Venipuncture and

Pharmacology for
Radiologic
RTEC
93
Technologists
10:30am- 12:40pm
Monday
1pm 3:10pm Wednesday

SB 571

VENIPUNCTURE

Chaptered 97-0384
Radiologic Technologic:Venipuncture
SB 571 authorizes a radiologic technologist,
under the general supervision of a physician and
surgeon to perform venipuncture in an upper
extremity to administer contrast materials
manually or by using a mechanical injector if the
radiologic technologist has received specified
training and education and has been issued a
certificate from an approved school of radiologic
technology or an instructor indicating satisfactory
completion of the required training.

Central Line Injections by RT

The California Law
does not address
arterial injection by
RT
Employers policies

Saline flush

CALIFORNIA HEALTH AND

SAFETY CODE
HEALTH AND SAFETY CODE
SECTION 106955-107111

ECC CONTRAST MEDIA

INJECTION POLICY
"STUDENT RADIOLOGIC
TECHNOLOGISTS MAY NOT, UNDER
ANY CIRCUMSTANCES INJECT
CONTRAST MEDIA".
HEALTH AND SAFETY CODE CHAPTER
554 STATUTES OF 1995 SENATE BILL
#1334

SENATE BILL #1334

The above mentioned senate bill as of January
1996 allows TECHNOLOGISTS to complete the
injection of a contrast media which was started
by Authorized personnel. This bill did not
address and was not meant to include
STUDENT Radiologic Technologists.

Students who violate this policy shall be

immediately suspended for two days and
possible further action.

CONTRAST MEDIA
CONTRAST
X-RAY DYE
COLORLESS OR
WHITE

Contrast Media
Negative contrast
(AIR OR CO2)

Positive contrast
(all others)

Radiolucent

Radiopaque

Low atomic # material High atomic # material

Black on film

White on film

2 BASIC TYPES OF
CONTRAST
BARIUM Z# 56

IODINE

NON WATER
SOLUABLE

WATER SOLUABLE

GI TRACT ONLY
INGESTED OR
RECTALLY
KVP 90 120*

Z# 53

POWDER
LIQUID
INTRAVENOUS OR
GI TRACT
KVP BELOW 90*

Water Soluble

High atomic # 53
Radiopaque
Used to radiograph

Vessels
Arteries
Veins
Function of internal
organs

Iodine

KVP

TYPE
OF
CONTRAST
USED

DETERMINES KVP RANGE

IODINES
(Ionic / Nonionic

70 80 kVp
Water or Oil)

IONDINATED CONTRAST
WATER BASED
INJECTED

VESSELS/DUCTS
INGESTED
OPEN WOUNDS
ISOVUE 200(41%),
300(61%) or 370 (76%)

ISOVUE-M 200 OR 300

(iopamidol)
Intrathecal
Injection
Myelography
Pediatric
Myelography
Enhancement of
CT spine images

IODINE WATER BASED

CONTRAST
IONIC
LESS $$$

NON-IONIC
MORE $$$

MORE REACTIONS

LESS REACTIONS
*NON-IONIC PART 2
ISOMOLAL
EVEN LESS
REACTIONS

IODINATED Contrast
Agents

IONIC

NON-IONIC

High Osmolality (Higher Low Osmolality (Lower

risk of complications)
risk of complications)
Gadodiamide
(Omniscan)
Diatrizoate sodium
Iodixanol
(Hypaque)
(Visipaque)
Iothalamate
Iopamidol (Isovue)
meglumine (Conray)
Iopromide
(Ultravist)
Ioversol (Optiray)

Shell fish allergies Too

bad for the patient Not
important in Radiology!

Adverse Reactions
Caused By: Osmolality of the Media
Osmolality = The number of particles when
in a solution form.
The more particles in solution the more
water is drawn toward the molecule. This
causes a change in the electrolyte
balance in the body beginning the
adverse reaction

Iodine Contrast Material

Ionic Iodine Contrast
Anion Cation +
More patient allergic
reactions

Non-Ionic Contrast
Less patient allergic
reactions

Visipaque (iodixanol)
Isosmolar, Non-ionic
Water-soluble
Addition of electrolytes
Not to be used for
intrathecal injection
270 (49%) or 320
(63%)
Better for patients with
renal problems

Ionic Iodine Contrast

Non-ionic Contrast

Non-ionic Contrast:
Isosmolar

Dose standards for

intravenous contrast
agents

Adults
Typically 100ml to 150ml is used for
all patients regardless of body weight
200 ml used for angiography or CT
angiography
Maximum of 200 ml can be used in
one day must test BUN & Creat
again prior to next contrast injection.

Dose standards for

intravenous contrast
agents
Pediatrics

Standard of 2.0 ml/kg for pediatrics

Sometimes a simpler division of
patients into 2 or 3 categories is
used. (eg. small/medium/large.)

Converting Pounds to
Kilograms
1 pound (lbs) ~ 0.45 kilograms
1 kg ~ 2.2 lbs (pounds)
Patient wt 35 lbs
How much contrast do you give?

Contrast Dose
Calculation
35 lbs X 0.45 = 15.75 kg
15.75 X 2 = 31.5ml of contrast