morphine adminstration hida scan

Guidelines For Morphine and CCK administration on Weekends.

I was asked by a radiologist whether we can do morphine administration on weekends. The answer is, yes. The patients nurse will have to be involved and the Radiologist will have to review the images and sign off on the order. According to the protocol if gallbladder is not visualized by 30 min, the radiologist will have to make a decision whether to give morphine or continue to acquire more images. Therefore the Radiologist will have to be updated with the progress of the study at 30 minutes.

If the decision to give morphine is made, the patients nurse is notified and a stat order requesting for Morphine dose will be sent to the pharmacy. On the order form specific request should be made so that pharmacy will send Morphine dose to the location where the patients nurse is located. It will take at least 30 minutes for pharmacy to process the order and for the patient nurse to arrive at the Nuclear Medicine department therefore communication with the nurse, pharmacy and Radiologist is critical. If most of the choletec dose is in the small bowel by the time the nurse arrives, the Radiologist will have to make the call as to whether to proceed with morphine or re-inject with 1-2 mCi choletec before Morphine administration.

If the study is ordered with CCK, Calculate the amount of CCk to be administered

[patient weight(lbs) / 2.2 X .04 ] , Have the Radiologist sign the order and Fax the request to pharmacy (fax 43424). Specify for CCk to be sent to radiology nurse care. It takes pharmacy about 30-45 min to prepare and tube the CCk to radiology. Since radiology nurses are not available on weekends, Nuclear Medicine tech will have to obtain vitals (BP, O2sat, Hx ) and document everything on progress note. The IV pump is set according to guidelines and the radiologist will review everything and start the IV pump.