Bendigo Radiology Case Study: Barium Enemas

Using an orogastric tube is generally a safe, cheap, and simple procedure as long as it is done correctly. You would need a stomach tube in order to administer medication or food to an inappetent patient. It can also be used when a pet needs decompression or removal of gastric contents. Another use would be to administer radiographic contrast media for stomach of intestinal contrast radiography also known as a barium series.

Radiologic technology is a satisfying and rewarding career. It is a technical and refined science. As a radiological technologist, there are many essential duties and responsibilities that have to be fulfilled in order to be a good one. First of all, radiological technologists have to maintain a well-mannered and professional behavior when gathering information. They have to assure their patients that they are in good hands therefore; they give patients the uppermost quality of care and services. Second of all, the main responsibility of a healthcare provider is to keep all knowledge of a patient’s health record confidential or secluded. That means radiological technologists cannot talk about patients at home or with friends and classmates

only resulted in a 3-day hosp. stay. The lining of the sigmoid colon is made up of

Advances in both radiography and radiation treatment keep on advancing and get to be more sophisticated. Cases incorporate digital subtraction angiography (DSA) in which, apparently, there is the potential for more prominent inclusion by radiographers and by radiation therapists in image guided radiation treatment. Looking even to the moderately later past underscores the degree to which change is happening in the radiography and radiation treatment work environment. Case in point, ten years prior it was radiologists who embedded cannulas for CT patients (AIR 2014, 1). Presently radiographers and attendants attempt the assignment. In private radiology hones, Australian radiographers now consistently embed central lines and do feature joint, shoulder, arm, and tendon infusions under supervision.

There seem to be an increasing application of Roen-en-Y gastric bypass today by some surgeons. This is a restrictive procedure that has minimal mal-absorption issues and it makes part of an array of bariatric surgeries. However, the most commonly used procedure is biliopancreatic diversion or Scopinaro, which have been used for more than two decades and are popular in with many surgeons more so in the developing countries. This process is intended to inhibit absorption of fat in a bid to trigger massive weight loss in patients who are morbidly obese. It restricts gastric thereby diverting bile and pancreatic fluids to the distal ileum (Consensus Development Conference Panel, 1991). This procedure therefore exposes a limited area of small bowel for the absorption of nutrients that need biliary and pancreatic fluids. The procedure and its variations are still common as indicated above including; biliopancreatic diversion with duodenal switch, which also result in malabsorption. It is however noted that most patients who undergo this procedure also experience severe protein and fat related malabsorption problems.

During the capstone simulation experience, I believe I performed well in quickly reporting the perforated bowel to the provider. This is an urgent issue that needs to be addressed quickly to prevent many serious complications such as: peritonitis, sepsis, hypovolemia, and low H&H due to excessive bleeding. The routine procedure of a colonoscopy is not without risks and this simulation experience was a great example of how an adverse event can go undetected until after discharge or when the physical symptoms appear and start ailing the patient.

The code of conduct for medical radiations practitioners outlined by the Medical Radiations Practice Board of Australia (2014) states to assist and support practitioners to deliver suitable effective services with an ethical framework to highlight elements of good practice and professional behavior amongst patient-colleague relationships. Within Section 1.2 of the code “Professional values and qualities”, states that “Practitioners must have their own beliefs and values, there are certain professional values on which practitioners are expected to prioritize their patients and safely conduct practice regardless of setting to provide best “duty of care for patients …and to practice safely and effectively “(Medical Radiation Practice Board of

One of another main reason for all the irregularities during the procedure occur mainly due to the confusion of communication between the radiographer and the surgeon because of a formal language is not being used in order to operate the fluoroscopy (Suhm et al., 2003 ).This creates a confusion and loss of crucial time which eventually leads to numerous position adjustments, while doing so the radiographer had to expose the patient several times before the desired position can be obtained which can prove to be serious threat depending upon the nature of patient as exposure to radiation differs depending upon the nature and status of a patient.

