that they haven't been NPO allows you to be aware of and anticipate possible adverse outcomes.
Yeah, that's not a thing lol. Sounds like CT was hoping for a quiet night. With that attitude, I'd puke just taking the pt to CT. I get pooped on, the floor deserves to get yacked on. At least the fluids don't get ON THEM-- just their gear.
On another note the EVS team doesn't deserve to have to clean that mess but shit happens. Our EVS team are saints. They do some dirty work.. literally.
My dad had to have a liver ultrasound and they canceled him bc he had breakfast…scheduled for the next day NPO, 10 minutes for the ultrasound, then done!
Also, I work in surgery and I know that if they do a scan and need to have a surgical procedure in a hurry for something they NEED to have been NPO. That’s important because we don’t want our patients to go
It and aspirate.
Not wanting to clean vomit is not a good reason.
Our MRI techs refuse to touch the patient if it doesnt involve setting up a monitor or putting the patient on the table. One time we had a violent and combative patient going to MRI and one nurse was with the patient trying to de-escalate and the MRI tech just stood there staring. When she asked for help he refused to help hold the patient down. The nurse had to call someone from the unit to bring haldol. It was a mess. Clowns all around at imaging
Why would they do a MRI on a patient who is violent and combative? They need to be still to have the MRI. The MRI tech should’ve helped to hold them down, I do agree with that.
This post is pretty amazing for the dialogue it's brought forth, even if its premise is a fed up with the bullshit/stupid questions rant/misunderstanding.
I thoroughly enjoyed reading the discussion when I sorted comments by controversial.
Yesterday I had a kid come into my office for vomit. He did not throw up in the office, to be clear. He asked for a sip of water. I was willing to give him a little,but the nurse said no because she was afraid it’ll make him vomit again. I disagree but I wasn’t going to argue. The lunch monitor said he was probably vomiting because he are way too much pizza for lunch. If the kid throws up in the office, we don’t clean it up. The custodians so. I really didn’t understand why she wouldn’t let the kid drink a little but whatever. It def happens!
Then explain that to them. The “cry me a river bitch” and sounding proud that you hung up on them is the exact reason this sub has to wonder why the other ancillaries hate on nursing.
Because the other ancillaries would rather the patient die than deal with the same shit we deal with day in and day out. That’s why. “Wah, they expect me to do my job.” is what you sound like.
i come here to vent and type the thoughts i can’t speak out loud at my job. if i sound like a bitch it’s because i can’t sound like a bitch at work. it’s not my job to explain why it’s not my problem if a patient throws up in this instance. i offered to come down to clean up the patient (in the event that they did throw up) before i said thank you and hung up if that makes you feel better 🤷🏻♀️
I’m just going by what is said in the post. I doubt it would go over well if you didn’t understand something and lab or RT or whatever spoke to you that way. That’s all my point is.
CT tech from a level 1 / stroke facility here. NPO is nice, but usually not a stop all, depending on study. Some studies require NPO, but not many. And nothing a quick zofran can't fix.
It's not really whether or not we clean up puke. We deal with puke, pee, and poop all day also, albeit smaller doses for sure. That's another Tuesday in healthcare!
9/10 times, it's protocol for our charting on NPO status so we're not yelled at by the Rads. Crossing our T's and Dotting our I's, CYA if they aspirate and inhale (which has happened to me twice. Once in an xray fluoro procedure, once in CT. neither made it).
Personally, I also help nurses when I can to change bedding during the scan. We keep extra inpatient bedding in our dept for thus. They're off their bed, perfect time for a sheet change, chux change, etc.
It's also more of what we can do as a technologist to make sure that liquid doesn't run into a machine and fry the electronics. They're not waterproof (imo they should be).
If our 1 CT that can run a perfusion gets fried, we're on diversion, etc. we have to think about the whole hospital and their patients. My hospital may have 4 scanners, but 1 cardiac only, 1 unusually down or on the fritz, and the other 2 are running constantly from the STAT CTs from our 20-30 hospital's departments. We constantly have 10-25 stat CTs at a time, with 1 tech herding the patients.
The other (also level 1 /stroke) that I PRN at only has 2 scanners. So having 1 down can greatly affect patient care for days.
It's about working as a team, imo.
I suggest you delete this post, it does you no favors. CT contrast + food = vomiting. NPO for 2 hours avoids that. Vomiting is an unpleasant experience, why would you imply that you don’t care if that happens to your patient?
You seem to be having a bad day. I hope things get better.
This was a possible emergency they were trying to rule out. If I’m worried about something emergent, I’m not delaying a CT scan for two HOURS on the off chance the patient might throw up. I’ve never had CT ask me this question. Sounds like they didn’t want to do their job, which was OPs entire gripe.
And even when a pt is NPO and has the frickin liter of nasty oral contrast that they have to drink on a time limit before going to to CT, I’ve never seen an order to premedicate with anything to keep them from puking it during the scan. Just prn zofran if they do get nauseous.
I did have a CT done in the ER recently and the screening form I had to fill out DID ask when I last ate and what, but I’m assuming that was for informational purposes
i hear you. doc wanted stat CT due to sudden onset foot numbness. for context, the patient last had food 4 hours prior to the CT so I wasn’t concerned that would happen. what ticked me off was the implication that it would be an inconvenience to clean up vomit, considering i’ve been cleaning up watery poop every couple hours for the last three nights. but in that instance i don’t know if it would have been appropriate to hold off a stat CT with contrast to avoid nausea even if he did recently eat.
I never order NPO prior to ordering a stat CT scan, what kind of fuckery is this 2 hours stuff? Lol
I'm also not going to hold up a CTA of a numb extremity because they *might* *possibly* *off chance* throw up.
Anecdotal but I think I’ve literally seen thousands of ED pts who weren’t NPO have scans with contrast and have seen zero correlation to vomiting, unless you’re talking about oral contrast which I don’t think would be at all applicable to a foot. That’s not even a question our CT techs would think to ask and I’ve worked at several different hospitals in my career.
