CT Ordering Protocols
CT  PROTOCOLS
EXAM CONTRAST DX PREP
HEAD WITHOUT MOST CASES None
HEAD  WITH/WITHOUT  MASS ONLY NPO 3 hrs
CTA HEAD WITH MOST CASES NPO 3 hrs
CTA NECK WITH MOST CASES NPO 3 hrs
NECK WITH MASS  ONLY NPO 3 hrs
NECK WITHOUT SALIVARY STONES ONLY None
CHEST WITH MOST CASES NPO 3 hrs
CHEST WITHOUT HIGH RESOLUTION None
ABDOMEN WITH/WITHOUT ORAL AND IV NPO 8 hrs
PELVIS WITH/WITHOUT ORAL AND IV NPO 8 hrs
EXTREMITIES WITH MASS ONLY NPO 3 hrs
EXTREMITIES WITHOUT MOST CASES None
SPINES C,T,L WITHOUT MOST CASES None
SPECIAL CONSIDERATIONS
KIDNEY STONES ABD/PELVIS WITHOUT None
DIVERTICULITIS ABD/PELVIS WITH & WITHOUT ORAL & IV - NPO 8 hrs if possible
HEMATURIA  ABD/PELVIS WITH & WITHOUT IV ONLY NO ORAL - NPO 8 hrs
APPENDICITIS ABD/PELVIS WITH & WITHOUT ORAL & IV - NPO 8 hrs if possible
AAA CTA ABD/PELVIS WITH IV ONLY NO ORAL - NPO 8 hrs
PE CT CHEST WITH NPO 3 hrs if possible
AORTIC DISSECTION CTA ABD/CTA CHEST WITH NPO 8 hrs
LUNG NODULE CT CHEST WITH None - NEED PREV CXR REPORT
CROHN'S DISEASE CT ABD/PELVIS WITH NPO 8 hrs.  Arrive 1 hour early - 3 Volumen bottles - every 15 minutes

Patients can take all meds prior to exam and may have water

Notes:

1. Most of the time, you will be ordering exams of the abdomen and pelvis together – rarely is it appropriate to order one or the other.

2. With IV contrast is almost always better than without. However, if the patient has acute renal failure (non-dialysis dependent) or has had an anaphylactic response to contrast, no IV contrast will be given. 

3. Patients with a non-anaphylaxis contrast allergy should receive the following premedication protocol: Prednisone 50 mg by mouth 13, 7, & 1 hr prior to exam. We will give Benadryl 50 mg within 1 hour of injection; patient will need a driver.

4. The more clinical information you give us, the better we can do at answering your specific question. This will become even more important with the imminent arrival of ICD-10.

5. A radiologist is regularly available by phone if further clarification is needed; we would rather get a phone call than read the wrong study.  Please call (559) 734-5674 to be connected.