Order Radiology—CT/CTA

• If you haven't already:

1. Select the patient.

2. Click Write (ALT+W).

3. Click Radiology (ALT+Y).

4. Click CT/CTA (ALT+T).

• Complete the form

1. Click the checkbox (or press the corresponding letter) to select one or more exams. If not listed, click Other.

2. Click to select an option for each parameter presented. Parameters are defined by the exam selected, and some are not optional.

• Multi-trauma: see Ordering CT/CTA for Multi-Trauma

• Medical considerations (Chest PE Protocol, ED only): Select an option to indicate the probability of pulmonary embolism (PE), based on clinical judgement, or Wells' or Geneva predictors. If prompted, click an option to indicate the result (or lack of testing) of the patient's d-dimer assay. If prompted because the information does not meet guidelines for use of chest CT to diagnose or rule out PE, type a reason for the exam.

• Exam Type (Maxillofacial): Screening or Diagnostic

• Side (Ankle, Knee, or Shoulder): Left, Right, or Bilateral

• Contrast: Contrast use at Discretion of Radiologist, With Contrast, Without Contrast

• Oral Contrast (Abdomen/pelvis): With Oral Contrast (standard), Without Oral Contrast

• Conscious sedation

3. For a Cardiac exam, click the link "Click here to page oncall Cardiac CT fellow" to open PPD (Partners phone and paging), and then send the page.

4. Click OK (ALT+O).

• If you selected With IV Contrast or Without IV Contrast, click to select the option that gives your reason. If other, type a description, then click OK (ALT+O).

• If you selected Without Oral Contrast for an abdomen/pelvic exam, type your reason, then click OK (ALT+O).

• If you requested conscious sedation, note the scheduling alert, then click OK (ALT+O).

• For Abdomen/pelvis, select the primary area of focus.

• For Chest (PE Protocol), when prompted, click Yes or No to indicate if conscious sedation is required. Click OK (ALT+O).

5. Click OK (ALT+O).

6. Complete indications as follows:

• Select indicators, signs and symptoms, and rule out/assess for conditions from checkbox lists if they are presented. If Other, type a description.

• For acute trauma, type the date of the injury when prompted, then click OK (ALT+O).

• Type descriptions of indicators, signs and symptoms, and rule out/assess for conditions in the text fields provided when checklists are not defined.

• Type clinical history as appropriate.

• Click OK (ALT+O).

7. Select a Time.

• For Other, when prompted, type the time the exam is needed, then click OK (ALT+O).

• For STAT, note the number of the Radiology STAT emergency line, then click OK (ALT+O).

8. For a female patient, click No, Yes, or Unknown to indicate if she is pregnant. If Yes, type the estimated gestational age (weeks) of the fetus.

9. Type instructions or comments as needed.

10. Click the associated checkbox to indicate the need for additional copies, a special fund, and/or a special cost center. Type a description for each selection.

11. Click OK (ALT+O).

12. For CT Abdomen/pelvis with oral contrast, when prompted for consequent orders: .

• Click More Info (ALT+M) to display Pharmacy Suggested Dose Instructions (PSDI). Click OK (ALT+O) to return to the consequent order list.

• To skip consequent orders, click No (ALT+N).

• To add a consequent order to your session:

1. Gastrografin is selected by default. Click the checkbox to deselect if applicable.

2. As needed, click the checkbox in the Sel column to select one or more consequent orders.

3. Click Yes (ALT+Y).

• Deleting the CT order before signing automatically deletes the consequent order(s). See Deleting Orders.

• If you sign and then discontinue the CT order, you are prompted to delete the consequent medication orders. See Discontinuing Consequent Orders.

• Write additional orders as needed, then sign the session.