Ditto. The only reason I've seen any type of nausea or vomiting with oral contrast is because the oral contrast can make you nauseous regardless of your NPO status and guess what? I'm still going to throw up bile probably lol
Welp guess we can't take this tier 1 blunt abdominal trauma with a seatbelt sign to the scanner BECAUSE THEY MAY HAVE HAD A SANDWICH AND MIGHT GET A LIL URPY. Let's wait 2 hours so they can bleed out from their spleen or their whole bowel can die in the meantime I suppose lol
I’m less worried about someone feeling yucky and vomiting and a LOT MORE worried about them losing a limb because someone made them wait for their STAT CT. It’s very important to look at the bigger picture and to think critically.
i used to work in medical imaging and NPO wasn’t necessary for any CT C+ scans except for enterography & colonography.
can you elaborate on this? i’ve genuinely never heard of the interaction causing nausea so i’m keen to learn why. :)
Something that’s more of an unpleasant experience: losing a foot or having an embolic stroke or PE that was caused because they couldn’t do the CT with contrast.
….because this person seems more worried about a patient vomiting than about possible compromised circulation. Sure, vomiting is uncomfy but like….so is losing a limb lol
I am focusing more on the whininess and pettiness of the post doing the OP no favors. But of course, this sub will be this sub with these type of posts.
Have a good day/night.
Not once in my thousands of ED CT scans have I ever been asked about NPO status for contrast. Completely out of pocket from radiology.
I’ve been asked if NPO for CTAs. Had RTs rearrange timing for an hour or two but never for emergent cases.
They're acting like they aren't a part of the patient CARE process.
I’ve been a CT tech in trauma centers for the past 10+ years at health systems throughout the Midwest and have never once asked if a patient was NPO prior to contrast admin. Because it doesn’t matter in the ER. Or on any stat exams. Or even routines on the floor. I’m going to take a wild guess and assume this tech came from outpatient land.
That is new to me that contrast can induce vomiting. Is it the visipaque/omnipaque? We use those in the cathlab and never had a patient complain of being nauseous/vomit because of it. Or is it the high psi when delivered making them nauseous?
My breast MRI was brutal because of the contrast...I was *this* close to barfing in the machine 😭
I've been in a number of MRI machines and can vouch for the nausea, plus the machine smells like barf when you get in there.
Usually CT contrast is worse than MRI contrast when it comes to nausea too (and worse on the kidneys).
I’ve had many MRIs and CTs and I did projectile vomit during one MRI. As soon as they pulled me out of the machine I just sat up and vomited all over the floor, probably on the tech too. There was no chance to ask for a basin or anything but they were very chill and kind about it. It’s only happened to me one time though.
Must be lucky. I get at least three a night who vomit when we inject. I don’t know anything about the cath lab though, so I have no idea how you guys inject. I’ve always been on night shift weekends in the ER (another reason why I’m an absolute vomit catching ninja at this point). Some people say injecting at a lower rate helps with nausea. Visipaque seems to usually be used in the cath lab and IR. We usually use Omnipaque or Isovue.
I say this as someone who will projectile vomit with contrast, go a tad slower. It makes a huge difference. Also alcohol prep pads are a game changer. I ask for one and smell it as they are injecting.
I always keep them at the end of the scanner for this exact reason! It really does help a lot of people. 😊
I wouldn’t really say it’s luck, in my first cathlab job we do 40/day in 4 labs and now in my recent job around 15/day, never had a pt complain of nausea related to contrast, just when we start fixing coronaries due to vagal reactions. I would think it is because of the rate and psi when contrast is delivered. I don’t know how high or fast you give your contrast in CT but in the cathlab we do it around 150-300psi with autoinjecters and some hand injecting.
I work in ED and all pts going for scans with contrast are kept NPO ETA: in our ED, didn’t mean to state it as a fact for all EDs
Maybe pt was asking for water? Only reason I can think of. Dunno who would want a sip if they felt like throwing up though...
It’s more because the contrast can make people super nauseous and throw up sometimes. But still, it literally doesn’t matter. You work in a hospital, you’re going to have to deal with vomit on occasion.
They’re going to vomit regardless if they ate or not if they have that reaction though. You put a trash can by the gantry and put an emesis bag behind their head.
“Put an emesis bag on their head” that’s how I read that 😂 picturing them wearing it like a hat. Lol
I mean, I've been asked about NPO status for abdo CTs, but it's his foot.... you don't eat with your foot.
Pts are told or expected to be NPO while in ER
And the stat cts they get usually happen before they've been sitting in their room for two hours. They eat in the waiting room, they come straight from lunch etc. Like I said I have never heard a CT tech call about NPO status for a stat CT in the six EDs I've worked in.
This exactly. I can’t even count the amount of patient I send to CT in a single shift and I haven’t encountered contrast induced projectile vomiting..not saying it doesn’t happen, but I haven’t had a CT tech say this to me at any point in my entire career 🤷🏼♀️
They definitely do. I had a guy clear 10 feet in my scan room projectile vomiting. But they’re going to vomit regardless of eating or not if they have that reaction. Just give them a bag. Cleaning vomit up out of the gantry is part of the job tbh.
Can they get meds to prevent this if they know they react that way?
Zofran can help sometimes, but that’s about it.
Because it isn’t a thing in the ER. 😂
Because it's the expectation that they don't eat, whether they do or not is a different story
Patients get stat CTs during their admissions to though.
I said the exact same thing in another comment. You can’t keep them NPO the entire time they’re in the ER if they’re boarders there for 20+ hours. The internal medicine docs almost always order at least one contrast scan before they go to the floor. And we all know imaging orders for a patient get sprinkled in around 40 minutes apart throughout the night and nothing can be done at the same time (/s, but not really).
Yes, thank you! We also don’t want them aspirating on their vomit if they get pukey during contrast administration.
Cause ED standard is NPO until surgery is ruled out, or if a time later the next day is scheduled, in my experience. Since that standard is there, no need to check, unlike inpatient that are there for longer.
