Barium Enema with air PRINT
I. Equipment (May vary between sites)
a. Barium – Liquid Polibar Plus
b. IV pole
c. Double contrast enema bag set up: balloon insufflator, enema tip, air pump
d. Hemostats
e. KY GEL
f. Chux for table x2
g. Towels
II. Personnel
a. Radiologist/RA
i. Reviews order
ii. Administers contrast and takes spot images
b. Hospital Technologist
i. Calls patient 48 hours before exam to verify bowel prep instructions have been provided by ordering physician
ii. Verifies no biopsies within past 7 days
iii. Prints order and relevant notes for radiologist/RA review
iv. Documents patient history and pregnancy status prior to exam
v. Assists the radiologist/RA during procedure
vi. Responsible for overhead imaging
vii. Provides patient with aftercare instructions
III. Procedure
a. Scout KUB according to site protocol
b. Insert enema tip and inflate balloon
c. Contrast on with patient on left side
d. Fill colon to mid transverse
e. Roll patient as necessary to move contrast
f. Add air and drain barium as necessary
g. Stand table and drain barium
h. Return table to horizontal position for additional spot and overhead images
IV. Required Images
a. Fluoro spot images
i. Rectum and sigmoid colon
ii. Splenic and hepatic flexures
iii. Ascending, transverse and descending colon
iv. Suspicious lesions, tics or polyps
b. Overhead images
i. AP KUB
ii. PA KUB
iii. Sigmoid
iv. Bilateral Decubs
v. Post Evacuation
V. Special Considerations
a. Requests for same day ACBE following incomplete colonoscopy are contraindicated if biopsies or polypectomies were performed during the colonoscopy. (Pt must wait 7 days to have ACBE)
i. Example: Colonoscopy performed Monday, pt. must wait until the following Monday to have ACBE