Esophagram with air PRINT

Esophagram with Air

I. Equipment (May vary between sites)

a. 1 bottle EZ HD (Thick Barium) (60mL water)
b. Liquid E-Z Paque (Thin Barium)
c. EZ Gas II 1 package (open)
d. Small medicine cup (fill to approx. 1 tsp. line with water)
e. 1 EZ Disk Barium Tablet (small medicine cup) (barium pudding or applesauce in room)
f. 3 cups / 2 straws

i. Cup 1- thick barium
ii. Cup 2- thin barium
iii. Cup 3- water

II. Personnel

a. Radiologist/RA

i. Responsible for administering contrast, giving patient instructions, and taking spot images

b. Hospital Technologist

i. Prints order, reviews order with rad/RA
ii. Documents patient history and pregnancy status prior to exam
iii. Assists during procedure
iv. Provides patient with aftercare instructions

III. Procedure

a. Scout image

i. Required if patient s/p endoscopy or surgical procedure (within 1 week)
ii. To be cleared by Radiologist/RA
iii. Upright Abdomen (on expiration, must include bilateral hemidiaphragms)

b. Esophageal images with patient standing

i. LPO, AP (entire esophagus)
ii. Lateral cervical esophagus

c. Prone esophageal images

i. Single swallows of thin barium to evaluate motility
ii. Valsalva hiatal hernia evaluation
iii. Reflux check
iv. Add lead ruler to field of view for measurement purposes if hiatal hernia present (include HH measurement in dictation)

d. Stand table

i. Administer 13mm barium tablet with 150 mL water (if tablet sticks, save image, if tablet remains lodged after 5 minutes, advise pt not to eat for 45 minutes (liquids ok))

IV. Required Images

a. See procedure

V. Special Considerations

a. If 13mm Ba tablet sticks in vallecula- have patient swallow a tbsp. of barium pudding or applesauce