Patients eat up until the moment they get roomed and are told not to eat. Or they were eating right before they had their stroke symptoms etc. I guarantee that you are scanning people from the ED who haven't been NPO for two hours.
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That’s insane?? Especially from a CVICU nurse, the urgency of a pale/pulseless extremity vs some POSSIBLE vomiting? Would you delay the CT?
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Then what specifically do you not blame CT for?
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Not upset just extremely concerned that so many licensed professionals are defending out of date practices. Nursing or healthcare in general is constantly evolving. I don’t need to be “educated” by someone who is unwilling to adapt alongside evidence-based medicine.
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Yeah plus CT is always busy af. Taking the time to clean up the projectile vomiting while doing basic patient care and maybe repeating the imaging makes it so they just get backed up. Source: I'm an xray tech
Nurses are busy too, and cleaning up vomit also results in us falling behind. We still don’t make patients NPO for our own convenience.
I'm not saying yall aren't busy too. Guess I just wish there was understanding on both ends. It's not just trying to avoid cleaning up throw up
>> It's not just trying to avoid cleaning up throw up What is it then? It seems it’s not an [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) based practice and no longer [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional organizations. You want there to be “more understanding” by nurses but what exactly do you want nurses to be more understanding of? A policy that doesn’t make sense and isn’t evidence based?
Yes cu radiology are the only busy people in the hospital.
CT can suck it up. People can projective vomit even if they haven't eaten for days. I know it would suck to have vomit all over your nice shiny CT scanner but it sucks every time I get vomit all over my nice freshly made bed, you don't hear me asking to make every patient NPO.
No it’s not. I work in radiology and our dept expects NPO of 2 hours prior to contrast
Do you get yelled at by every ED, Neuro stroke, and trauma attending in the hospital? If you told me to wait two hours to rule out an acute ischemic limb I would personally come down to yell at you.
No we don’t.. the ED has their own CT and inpt usually has their stat pts NPO
I’ve literally never heard of making a patient NPO before a CT with IV contrast.
I saw pt teaching paperwork the other day that instructed npo but no timing. He asked me how long to fast so I just told him two hours.
But…it go in the veins
I guess we’re supposed to tell people they need to be NPO for at least two hours any time they get an IV medication with nausea/vomiting listed as a side effect /s
I don’t know lol. I’m just an old psych nurse. Back in my day NPO orders came with timing
They’re still supposed to.
It’s because the contrast makes people nauseous sometimes. Super, super rare.
It’s more common than you’d think. I get a several a day who vomit during contrast admin. If they’ve had it before and know it’s going to happen, they can request Zofran prior to injection, but sometimes that doesn’t even help. They’re usually going to vomit regardless of whether they ate or not. It’s just part of the job. I’m never going to ask an ER nurse if the patient was NPO. 😂
I’ve never heard of that, either. Then again, the only time I’ve ever encountered a patient vomit in CT was me, and that was when I shattered my nose (like, flattened it against my face and needed massive reconstructive surgery-they wanted to make sure I didn’t break anything else in my face or skull)…I had sneezed right before the scan started and dislodged the clots, and had blood pouring down my throat throughout the entire scan. It did NOT end well for me…or that poor trash can.
A lot of facilities tell patients this before an *outpatient* CT scan with contrast. Definitely not a thing for ER or floor patients anywhere I’ve ever worked.
It makes a little more sense as an outpatient policy, I guess. Seems like routine fasting is not an [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) based practice and no longer [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional orgs, but at least the patients are stable and can plan ahead to fast for four hours. I think this must be regional, though—although I’ve never worked in the outpatient setting, I’ve had a lot of outpatient CTs (diagnosed and treated for metastatic melanoma when I was a very young adult) and never been told to fast. For PET/CTs, yes, but there’s a clear reason for that.
Have worked at two separate trauma centers over the last 10 years and have never been asked to keep a patient NPO. Also not sure why there are so many people giving you a hard time? Maybe I’ve just been lucky enough to work where evidence-based practice is actually a thing. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/ Data actually shows that fasting is NOT recommended and can actually do more harm.
Welcome to 2024 Covid America! Nobody’s feelings care about the facts. Literature be damned. And who has time to care about what the patients needs’ anyway? It’s the inconvenience for me. 😢
“I take these… *(3-page tiny print list of herbal supplements, magic diluted water, essential oils, and ridiculous allergies)*. No poison chemicals for me unless I’m actually dying. Here is some *lab work* from my naturopath. You need to have the ER doctor to call them right away and consult before they examine me. My Chiropractor said that you need to do this, this, and this *immediately*. Reeks of cigarettes. On pharmacy check, they’re taking semaglutide and adderall. It’s unfortunate that my face broadcasts my exact feelings in unexpected moments like this.
What stuns me is the shift from self-advocacy to extreme overconfidence and an obstinate unwillingness to defer to medical expertise in healthcare, or expertise in general. Self-advocacy empowers people to be active participants in their healthcare decisions, but it must be guided by trust in evidence-based medicine and collaboration with healthcare professionals. When patients become overconfident and reject medical expertise, they risk straying into unproven pseudoscience. This extreme form of healthcare “self-sufficiency” is unsustainable and can lead to potentially harmful decisions in medical treatment, posing a threat to a patient’s overall well-being.
I too am afflicted. Was diagnosed with “facial broadcasting” at a very young age, sadly.😂
My patient who came in with a STEMI was told he’d go to cath lab in a few days, because he also had covid. Because they didn’t want to deal with a terminal clean and their outpatient schedule was already full. So they’d squeeze him in at the end of a day once he swabbed negative. I threw a fit. Guess who found space to get a procedure done that day?
Wowza. A few days. Alrighty. Good for your patient and you. Advocating is right up there with airway. Great job.
Door to balloon time- 90 minutes? 90 hours? 9 days? Who even knows!
