Exam Prep | Duke Department of Radiology

PROCEDURE PREP INSTRUCTIONS

ADULTS

Barium Swallow

No specific prep required for this exam.
Patient may take regularly prescribed medications.

Schedule an appointment

If you would like to schedule an appointment for your patient, please contact Duke University Hospital Radiology Centralized Scheduling at (919) 684-7999.

If you have any questions or require a same-day procedure, please contact the division of Gastrointestinal Radiology, Duke University Hospital, at (919) 684-7257, Monday thru Friday, 7:30 am – 3:30 pm.

Defecography

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Light breakfast morning of exam (eg: toast or cereal).
Patient may take regularly prescribed medications.
At the time of scheduling, a letter with information regarding the procedure will be generated and mailed to the patient.

Schedule an appointment

If you would like to schedule an appointment for your patient, please contact Duke University Hospital, Radiology Centralized Scheduling at (919) 684-7999.

If you have any questions regarding this procedure, please contact the division of Gastrointestinal Radiology, Duke University Hospital, at (919) 684-7257, Monday thru Friday, 7:30am – 4:00pm.

Nuclear Cardiology

Schedule an appointment

To schedule an appointment for your patient, please contact Duke Radiology Centralized Scheduling at (919) 684-7999, Monday thru Friday, 7:30am – 5:30pm.

For same day appointments or questions, please contact the division of Nuclear Medicine at (919) 684-7220, Monday thru Friday, 8:30am – 4:30pm.

Nothing by Mouth (NPO) 4 hours preferred prior to study.

Rest MUGA
(NPO preferred)

Myocardial Perfusion*
*No caffeine 18 hours prior to the study. Wear clothing suitable for exercising.

Nuclear Medicine

Schedule an appointment

To schedule an appointment for your patient, please contact Duke Radiology Centralized Scheduling at (919) 684-7999, Monday thru Friday, 7:30am – 5:30pm.

To schedule thyroid procedures, same day appointments or questions, please contact the division of Nuclear Medicine at (919) 684-7220, Monday thru Friday, 8:30am – 4:30pm.

To schedule a PET, please contact Radiology PET scheduling at (919) 684-7714 or for questions contact the division of Nuclear Medicine at (919) 684-7220, Monday thru Friday, 8:30am – 4:30pm.

No Special Prep Instructions

Bone Scans
Patient should be well hydrated

Nothing by Mouth (NPO) 4 hours prior to study

Gastric Emptying Liquid
Gastric Emptying Solid
Gastric Reflux
PET
Brain Scan
Whole Body Scan
Hepatobiliary*
*No Narcotic Pain Medication such as Morphine 6 hours prior to the study
Meckels Scan

Nothing by Mouth (NPO) 2 hours prior to study

I-131 Therapy*
*Stat Beta HCG for females 12 – 55 years old unless patient had total hysterectomy or 5 years post menopause.

Nothing by Mouth (NPO) 1 hour prior to study

Thyroid Metastases/Uptake
Thyroid Uptake/Scan

Potassium Iodide Oral Solution (SSKI) 1 day prior to study as prescribed by referring physician

MIBG

Upper GI With/Without Small Bowel Follow Through

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Upper GI Procedure Prep PDF

Nothing by Mouth (NPO) after midnight the night prior to exam.
Patient may take regularly prescribed medications with a small sip of water.

Schedule an appointment

If you would like to schedule an appointment for your patient, please contact Duke University Hospital Radiology Centralized Scheduling at (919) 684-7999.

If you have any questions regarding this procedure, please contact the division of Gastrointestinal Radiology, Duke University Hospital, at (919) 684-7257, Monday thru Friday, 7:30am – 4:00pm.

Ultrasound

Schedule an appointment

To schedule an ultrasound appointment for your patient, please contact Duke Radiology Centralized Scheduling at (919) 684-7999, Monday thru Friday, 7:30am – 5:30pm.

For same day appointments or questions regarding ultrasound, please call (919) 684-7431.