Finding ways to enhance the practice or patient care should remain a priority. The simple task of revising the colonoscopy instruction sheets will not only benefit the patient, it also benefits the staff and organization. The procedure room is set up before each patient arrives and when the procedure is aborted or rescheduled due to an inadequate prep, supplies are wasted. This also leaves the staff sitting around waiting for the next scheduled patient. The blame for the backlog has been placed on the VA medical center, however, those who are non-compliant or continuously cancels are not held accountable. There should be no excuse involving the instruction sheets once revised. The patient should leave the hospital feeling educated and ready to be compliant with the regimen. The VA medical center is making every effort to help the veterans receive the necessary care and revising the instruction sheets is a problem in the GI lab that needed addressing.

All n=24,522 patients received either GoLYTELY (Braintree Laboratories Inc, Braintree, Mass), HalfLytely & Bisacodyl Tablet Bowel Prep kit (Braintree Laboratories Inc, Braintree, Mass), Citrate of Magnesia (Aaron Industries Inc, Clinton, SC), or Fleet Phospho-soda (C. B. Fleet Co Inc, Lynchburg, Va) as oral bowel preparation solutions prior to their procedure.

There are contraindications to the use of whole bowel irrigation in cases of unprotected airway, patients at risk of gastrointestinal hemorrhage or perforation and absent bowel sounds. Side effects of whole bowel irrigation include vomiting, bloating and rectal irritation. In 1997, a position paper was published on whole bowel irrigation by the American Academy of Clinical Toxicology and the European Association of Poison Centres and Clinical Toxicologists which was followed by an update in 2004. The 2004 update indicated that there is no new evidence that would require any new conclusions from the 1997 position paper which stated that whole bowel irrigation is not recommended due to the lack of data from controlled clinical studies that shows the benefits of its use. In 2015, American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists published another article reviewing published literature from 2003 through 2013 and found no new evidence to change the conclusions from the 2014 position

After reviewing the website I noticed that this website takes you to a colon cleanse kit you can use at home. These colon cleanse kits are harmful to the body in more ways than one. I would highly advise you to not use the product. These types of enema kits tend to use more water than your normal enemas that are provided by a physician prior to a procedure. Theses colon cleanse kits can cause potential side effects such as vomiting, dizziness due to dehydration, bowel perforation, infection, and or kidney failure. These irrigations can also deplete the colon of the natural flora that is produced in

All patients with suspicion of large bowel obstruction should be admitted and evaluated by Surgery (with the possible exception of some end-of-life patents)

When assisting the patient, the radiographers have to make sure they provide radiation safety not only for the patient but also for themselves. There are many different methods to providing safety. With the equipment and radiation dosage, highest KVp and the lowest mAs is used to provide the minimum amount of dosage required for the procedure. Furthermore, safety can be provided by reducing the amount of rime in radiation area, by putting as much distance between you and the radiation source as possible. When performing a portable examination stand at least six feet from x-ray source and wear a lead apron. The patient should remove any jewelry or metal accessories that may interfere with radiation procedure and both the technologist and the patient needs to wear protective lead shields for example lead gloves, aprons, skirts and thyroid shields to protect the other body parts from the radiation. It is advised to also always wear monitoring device at collar level. Lastly, the technologist uses immobilization devices to hold the patients when needed.

The barium is then released from the bag and begins to flow slowly into your colon. As the barium begins to fill your bowel you will feel some pain and pressure, and an urgency to have a bowel movement. The doctor will watch the barium as it moves through your intestine on a TV screen, using a special “live x-ray” called fluoroscopy. You will be asked to turn to different positions, and the table may be tilted slightly to help the barium flow through your colon and to take x-rays from different directions. Sometimes a slightly different version of the test may be done. It is called a double contrast barium enema. If a double contrast study is being done, the barium will be drained out, and then air will be injected into your colon. As you can imagine with the air contrast study, the amount of cramping and pain increases, due to the expansion of the bowel with air. After all of the films are taken the enema tube is removed, and you are taken to the restroom to expel the remaining barium and air. One or two films may be taken afterwards, to check how much barium is remaining in your bowel. The entire test takes anywhere from thirty minutes to one hour. After the exam you may resume a regular diet, and be sure to drink plenty of liquids to replace those you have lost and to help flush the remaining barium out of your system.