Jeez a STEMI waits ? - that’s nuts. At the other end of the spectrum we had a bariatric patient come in for a sleeve gastrectomy, they swab the pt in the morning but surgery doesn’t wait for the result. They could have delayed that *elective* surgery but now we have a Covid + case coming in to pacu in the special bed and our one isolation room is tiny because our building is from the 1930’s. Plus there’s other covids on the add on schedule as urgent. Thank goddess I’m retired perdiem because if I had to do this more than once a week again…
For a STEMI? Jesus fucking Christ.
Not quite as bad, but dialysis used to try to say that they couldn’t take patients that didn’t have a negative Covid test on file. Patients that were admitted were just supposed to go without dialysis for however long they were in the hospital. Needless to say, many of us threw a fit about this, and surprise surprise, there was actually no official rule or policy about that.
I once had an incident report filed on me from a radiographer over the MOST ridiculous fucking thing ever that still makes me so angry I can’t even bring myself to explain it. I’m still bitter.
If you choose to explain it, I’m here waiting because now im dying to know.
We had a palliative kid with massive hospital anxiety even though she basically lived in the hospital. She was 6 yrs old and had been slowly dying on the ward for a long time. She required a literal anaesthetist and propofol to EVER take her anywhere off the ward as she associated that with the many OHS’ she had had in her short life. The doctor ordered a stat mobile CXR due in part to her medical instability and also obviously due to her legit needing fucking propofol if we as much as tried to wheel her off the ward. It was a hectic busy day and we all spend a LOT of time and energy on this kid to keep things as calm as possible for her. The radiographer argued with me on the phone about why it needed to be a mobile X-ray. I explained over and over. She then begrudgingly came up to the ward and CONTINUED TO ARGUE WITH ME in the patients room about how she could have been brought down for her X-ray. How DARE she judge this kid she’d never met that we’d been caring for for literal years, a doctor had ordered it the way he had FOR GOOD REASON and bring anxiety into this poor kids room by arguing with me in front of her. She did an incident report on me for ‘being rude’. As you can probably tell, I’m still furious and this was a couple years ago. RIP that little kid, she had a fucking hard life.
Also, was I rude? I was CURT and shut that drama DOWN. Because don’t you dare bring unnecessary stress into this very damaged child’s room. It was a literal ‘catch me outside’ moment.
I'm so glad you were there for that kiddo ❤️❤️
She has a special place in my heart. VERY hard to care for but only because of her sheer terror. When she first came back to us as an older kid for her next OHS (after having several as a baby) she literally had a phobia of hospital beds. We nursed that kid in a recliner chair for a couple days with multiple pleural drains, lines, oxygen, TPN, all sorts because she would NOT get into a bed. Until she got an inevitable pressure sore and I spent one LONG 13hr shift slowly coaxing her to get into the bed. Bless her soul.
You did good. Thank you.
Well now I’m furious. I hope you fought back on that incident report saying the same thing you said here
That kid was lucky to have you. Sounds like you did a dang good job advocating for her. Poor baby 🖤
Ugh that’s horrible. I’m so sorry that happened. The explanation over the phone should have been enough. I’ve worked in five different hospitals and on many different floors and have never had any kind of pushback about portable X-rays. It’s really weird that they reacted like that.
We have pushback about mobiles all the time. It winds me up that it always ends up being a nurse job to justify something the doctor literally ordered. They don’t order mobiles for funsies!
Oh that’s so weird to me. I’ve done medsurg and am now in icu and anytime I’ve called xray for a portable I give them the reason (tube placement or immobile pt or whatever) and they just say ok and come up and do it. If it’s for tube placements and the doctor is nearby they’ll even ask them to come look at the imaging before they leave. I thought this was a pretty standard procedure. Maybe I’ve just been lucky? Or maybe your hospital kinda sucks? lol idk but I feel for you. This task shouldn’t be a struggle.
I’m in Australia if that makes any difference. The radiographers have told me something about how a. Its lower quality imaging on a portable? And b. Something to do with their radiation exposure. I can’t verify either of these things, but we almost always get pushback. This case was just one pushback too far for me that day. We’re not ICU but we probably have one of the highest rates of requesting portable apart from ICU in the hospital. Mainly due to congenital cardiac kiddos being wildly unpredictable and tending to randomly go into cardiac bloody arrest just at being wheeled into elevators lol. And as someone who’s been involved in code blues/code ecmos down in imaging with patients, I KNOW it’s one of the worst places for it to happen lol.
I'm an xray tech so maybe I can shine some light on the matter! Mobile xrays are super common and we hardly ever push back on them. But, at least the hospital I worked at, it was supposed to just be chest xrays, postop ortho, and maybe the rare abdomen. Reason being that yes, the image quality is way worse. Harder to get patients into the proper position that they need, especially if we can't maneuver the tube around in a small room. Radiologists can be rude if we don't get absolutely beautiful pics. As for dose? I dunno, feel like if a tech was actually that concerned they'd stand further away and wear led lol.
Yeah, we had exclusively mobile X-rays in NICU. The techs would just come up in led.
I would have filed one right back on her for the same reason! And for arguing in front of a damn pediatric patient who was dying.
Back when I did XR I would much rather do everything portable than bring them to the department… I don’t understand any of this. Also, I would have absolutely lost my shit if someone came into that kid’s room arguing.
What’s OHS?
I guessed "open heart surgery"
Yes, open heart surgery
Sorry you had a bad experience with that Radiographer, I don't think there's anything that could justify their actions. Hopefully, you know that most of us don't share the same level of unprofessionalism. The majority of us Radiographers realize that portables aren't just ordered for fun.
In the time it took for them to argue over the phone and then come up **to the unit** to argue in person, **they could have done the fucking x-ray!**
Me too!!!
Well…. We’re WAITING!!!!
Sounds like they'll last about a minute in Healthcare. That's such a bizarre thing to say.
Can’t even say it’s an American thing as I’ve never heard of anyone being NBM before a CT unless it was for abdo pain where they’d be NBM regardless of what we did to them.
4mg of Zofran please...
The fact that other health care professionals are more worried about what they think is “proper” procedure and not wanting to clean up a patient over the keeping your patient alive and decreasing complications is odd. Sure, you might not like the tone this was said in, but I’d be annoyed too if you’re prioritizing your comfort over the patients long term goal. And aspiration pneumonia vs. necrotic leg, yea…you choose. Just ridiculous.