No special prep instructions

Abscess Search Pelvis
Abscess Search Upper
Appendix
Ascites Search
Carotid
Chest Wall (mark effusion)
Endovaginal
Graft (Hemodialysis Access)
Groin
Hernia/ Muscle Soft Tissue
Hips
Kidney
Liver
Liver Doppler
Muscle Soft Tissue
Pancreas Transplant
Parathyroid
Penile
Popliteal Arteries
Popliteal Space (baker’s cyst)
Renal
Renal Transplant
Spine
Spleen
Testicle
Thyroid
Vein Mapping
Venous/Lower Bilateral
Venous/Lower Unilateral
Venous/Upper Bilateral
Venous/Upper Unilateral

Nothing by mouth (NPO) after midnight (minimum 6-8 hours)

Abdomen
Aorta
Bile Ducts
Gallbladder
IVC
Pancreas
Retroperitoneum

32 oz. of fluid one hour before appointment time, patient is not to void after drinking

Pelvic

As ordered by Physician

Renal & Biopsy
Renal Transplant Biopsy

PEDIATRICS

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To schedule your patient for an appointment, including a same day appointment, or for questions, please contact Pediatric Radiology at (919) 684-7302, Monday thru Friday 8:00 am- 5:00 pm.

In-Patients must have appropriate identification bracelet on wrist or ankle.
The patient’s chart must accompany in-patients for all special procedures (fluoroscopy, sonography, CT, MR, interventional, nuclear medicine) or complex radiology (e.g. flexion extension cervical, spine series, IVP, skeletal survey) exams. These examinations should be scheduled at least one day in advance when possible.
Studies with an (*) indicate administration of iodine containing contrast media. Patients with known iodine allergy or sufficient allergic history (at the discretion of responsible staff, and governed by SOP for adult for contrast allergy) may require a steroid prep prior to receiving contrast. Contact Pediatric Radiology staff at (919) 684-7302, if contrast allergy is known or suspected.
A parent or legal guardian is needed to give consent for all sedation and invasive procedures. If a parent or legal guardian is not accompanying the patient, other arrangements for obtaining consent should be made when scheduling the exam including but not limited to, phone consent and prior signed informed consent (within hospital guidelines).

NPO GUIDELINES FOR PEDIATRIC RADIOLOGY PERFORMED SEDATION STUDIES (for all patients)

Clear Liquids - 2 hours
Breast Milk - 4 hours
Solids - 6 hours

Hours specified are the minimum acceptable between last feeding and scheduled sedation. Clear liquids must be truly “clear” (i.e. apple juice, Kool-aid, Sprite, Ginger Ale, etc.). Orange juice and milk are not considered clear liquids (NPO means “nothing by mouth”).

Body CT

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To schedule your patient for an appointment, including a same day appointment, or for questions, please contact Pediatric Radiology at (919) 684-7302, Monday thru Friday, 8:00am – 5:00pm.

Abdominal Pelvic & Liver

0 – 18 Years
Oral contrast sent to ward from inpatient pharmacy. For outpatients contrast is given on arrival in the Radiology Department.

Chest/Extremities Biopsy

0 – 18 Years
Oral contrast may or may not be needed.

Abscess Drainage

0 – 18 Years
Sedation and preparation of sedation is the responsibility of the hospital sedation teamMonday thru Friday, 7:30am – 5:00pm. Other arrangements need to be made by the referring clinical service during evenings and weekends.

NOTE: Peripheral IV, Broviac, Hickman, and Infusapot catheters are acceptable for low osmolar contrast media IV. Infusaports should be accessed before the patient arrives in the Radiology Department. Any sedation required Monday thru Friday, 7:30am – 5:00pm will be the responsibility of the hospital sedation team which is part of the Children’s Procedural Sedation Unit (CPSU). Other arrangements for sedation will need to be made by the referring service during other hours.

Iodinated Contrast Study: check allergy history If the patient is allergic and contrast needs to be given, then an oral corticosteroid and oral antihistamine premedication preparation can be given. These medications are ordered by the referring physician. This regimen suggested for children by the American College of Radiology (ACR) in their 2013 Manual for Contrast Administration, page 53 is as follows:

Prednisone Diphenhydramine 0.5-0.7 mg/kg PO (up to 50 mg) at 13 hours, 7 hours and 1 hour prior to contrast injection1.25 mg/kg PO (up to 50 mg) 1 hour prior to contrast injection

Appropriate intravenous doses may be substituted for patients who cannot ingest PO medication

Gastrointestinal Studies

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To schedule your patient for an appointment, including a same day appointment, or for questions, please contact Pediatric Radiology at (919) 684-7302, Monday thru Friday, 8:00am – 5:00pm.

