Lesson 1Patient consent and explanation: describing IV contrast risks and benefits and breath-hold requirementsExplains getting informed consent for IV contrast CT, clearly stating benefits, risks, and options, while teaching staff to explain breath-hold steps, manage anxiety, and confirm patient understanding before scanning.
Explaining purpose of CT for suspected appendicitisDiscussing IV contrast benefits and diagnostic valueOutlining common and rare contrast-related risksDescribing breath-hold steps and practice runsChecking patient understanding and answering questionsLesson 2Safety during contrast administration: monitoring for immediate reactions, emergency drug availability, and post-contrast observationFocuses on safe contrast injection, including monitoring during infusion, spotting early hypersensitivity or leaks, ensuring emergency drugs and gear are ready, and post-contrast observation steps.
Baseline assessment before contrast injectionMonitoring patient during injection and scanRecognizing and managing acute reactionsDetecting and handling contrast extravasationPost-contrast observation and discharge adviceLesson 3Contrast timing and phases: portal venous phase timing for appendicitis, bolus tracking basics, and enteric/oral contrast considerationsDescribes portal venous phase timing for appendicitis CT, basics of bolus tracking and test bolus, and when oral or enteric contrast helps or not, including hospital preferences and patient tolerance.
Portal venous phase timing for appendicitisBolus tracking setup and trigger thresholdsFixed delay versus bolus tracking approachesRole of oral contrast in suspected appendicitisManaging patients unable to tolerate oral contrastLesson 4Pre-scan screening for contrast contraindications: allergy history, metformin advice, and renal impairment managementCovers pre-scan checks for IV contrast safety, including allergy history, past reactions, metformin use, kidney issues, eGFR limits, and when to consult radiology or nephrology before contrast CT.
Taking detailed contrast allergy historyHandling prior mild versus severe reactionsAssessing renal function and eGFR thresholdsMetformin use and withholding recommendationsWhen to seek radiologist or nephrologist inputLesson 5Verifying CT request and identity: pregnancy screening, recent contrast reactions, and renal function checks (eGFR threshold considerations)Details checking CT request, patient identity, and pregnancy status, plus prior contrast reactions and kidney function, ensuring eGFR and risk factors are noted before IV contrast CT.
Confirming patient identity with two identifiersReviewing clinical indication and CT request formPregnancy screening and documentation stepsChecking prior contrast reactions and notesReviewing eGFR and recent renal function testsLesson 6Motion management and breath-hold technique for optimal image qualityCovers ways to cut motion artefacts, including breath-hold practice, timing with scanner, handling breathless or painful patients, and using shallow breathing or adjustments when needed.
Pre-scan coaching and practice breath-holdsStandard breath-hold commands and timingManaging patients with pain or limited cooperationStrategies for shallow breathing acquisitionsRecognizing and reducing motion artifactsLesson 7Acquisition parameters: kVp, automated mA modulation, slice thickness, and reconstruction kernels for abdominal CTReviews key settings for abdominal CT, including kVp choice, auto mA modulation, pitch, rotation time, slice thickness, and reconstruction kernels, and their effect on noise, resolution, and diagnosis.
Choosing kVp based on size and indicationSetting pitch and rotation time appropriatelyAutomated mA modulation configurationSelecting slice thickness and reconstruction intervalSoft tissue and high-resolution kernel choicesLesson 8Radiation dose optimisation: dose-length product (DLP) awareness, iterative reconstruction, and protocol tailoring for adult patientsFocuses on cutting radiation dose while keeping diagnostic quality, explaining CTDIvol and DLP, auto exposure control, iterative reconstruction, protocol tweaks for body type, and noting dose in records.
Understanding CTDIvol and DLP on the consoleUsing automated tube current modulation safelySelecting appropriate kVp for adult patientsApplying iterative reconstruction to reduce noiseAdjusting protocol for BMI and clinical questionLesson 9Special patient considerations: obesity, claustrophobia, and analgesia needs for painful abdominal patientsAddresses adapting CT for special groups like obese, claustrophobic, or very painful patients, with strategies for table limits, field of view, reassurance, calming, and safe pain relief coordination.
Technical challenges in obese patientsAdjusting FOV and dose for large body habitusManaging claustrophobia and anxiety in CTPositioning painful patients with appendicitisCoordinating analgesia and sedation if neededLesson 10IV access and contrast selection: contrast types (nonionic iodinated), typical volumes and concentrations for abdominal CT, and injection ratesExplains choosing nonionic iodinated contrast, typical volumes and strengths for adult abdominal CT, IV cannula size and site, and injection rates and pressures for portal venous phase.
Choosing nonionic iodinated contrast agentsStandard volume and concentration for adultsSelecting IV cannula gauge and insertion siteSetting injection rate and pressure limitsChecking IV patency before injection startLesson 11Scan protocol and positioning: supine positioning, scan range for appendicitis, and arms-up considerationsDetails proper supine positioning, arm placement, and scan range for appendicitis CT, covering from diaphragm to pubic bone, table centring, and ways to cut artefacts and boost comfort.
Supine positioning and table height alignmentArms-up versus arms-down: pros and consDefining scan range for suspected appendicitisCentering to isocenter and avoiding gantry collisionPadding, straps, and comfort aids for stabilityLesson 12PACS reporting workflow and urgent communication: how to mark study for radiologist read and communicate suspected complications (perforation, abscess) to the clinical teamOutlines sending studies to PACS correctly, adding urgency flags, ensuring radiologist knows of suspected issues, and structured talk with clinicians on perforation, abscess, or sepsis worries.
Correctly labeling and sending series to PACSMarking studies as urgent or stat in the systemAdding key clinical details in technologist notesEscalating suspected perforation or abscessDocumenting verbal communication with cliniciansLesson 13Image review and quality check: evaluating contrast opacification, breathing motion artifacts, and repeat criteriaExplains systematic image review for technical quality, including contrast in bowel and vessels, motion or streak artefacts, appendix coverage, and when to repeat or add scans.
Checking scan range and anatomic coverageAssessing portal venous enhancement qualityIdentifying breathing and motion artifactsEvaluating noise, streaks, and beam-hardeningDeciding when repeat or extra series is needed