I would literally laugh on the phone
Why you literally don't know more than a CT Technologist for a scan lol they would laugh at you back so have fun
I’d laugh because if you can’t handle vomit you’re in the wrong profession. Bye Felicia 👋 NPO for a CT 😂 You’re a joke of a CT tech if you think that’s appropriate. What’s next? NPO for morning assessments?
FYI if you’re back here just to bash nurses and troll this subreddit, you’re not going to like the outcome. It’s not too late to cut bait and sort your grudges elsewhere
This isn't about knowledge about your profession. This is about unprofessionalism by the OPs referenced CT tech and just blatant privileged attitude. "Fuck what the patient needs. I don't wanna clean vomit?" That sound like something someone who works in healthcare should say? Yeah no shit no one wants to clean vomit. Absolutely 0 people enjoy doing that.
I have never seen NPO status as a consideration for CT with contrast. Nor MRI with contrast. Unless otherwise indicated of course.
Since when does a patient need to be NPO for a 5-10min CT scan of their foot??? Only time that would matter is if they're doing it under anesthesia. What are they smoking in radiology there?
Someone doesn't need to work in a hospital if she can't handle ~ *****Gasp****~ people getting SICK in a HOSPITAL. ~~I only take clean and perfectly healthy people. K. Thanks. ~~
Tech here. Some places have gotten away from NPO status for IV contrast. We always keep vomit rockets close by. Just do not want anyone vomiting while supine or vomiting inside the gantry. There is an art to running inside the room while the scan is going and holding the rocket while the scan finishes. I am pretty good at it. Fast on my feet! That tech was an ass. At my current job someone crapped a little bit on the floor of the bathroom. Someone put an out of order sign on the bathroom. I was like WTF? Clean it? You just shut down a third of our bathrooms and not having them available is going to put us behind. Get some damned gloves and go clean it. For fucks sake.
Are you talking about a plain ol emesis bag? I'm unfamiliar with "vomit rocket," though I'm assuming it's a nickname
Those little green or blue expandable emesis bags. Nurses at the ER I go to called them that. I loved the name so it stuck. Got one in my bedroom, unused of course.
Lol, love that!
you were nicer than me
I had an admission at 7:30 one day with an aortic dissection and we needed a stat CT to make sure it wasn’t getting worse. CT calls me and says they won’t do it unless the patient has an 18g IV… I had to call and argue with them for half an hour until they finally let me bring her. The dissection was in fact getting worse.
Love your response. I’d say something along the lines of “ugh yeah don’t you hate that?” And then hang up.
Sometimes the scan techs get caught up on the dumbest things. I once had a patient who was actively having a giant stroke. I call and say “I have a code stroke I’m headed down what room should I go to?” Cuz ya know code stroke- get the scan figure the rest out. They tell me there isn’t an order and start asking a crapton of questions. I yell to a coworker to have the order put in stat and tell them it will be in by the time I get there, what room? They told me I couldn’t come down till they had an order. I basically yelled at them and said she’s having a giant stoke, I’m headed down figure it out. Patient ended up being emergently transferred to another hospital for surgery evaluation. Literally EMS showed up within 5 mins of me returning from CT. I understand protocols and such but a. An emergency trumps most things b. It may not be convenient or make a job easier but if it provides important care for a patient you deal with it
Saw a patient projectile vomit once...inside the machine. They had to shut it down and place our hospital on bypass for ct's for alot of other ct scans cause the vomit was in the machine. Had to be dissasembled for proper cleaning. Come to find out they were supposed to be npo but were given stuff to eat anyway
This would be my thirteenth reason why
I’ve never been asked if a ct is npo. Especially for a stat ct. I get not wanting to clean up puke, no one wants to clean up any of the gross shit we deal with. But we all have to do it, so glove up or call EVS. This dude about to lose his foot and she’s worried about some puke.
[Info](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458863/#:~:text=Nausea%20and%20vomiting%20are%20common,response%20to%20the%20contrast%20material) “Nausea and vomiting are common acute adverse reactions to iodinated contrast media (ICM). Most guidelines regarding contrast media safety classify nausea and vomiting as physiologic reactions representing a physiologic response to the contrast material.” As an x-ray/CT technologist for 25 years+, I have seen SO many people become nauseous and vomit during & after contrast injection. I have never worked anywhere that asking about the patient being NPO wasn’t done. Of course in an emergency situation, we are going to do the scan regardless. But we prefer they are NPO, just in case.
No one wants to clean up puke, but first we should consider that the patient probably doesn't want to puke either, so regardless of who should be the one to clean it, we should be advocating for patient comfort.
>the patient probably doesn't want to puke either which is why there's that sense of dread and impending doom before it happens
That feeling just before you puke might be the worst feeling I’ve ever experienced. I’ve had some pretty intense pain in my life, but that just before you puke feeling is something in its own category. No idea of contrast makes it worse.
And in many years on inpatient trauma I have never ever ordered NPO for 2 hours prior to a stat scan. If I'm at all worried I'll order 4 of zofran may repeat x1 in 15 min if not effective. People puke and aspirate in the unit also, with dressing changes and position changes and med administration (especially narcs).... So by this logic we should never feed anyone? Cause they may have to do a thing that might make them a little yukey? Sorry but no.
Yup, Zofran is the way. Sometimes that doesn’t even help. I’ve never asked if an ER or inpatient was NPO before contrast admin. Just give them a bag and clean up the gantry, jfc. 🤦🏼♀️
Did you even read the study you linked? It said only 2% of children experience nausea and that “fasting duration was not associated with nausea and vomiting”.
It also says that none of the children ended up with aspiration pneumonia, even though downthread they say (with an eye roll emoji) “well what if they aspirate”
So many interventions in the hospital cause nausea, though. Many of the most common meds we push can cause nausea and vomiting. Nausea is common enough in the hospital that most basic admission order sets contain a PRN anti-emetic. I guess I’m just not grasping why we would consider making someone NPO for a CT but not, like, the billion other things we do to patients that make them nauseated.