Barium Enema (Single Contrast Enema, Barium or Water Soluble*)

0 – 18 Years
No prep is needed for a pediatric patient undergoing a fluoroscopic single contrast enema

Barium Enema with Air Contrast (Double Contrast Enema)

NOTE: This exam is usually performed for rectal bleeding. If inflammatory bowel disease or acute abdominal disease is suspected, no bowel prep should be given. These exams are needed so infrequently in pediatric radiology that preparation will be discussed on a case by case basis. The referring clinician and or the patient can call the pediatric fluoroscopy technologists and radiologists at (919) 684-7302, Monday thru Friday, 8:00am – 3:30pm or Saturday mornings, 8:00 – 11:00am for instructions.

Esophagram

0 – 18 Years
No prep needed

Upper GI Series, Small Bowel Series, Upper GI w/o Air, or Video Swallow

0 – 6 Months
NPO 2 hours prior to exam
6 Months
NPO 3 hours prior to exam
2 Yrs, 11 Mos
No solids after 18:00 hours the evening before
3 – 18 Years
NPO after midnight
May have clear liquids only up to 4 hours prior to exam, schedule exam in the morning

NOTE: If a nuclear medicine gastric emptying study is also ordered, the nuclear exam should be performed before the Upper GI or small bowel series

If and only if the patient had an exam with enteric contrast such as a contrast enema, an esophogram, video speech swallow, or CT with oral contrast within 3 days prior to the scheduled Upper GI or small bowel series, then laxatives or enemas may be useful to help clear contrast from the colon prior to the new exam. A scout image will be performed before the procedure to assess for any residual contrast in the colon.

Genitourinary and Chest Fluoroscopy

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To schedule your patient for an appointment, including a same day appointment, or for questions, please contact Pediatric Radiology at (919) 684-7302, Monday thru Friday 8:00am – 5:00pm.

IVP*

0 – 6 Months
NPO 2 hours
6 Mos – 2 Yrs
NPO 4 hours
2 – 18 Years
NPO 6 hours

NOTE: All IVPs need to be approved by a staff radiology physician

Voiding Cystourethrogram* (VCUG)

0 – 18 Years
No special prep
Iodinated contrast is placed into the bladder

NOTE: A transurethral bladder catheter will be placed by the radiology technologist using standard sterile technique in radiology

T-Tube Cholangiogram*

0 – 18 Years
There is no bowel preparation for this exam

NOTE: Antibiotics should be taken for this exam as prescribed by the ordering Physician

Chest Fluoroscopy* with Films (Line Injections)

0 – 18 Years
There is no bowel preparation for this exam

NOTE: Any patient with a known iodinated contrast allergy who needs this exam to be performed should have an oral Prednisone and oral antihistamine preparation prior to any intravenous contrast study. These pre-medications are ordered by the referring clinician.

The regimen suggested for children by the American College of Radiology (ACR) in their 2013 Manual for Contrast Administration, page 53 is as follows:

Prednisone
0.5-0.7 mg/kg PO (up to 50 mg) at 13 hours, 7 hours and 1 hour prior to contrast injection
Diphenhydramine
1.25 mg/kg PO (up to 50 mg) 1 hour prior to contrast injection

Appropriate intravenous doses may be substituted for patients who cannot ingest PO medication

Port Injections: The port needs to be accessed by the clinical care team prior to transportgin the patient to radiology. This examination needs Radiologist approval when scheduling study.

MRI

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IV access before reaching the department is preferred if gadolinium contrast or sedation is to be given. Broviac, Hickman, and Infusaports should be accessed prior to arrival in department. To schedule your patient for an appointment, including a same day appointment, or for questions, please contact Pediatric Radiology at (919) 684-7302, Monday thru Friday 8:00am – 5:00pm.

All Body MRI

0-18 Years
Routine diet, unless sedation is anticipated

All Neuro/Spine MRI

0-18 Years
Routine diet, unless sedation is anticipated

Nuclear Medicine

NOTE: For Pediatric Preps call (919) 684-7220 or (919) 684-7369

Ultrasound

Thank you for choosing Duke Radiology!

To schedule your patient for an appointment, including a same day appointment, or for questions, please contact Pediatric Radiology at (919) 684-7302, Monday thru Friday 8:00am – 5:00pm.