Lesson 1Patient consent and explanation: describing IV contrast risks and benefits and breath-hold requirementsExplains how to obtain informed consent for IV contrast CT, clearly outlining benefits, potential risks, and alternatives, 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 administration, including patient monitoring during injection, recognizing early hypersensitivity or extravasation, ensuring emergency drugs and equipment availability, and post-contrast observation procedures.
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 is useful or unnecessary, including institutional preferences and patient tolerance issues.
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 screening for IV contrast safety, including allergy history, prior reactions, metformin use, renal impairment, eGFR thresholds, and when to involve radiology or nephrology before proceeding with 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 verification of CT request, patient identity, and pregnancy status, along with checking prior contrast reactions and renal function, ensuring documentation of eGFR and risk factors before proceeding with 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 techniques to minimize motion artifacts, including coaching on breath-hold practice, timing instructions with scanner, handling dyspneic or painful patients, and using shallow breathing or respiratory compromise strategies 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 acquisition parameters for abdominal CT, including kVp selection, automated mA modulation, pitch, rotation time, slice thickness, and reconstruction kernels, emphasizing their impact on noise, resolution, and diagnostic confidence.
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 optimization: dose-length product (DLP) awareness, iterative reconstruction, and protocol tailoring for adult patientsFocuses on minimizing radiation dose while preserving diagnostic quality, explaining CTDIvol and DLP, use of automated exposure control, iterative reconstruction, protocol tailoring for body habitus, and documentation of dose indices 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 technique for special populations, including obese, claustrophobic, and severely painful patients, with strategies for table limits, field of view, reassurance, anxiolysis, and safe analgesia 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 selection of nonionic iodinated contrast, typical volumes and concentrations for adult abdominal CT, IV cannula size and site choice, and injection rates and pressures suitable for portal venous phase imaging.
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 correct supine positioning, arm placement, and scan range selection for appendicitis CT, including coverage from diaphragm to symphysis, table centering, and strategies to reduce artifacts and improve comfort and reproducibility.
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 how to correctly send studies to PACS, apply urgency flags, and ensure radiologist awareness of suspected complications, while teaching structured communication with clinicians for perforation, abscess, or sepsis concerns.
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 how to systematically review images for technical adequacy, including contrast enhancement of bowel and vessels, motion or streak artifacts, coverage of appendix region, and criteria for repeating or supplementing acquisitions.
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