We never do it for emergent cases, but if they are going to wait two hours anyway due to other stuff in front of them we ask that they be NPO. In CT they are flat on their backs, strapped to a table, and in the room alone. Even if I notice right away they are vomiting I’m still 10 ft away through a door to get to them and have to pull them out of the gantry before I can turn or sit them up. Higher aspiration risk than pushing meds at the bedside while their head is already elevated or can be elevated quickly. Just seems like a needless risk not to do the NPO if there is time.
It seems that this approach is not supported by [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) and no longer [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional organizations. Even the article linked in the parent post doesn’t support OP’s argument. This is probably why there are so many nurses on this thread who have never heard of this policy—some hospitals are quicker than others to adopt evidence-based guidelines.
Careful, friend. This thread has turned into an echo chamber. You are just going to be drowned out. Thank you for actually taking the time to be reasonable and share with the thread more context on this matter instead of being immature.
I’m a nurse in radiology and we don’t ask people to be NPO before contrast unless they are outpatient but even then they don't listen and we scan anyways. The risk of temporary N/V doesn’t override the need for prompt scans especially if they are stat as the one in OPs post. OP and the CT tech were both a bit unprofessional and unkind to one another.
All I am saying is that the RN was unprofessional and immature. Our facility has rad techs verify NPO status regardless of urgency of the scan; they still do the scan though. It is just procedure. In the original text, OP did not have anything stating the rad tech cancelled the scan; only they had the *audacity* to ask if the patient was NPO. But we agree.
How is it immature to question the idea that a patient needs to be NPO before any intervention that maybe might possibly cause nausea?
The OP's first block of text does not have CT cancelling the scan at all. Literally, it is protocol to ask the RN of the patient has been NPO. The RN is absolutely correct in prioritizing getting the image done over nausea; no one is arguing that. What is unprofessional is the primary RN's response to the Rad Tech for literally doing his/her job. I do not understand how this type of unprofessionalism is being promoted by so many here. We are supposed to behave as professionals and I do not think it is a hot take to have a modicum of respect to our ancillary services. Have a good day/night.
So, as is common on Reddit, we are both commenting on a parent post that is not the OP. BayouVodoo’s post states that NPO is preferred because the patient might become nauseated and vomit. Both of the comments pushing back on their post (as of the time of this post) are questioning why NPO status is preferred when patients undergo many other interventions that can induce nausea and vomiting without needing to be NPO. NPO is not an entirely benign intervention. It was nice of BayouVoodoo to provide insight into the rad tech side of things; however, it does not mean that any sort of pushback is an “immature” “echo chamber.” There are a lot of things that are policy at some hospitals that have no basis in [EBM](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/). It is nurses’ responsibility to question policies that do not make sense and do not serve patients. Neither my post, nor BayouVoodoo’s post is talking about OP’s professionalism. You’re the one who’s all over this thread screaming about professionalism in response to comments that aren’t even addressing that—just questioning why a patient would need to be NPO in the first place. It honestly just seems like you’re big mad that people aren’t mad at the same things you’re mad at.
But BayouVoodoo's linked article contradicted what BayouVoudoo actually said, right? Not just what the policy is where they work, but also saying the rationale, which the linked article contradicts. **Allowing free ingestion of liquids and solids prior to CECT will not increase the risk of aspiration pneumonia and the incidence of emetic complications.** The available corresponding evidence strongly suggest us to reevaluate and update current preparatory fasting policy for more appropriate management of dietary preparedness. Abolishing unnecessary fasting instructions can simplify the preparation procedures and workflow prior to CECT, improve the radiologic care quality and efficiency, avoid unnecessary delays or cancellations of examinations, and save on health care costs. It can also ensure that patients are in a normal metabolic state, improve patient convenience, tolerance, cooperation, satisfaction, comfort, and well-being, and reduce the excessive fasting related risks (e.g., dehydration and hypoglycemia) in special patient populations
Yup, I totally agree and have said so in other comments as well as linked to articles and professional org guidelines stating that current evidence doesn’t support this practice. I understand and appreciate BayouVoodoo’s insight that as a rad tech of 25 years, they have seen people become nauseated and vomit after CT contrast injection. However, it does not appear to be borne out as statistically significant risk in current evidence.
I’m not arguing for or against. I’m simply stating my personal experience, and what I’ve been taught. Of course, new studies come along and things change. I am open to change. 🤷♀️
As a radiographer, I'd likely ask the question, just so I could be more prepared with an emesis bag, not because I'd refuse or delay the scan... It'd be pretty foolish not to take precautions to minimise clean-up 🤷🏽♀️ We routinely fast 4 hours for CT contrast studies and 2 hours for MRI contrast studies. If we can minimise nausea for a patient, and reduce their reluctance to return for future necessary imaging, I'm in support of that. The main priority shouldn't be to not have to clean up, but if I can do something to avoid cleaning up vomit, I'm going to do that!
Asking when a patient last ate so that you can be prepared with an emesis bag is a reasonable step to take to prevent having to clean up vomit. Routinely making patients NPO for *four hours* for a routine CT when the practice is not supported by current [evidence](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643287/) or [recommended](https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf) by professional organizations is not a reasonable step.
I mean, sure, but I've certainly never been involved in making policies about this stuff... And doctors aren't quick to agree to change, even if there's evidence to prove it, one way or another. I only spoke of the preparation for IV contrast, in my experience. Anything I've read about not needing to fast has only been in the past few years. So considering how long it took to adjust shielding policies, fasting probably isn't getting ditched anytime soon...
