I'VE BEEN DOING CT FOR SIX AND A HALF YEARS ON SECOND AND THIRD SHIFTS AT A 125 BED HOSPITAL. SOMETIMES WE DON'T GET A LOT OF VARIETY, SO LAST WEEK I HAD AN INTERESTING EXAM FOR ME.

AN INPATIENT NEEDED AN ABDOMEN/PELVIS CT WITH ORAL AND IV CONTRAST. THE PATIENT ALSO NEEDED TO HAVE GASTROGRAFIN GIVEN THROUGH THEIR COLOSTOMY. THE PATIENT ARRIVED IN THE DEPARTMENT AROUND 9:00PM. I THOUGHT A CONE SHAPED COLOSTOMY TIP WOULD BE THE EASIEST THING TO USE FOR BOTH ME AND THE PATIENT. OF COURSE I WASN'T ABLE TO FIND ONE ANYWHERE IN THE DEPARTMENT. AT OUR HOSPITAL THE RADIOLOGIST AND RADIOLOGY NURSE BOTH LEAVE AT 5:00PM, SO THERE WAS NO ONE TO ASK WHAT THE BEST THING TO DO WAS. I ENDED UP ATTACHING A 14 FR URINARY CATHETER TO AN ENEMA BAG AND ADMINISTERING THE GASTROGRAFIN THAT WAY. IT SEEMED TO WORK FINE, ALTHOUGH I WASN'T SURE HOW FAR TO ADVANCE THE CATHETER INTO THE COLOSTOMY.

IN THE END IT WAS A GOOD STUDY. BE CREATIVE AND ADJUSTING TO THE NEEDS OF EACH PATIENT INDIVIDUALLY IS ONE OF THE THINGS I LOVE ABOUT THE RADIOLOGY FIELD.