Is it routine to do a urine pregnancy test prior to plain x-rays?

[Guest UVAPAC]

I was just curious if this policy varies from hospital to hospital and clinic to clinic.

[Acebecker]

If I'm going to do a pelvic film then generally yes.  Our rad tech double checks this.  On other films (e.g. forearm) we will inquire about it.  Either we'll do the UPT or we'll shield the patient's pelvis for all images otherwise.

[sk732]

As Ace mentioned, that's how my facility works.

 

As a comical aside, my first week working at my previous hospital, an X Ray tech literally tossed back a req I filled out and said "You didn't fill this out properly!"  I asked what they meant...they showed me the line that we had to enter that said "Is this patient pregnant?" where we had to fill in the blank line with "Yes" or "No" or "Indeterminate" (you know - really STAT stuff for traumas and the like).  I looked at him and said, "Fine, I'll play your silly game" and proceeded to write "DUH" and drew an arrow up to the "Gender" box on the form...this was for ankle views on a 12 yo boy.

 

I now break the ice a bit by asking ALL patients prior to XRay "Is it possible that you might be pregnant?".

 

Back to our regularly scheduled programming.

 

SK

[Reality Check 2]

Our xray folks require it if the pt can't say 100% that they aren't.

One tech is a hag and makes it happen on ankle/wrist films and still shields everyone. She has wasted countless hours getting films and is slow to begin with. Drives me crazy. Says it is her judgment and I can wait.

 

In the office I am pretty strict on getting preg tests before certain meds or if I get that feeling - I have been right many times and that vague UTI turns out to have a heartbeat....

 

Not sure if we have a policy - just follow common sense

[AliB]

... and then there's that patient that CAN'T be pregnant ... AND you have the bHCG results from the lab (<1) that say she isn't ... and lo and behold the abdominal CT reveals a 2nd trimester pregnancy ... THEN you investigate and find out the lab sent the wrong results back then ... 

 

Former tech here - I would still shield thyroid and genitals even when doing extremities (doesn't slow anything down enough to be a factor) - but we didn't mandate a pregnancy test unless we were going to directly image the abdomen/pelvis.  

[Reality Check 2]

I have done a tinkle stick in my office and handed it to the patient to take across the street to the imaging office.

 

I saw the patient walk out of the bathroom with the urine cup. I saw the MA dip it and I saw the neg results myself.

 

That makes me feel pretty good.

 

We recently had a urine come back from the lab across the street that said positive preg on a 75 year old male who does not have prostate cancer nor is receiving hormone therapy.  Wow, probably should have called The Enquirer on that one.

 

It took us the rest of the day to rule out that the urine had actually come from anyone in our office and had to have been collected and processed at the lab site. Bet they had fun trying to figure out whose urine that really was..........

 

Be safe, be smart, do the right thing

[Acebecker]

I know you know this but your 75 yo male could have testicular cancer.   :)  That's always a fun conversation.

[Reality Check 2]

Yep. 

This is my doc's patient.

I think a preop for ortho surg.

We repeated the urine in our office and it was good.

 

He mentioned that out loud but followed up on it.

 

The satellite of this major lab company near our office has had some issues recently - they lost my blood tubes that we drew in the office for thyroid. Somehow lost in a 500 foot trip by courier in a cooler across the street........

 

We are doing some quality checks.

[True Anomaly]

Our techs only care if it's a CT scan