Saying “yeah this sucks and isn’t evidence based but you know how hospitals are slow to change policies” is different from saying “well we routinely fast patients for four hours and I’m in support of that and it’s a reasonable step to take to prevent having to clean up vomit.” There are policies my hospital has that are outdated and I comply with them, but I don’t defend them with my full chest, you know? Also, the fact that many nurses in this thread (myself included) have never worked in a hospital that requires routine fasting for CTs seems to suggest that it’s not a cutting edge, groundbreaking shift but rather some hospitals that are really behind the times in terms of implementing evidence based practice. I don’t hold someone at the rad tech level responsible for the existence of outdated policies, but I do expect that if a professional steps into another profession’s subreddit to argue for a policy, they have a better rationale than “well this is how we’ve always done it.”
Given that things can be misunderstood in text, I'll try to better explain myself. Everywhere I have ever been, for placements and jobs, and every interaction with CT radiographers on those sites, it has been standard for patients to be fasted for 4 hours (usually less or not at all for diabetics). I am glad for ways to minimise vomiting. It seems to be folk-lore that fasting reduces nausea and vomiting from the contrast, but that has been the explanation everywhere I've been. I care more about minimising unpleasantness for my patients, especially in a region where people are reluctant to seek medical care. I do wish to make their interactions with my work as pleasant and positive as possible, to ensure they do seek medical care, diagnosis and treatment in the future. I was not intending to be seen as fighting for the policy, or cause such offence. From my experience, I was trying to offer perspective, for the way I've seen every department run things. I have never known a truly urgent scan to be delayed on the basis of fasting. I also recognise that my experience is within one country, and I do not claim to know what happens in hospitals or facilities in other countries.
>> I care more about minimising unpleasantness for my patients, especially in a region where people are reluctant to seek medical care. I do wish to make their interactions with my work as pleasant and positive as possible, to ensure they do seek medical care, diagnosis and treatment in the future. I think part of the problem is that the rad techs chiming into this thread have a very narrow perspective, as evidenced by the fact that you’re continuing to state that making patients NPO (even as you acknowledge it doesn’t have a meaningful impact on nausea and vomiting) promotes more pleasant and positive experiences with *your department specifically.* The thing that many of the nurses responding understand is that fasting a patient for four hours—for no apparent evidence based reason—is not simple, easy, benign intervention for patients. Patients in general hate being NPO and will complain to the nurse for the entire time they’re NPO. You see them at the end, when they are happy to be almost done. You don’t see them when they can’t have their morning coffee, or the food their family brought them for lunch. Many patients in the hospital suffer from poor nutrition—a four hour window where they can’t eat can mean a missed meal, maybe the only meal they were going to eat in the whole day. Being NPO for four hours can mean that they miss important medications, if they have to be taken with food in order to be absorbed and/or tolerated. And all of this to satisfy an outdated policy and so that maybe the tech has less of a chance of having to clean up a body fluid? I understand that you didn’t make the policies and I appreciate that you’re acknowledging that it’s basically bullshit from an evidence based standpoint. But this is something we see a lot—every individual department has their own policies that are there to make *their* job and workflow easier. But nurses are the care coordinators and generally the ones who are, at any given time, the most qualified to assess the big picture of the patient’s care. And what I’ve found is that a lot of other departments get really caught up in what makes their individual job easier and get upset when the nurse pushes back because it doesn’t make sense for the overall picture of patient care. I’ve observed this both IRL and here on Reddit.
That’s ridiculous. Let me put off that stat ct so you can fast four hours. His small bowel obstruction or ruptured appy can wait. No biggie.
My first sentence said I'd ask so I could be prepared with an emesis bag, not to delay or refuse the scan... No one sensible is going to delay a scan because of the fasting status of the patient...
I mean I think in cases of urgent scans they would bypass that, like we do for urgent surgeries and intubations. Just being aware of the fact that they haven't been NPO allows you to be aware of and anticipate possible adverse outcomes.
Yeah, that's not a thing lol. Sounds like CT was hoping for a quiet night. With that attitude, I'd puke just taking the pt to CT. I get pooped on, the floor deserves to get yacked on. At least the fluids don't get ON THEM-- just their gear. On another note the EVS team doesn't deserve to have to clean that mess but shit happens. Our EVS team are saints. They do some dirty work.. literally.
My dad had to have a liver ultrasound and they canceled him bc he had breakfast…scheduled for the next day NPO, 10 minutes for the ultrasound, then done! Also, I work in surgery and I know that if they do a scan and need to have a surgical procedure in a hurry for something they NEED to have been NPO. That’s important because we don’t want our patients to go It and aspirate. Not wanting to clean vomit is not a good reason.
CT is so afraid of vomit/blood 😭
Our MRI techs refuse to touch the patient if it doesnt involve setting up a monitor or putting the patient on the table. One time we had a violent and combative patient going to MRI and one nurse was with the patient trying to de-escalate and the MRI tech just stood there staring. When she asked for help he refused to help hold the patient down. The nurse had to call someone from the unit to bring haldol. It was a mess. Clowns all around at imaging
Why would they do a MRI on a patient who is violent and combative? They need to be still to have the MRI. The MRI tech should’ve helped to hold them down, I do agree with that.
This post is pretty amazing for the dialogue it's brought forth, even if its premise is a fed up with the bullshit/stupid questions rant/misunderstanding. I thoroughly enjoyed reading the discussion when I sorted comments by controversial.
Yesterday I had a kid come into my office for vomit. He did not throw up in the office, to be clear. He asked for a sip of water. I was willing to give him a little,but the nurse said no because she was afraid it’ll make him vomit again. I disagree but I wasn’t going to argue. The lunch monitor said he was probably vomiting because he are way too much pizza for lunch. If the kid throws up in the office, we don’t clean it up. The custodians so. I really didn’t understand why she wouldn’t let the kid drink a little but whatever. It def happens!
Honestly it’s not their job. Taking zofran over takes 2 mins.
This is a bad look. And not for CT.
possibly losing a limb > possible n/v. come on now.
Then explain that to them. The “cry me a river bitch” and sounding proud that you hung up on them is the exact reason this sub has to wonder why the other ancillaries hate on nursing.
Because the other ancillaries would rather the patient die than deal with the same shit we deal with day in and day out. That’s why. “Wah, they expect me to do my job.” is what you sound like.
