Problem Patients

 

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There are occasions when the patient's condition can create difficulties in obtaining lung images. We have given some thoughts below on how to tackle the following issues -

  1. A fully-ventilated patient from the ITU

  2. A fully conscious patient but with a tracheostomy

Fully Ventilated Patient from the ITU

  1. Only limited views are possible since the patient will often have iv lines, catheters, pumps etc and will be semi-conscious

  2. A reservoir system is not possible. The Kr81m gas line may connect 'in-circuit' via a 22mm 'T' piece to the inlet side of the patient's respirator; however advice should be sought from the accompanying Doctor or Nursing sister.

  3. Only limited views will be possible. Anterior perfusion and ventilation views should be feasible however posterior views will generally not be possible. Additional views could include anterior oblique and lateral views

Fully mobile patient with a tracheostomy
  1. All standard views should be possible

  2. No reservoir system can be used. The Kr81m gas line should be held directly at the opening of the tracheostomy site.

  3. It is possible to obtain a tracheostomy mask. In practice there is little to be gained in image quality. However such a mask may reduce Kr81m leakage into the room.

  4. A fan should be used beside the patient to blow free Kr81m gas away from the camera (take care that the force and direction of the fan does not impede the flow of Kr81m gas at the tracheostomy)

 

 

 

 

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Last modified: November 29, 2002