#6 Clinical Experience

Well, clinicals have been great this semester. It has been a great feeling scanning in Ct again. I hope everyone has enjoyed this semester and experienced many great opportunities. Our hospital had many changes switching to a electronic medical records system, but for the most part the glitches have been resolved. I'm sure with winter well on its way we will have a lot of scans due to falls. Hope everyone has learned and enjoyed this semester, and has a wonderful time over the holidays.

Clinical Experience Week #5

Hello!! Hope everyones clinicals are going well. It has been hectic the last few weeks at the hospital. We launched our new electronic medical record system. Pretty interesting. We all had to go thru several training classes, but to say the least the first day was not very fun. Day by Day there were a lot of corrections made, so now it is a lot easier to use.

Interesting case:

Thirty nine year old male presented to the ER with right flank pain, nausea, and vomiting. This patient had no prior medical history.

The ER doctor ordered Ct abd/Plv with and without contrast.

We used 100 ml Omnipaque 350 and did sagittal and coronal two-dimensional images.

Impression on report:

An 11 centimeter mass involving the upper pole of the right kidney, highly suggestive of renal cell carcinoma.

Mild hydronephrosis without obvious cause. A small amount of heterogenous density with the distal right ureter could conceivably represent hemorrhage.

Tiny indeterminate right middle lobe nodule

A few borderline enlarged retroperitoneal lymph nodes.

Clinical Experience # 3

The last several months have been very hectic. Our hospital is switching to a new Epic system this coming weekend. I will be working when they bring the system up and our PACS will be up and down for a period of sixteen hours. It should be interesting. With this system the doctors have to put in there own orders, so I am curious of how this will turn out.

I have provided a image from a Ct abd/plv that was done on a 14 yr old that had a appendicitis. He was in the ER complaining on right lower quadrant pain. This was a Ct of abdomen and pelvis obtained while injecting 75 cc of Omnipaque 350 intravenously.

Impression was as follows:

Acute appendicitis with minimal pelvic ascites and also fluid around the inflamed appendix.

Hope everyone is having a GREAT semester.

Clinical Experience Update #2

My clinical rotation this semester is going great. There are a lot of different exams that I am able to see. It is nice being back in CT since I haven’t worked in CT for over a year. I am glad a lot of what I knew is coming back to me. I never want to lose the experience. One interesting case was a 76 year old male that came thru the ER. He was unresponsive and had bottomed out vital signs. We did the routine CT head without contrast and this is what the scanned showed.
A large intraparenchymal hemorrhage involves the right frontotemporal lobe with extension into the ventricular system. The hemorrhage measures approximately 8.5 cm in maximum dimension. There is significant surrounding edema and mass effect. There is approximately 12 mm of right to left midline shift. There is complete effacement of the right lateral ventricle. Hemorrhage was seen extending into the lateral third and fourth ventricles.

CLINICAL EXPERIENCES #1

There have been many interesting cases in CT over the last few weeks. The CT head image to the left was more interesting of what actually happened to this patient. The patient was 65 years old and when entering the CT room her face was severely bruised and major swelling. When getting history from this patient she told me that she had fell and was stuck laying in her bathroom for sixteen hours before she was found. Her daughters lived out of town and when they weren't able to contact her by phone they sent someone to check on her. I could not imagine having to lay on the floor wondering how long before there would be any help.

The report suggest that there is prominent extracranial hematoma over the right orbit and right frontal region. The intracranial structures are unremarkable with no evidence of fracture or other abnormality.

INTRODUCTION

MY NAME IS KIMBERLY DUNCAN. I CURRENTLY WORK AT GATEWAY HOSPITAL. I AM EXCITED ABOUT FINISHING MY BACHELOR DEGREE IN CT/MRI. I AM MARRIED WITH TWO SONS. I AM LOOKING FORWARD TO TAKING THE CT/MRI CLASSES.