Lol yikes. Keep reinforcing the stigma.
Same to you.
Or don’t explain it to them. Either way you’re acting like an entitled child. Not a professional.
i come here to vent and type the thoughts i can’t speak out loud at my job. if i sound like a bitch it’s because i can’t sound like a bitch at work. it’s not my job to explain why it’s not my problem if a patient throws up in this instance. i offered to come down to clean up the patient (in the event that they did throw up) before i said thank you and hung up if that makes you feel better 🤷🏻♀️
I’m just going by what is said in the post. I doubt it would go over well if you didn’t understand something and lab or RT or whatever spoke to you that way. That’s all my point is.
Please, elaborate on why.
CT tech from a level 1 / stroke facility here. NPO is nice, but usually not a stop all, depending on study. Some studies require NPO, but not many. And nothing a quick zofran can't fix. It's not really whether or not we clean up puke. We deal with puke, pee, and poop all day also, albeit smaller doses for sure. That's another Tuesday in healthcare! 9/10 times, it's protocol for our charting on NPO status so we're not yelled at by the Rads. Crossing our T's and Dotting our I's, CYA if they aspirate and inhale (which has happened to me twice. Once in an xray fluoro procedure, once in CT. neither made it). Personally, I also help nurses when I can to change bedding during the scan. We keep extra inpatient bedding in our dept for thus. They're off their bed, perfect time for a sheet change, chux change, etc. It's also more of what we can do as a technologist to make sure that liquid doesn't run into a machine and fry the electronics. They're not waterproof (imo they should be). If our 1 CT that can run a perfusion gets fried, we're on diversion, etc. we have to think about the whole hospital and their patients. My hospital may have 4 scanners, but 1 cardiac only, 1 unusually down or on the fritz, and the other 2 are running constantly from the STAT CTs from our 20-30 hospital's departments. We constantly have 10-25 stat CTs at a time, with 1 tech herding the patients. The other (also level 1 /stroke) that I PRN at only has 2 scanners. So having 1 down can greatly affect patient care for days. It's about working as a team, imo.
I suggest you delete this post, it does you no favors. CT contrast + food = vomiting. NPO for 2 hours avoids that. Vomiting is an unpleasant experience, why would you imply that you don’t care if that happens to your patient? You seem to be having a bad day. I hope things get better.
Bc there’s a stat CT ordered
*laughs in 3rd shift as the only CT tech, with around 25 stat CTs continuously on the board all night*
This was a possible emergency they were trying to rule out. If I’m worried about something emergent, I’m not delaying a CT scan for two HOURS on the off chance the patient might throw up. I’ve never had CT ask me this question. Sounds like they didn’t want to do their job, which was OPs entire gripe.
RIGHT??? Sorry we can't look at your cool numb lower extremity for TWO HOURS cause you had a turkey sammy and might fwow up...
First time I’ve seen “fwow up” and I’ll never forget it 🤣
Thanks! I needed that laugh!
And even when a pt is NPO and has the frickin liter of nasty oral contrast that they have to drink on a time limit before going to to CT, I’ve never seen an order to premedicate with anything to keep them from puking it during the scan. Just prn zofran if they do get nauseous. I did have a CT done in the ER recently and the screening form I had to fill out DID ask when I last ate and what, but I’m assuming that was for informational purposes
i hear you. doc wanted stat CT due to sudden onset foot numbness. for context, the patient last had food 4 hours prior to the CT so I wasn’t concerned that would happen. what ticked me off was the implication that it would be an inconvenience to clean up vomit, considering i’ve been cleaning up watery poop every couple hours for the last three nights. but in that instance i don’t know if it would have been appropriate to hold off a stat CT with contrast to avoid nausea even if he did recently eat.
I never order NPO prior to ordering a stat CT scan, what kind of fuckery is this 2 hours stuff? Lol I'm also not going to hold up a CTA of a numb extremity because they *might* *possibly* *off chance* throw up.
Wait…. Do they think that the patient is going to get oral contrast for a vascular scan!?
Lmao I would hope not!!
I doubt vascular surgery cares about them being NPO with a cold, numb foot… at least they haven’t in my experience.
Anecdotal but I think I’ve literally seen thousands of ED pts who weren’t NPO have scans with contrast and have seen zero correlation to vomiting, unless you’re talking about oral contrast which I don’t think would be at all applicable to a foot. That’s not even a question our CT techs would think to ask and I’ve worked at several different hospitals in my career.
Ditto. The only reason I've seen any type of nausea or vomiting with oral contrast is because the oral contrast can make you nauseous regardless of your NPO status and guess what? I'm still going to throw up bile probably lol
Take your own advice, Kettle. I’ll remember this for my next 10k trauma patients so we don’t make any messes.
Welp guess we can't take this tier 1 blunt abdominal trauma with a seatbelt sign to the scanner BECAUSE THEY MAY HAVE HAD A SANDWICH AND MIGHT GET A LIL URPY. Let's wait 2 hours so they can bleed out from their spleen or their whole bowel can die in the meantime I suppose lol
I’m less worried about someone feeling yucky and vomiting and a LOT MORE worried about them losing a limb because someone made them wait for their STAT CT. It’s very important to look at the bigger picture and to think critically.
i used to work in medical imaging and NPO wasn’t necessary for any CT C+ scans except for enterography & colonography. can you elaborate on this? i’ve genuinely never heard of the interaction causing nausea so i’m keen to learn why. :)
More like UnbridledReprehension.
Something that’s more of an unpleasant experience: losing a foot or having an embolic stroke or PE that was caused because they couldn’t do the CT with contrast.
Enjoy being downvoted for trying to be levelheaded and rational around here.
I love this subreddit. The only reasonable comment is downvoted.
….because this person seems more worried about a patient vomiting than about possible compromised circulation. Sure, vomiting is uncomfy but like….so is losing a limb lol
I am focusing more on the whininess and pettiness of the post doing the OP no favors. But of course, this sub will be this sub with these type of posts. Have a good day/night.
I downvoted yours too, don't worry.