Protocol for Nuclear Medicine Hida Scan “Biliary Function”
With the Administration of Tc Choletec and Morphine Sulfate
1Nuclear Medicine Technologist anticipates the need for morphine and asks the patient if they have a ride home and if patient is allergic to morphine.
2NM Tech is told by the radiologist the patient needs morphine
3NM Tech asks the patient if they have someone to drive them home.The patient can arrange for a family member or friend to drive them home. If the patient does not have a driver, Inland Imaging will provide Taxi service for the patient. ( see Taxi service protocol )
4NM Tech calls the Inland Imaging staff Nurse and requests Morphine for a Hida Scan Patient. Explains the patient has a driver and not allergic to morphine. NM Tech gives the nurse thename and extension of the Radiologistto call.
5NM Tech calls scheduling and scheduler adds Nurse Time in Centricity & Nurse Modifier for Nurse’s Elecronic Worklist
6NMTech makes sure IV is working, has patient go to bathroom to void, gets patient on table, gets patient ready for Nursevisit.
7The Inland Imaging Staff Nurse will obtain a Phone or Verbal Order from the Radiologist for IV Morphine (Standard Dose 2mg IV)
8The Nurse will obtain baseline Vital Signs from patient (BP, P, RR, Room Air O2 Sats,) prior to administration of IV Morphine and document accordingly on OLF in MedPro, with Ordering Radiologist Name.
9The Nurse will document a brief “Review Of Systems” with at minimum: List of Patient’s Medications (reviewed).
10Nurse will return after the completion of the Hida Scan and repeat Vital Signs & Documentation as said.
11Nurse will bill for the Morphine in Centricity
12Nurse will inform patient not to drive for the remainder of the day, and give written instruction sheet.
13Nurse will notify on site Radiologist if patient has any Adverse Reaction to the Morphine Injection.
14Patient can be discharged from Nuclear Medicine Department or Nurses’ Station.
Rationale: Qualified personnel administer, monitor, intervene and provide a Safe, Comprehensive andAppropriate Process, in a standardized manner, for giving Morphine Sulfate to Nuclear Medicine Hida scan patients.
HIDA SCAN = Technetium 99m Mebrofenin,delivered IVin Nuclear Medicine department for the detection of Gallbladder Disease.
Morphine, an opioid narcotic (controlled substance),is used as an interventional drug during an abnormal HIDA scan. After approximately 75 minutes of imaging, if the gallbladder is not visualized, Morphine can be used to contract the Sphincter of Oddito cause a back pressure of bile flow and "trick" the gallbladder into filling with the radiolabled bile.
Original Date February 2013 ( updated 4/2014) fw
Keywords: Hida, Nuclear Medicine, Nurse Protocols, Morphine Administration