Esophagram/Barium Swallow
03/06/2020
“Modified” = w/speech. Esophagram = Barium Swallow
PREP: none
Get four cups: First cup-put sip of water in-this is for the fizzies. Second cup is for the thick barium. Third cup is for the thin barium. Fourth cup-fill with water.
Stand table upright.
Ask patient history questions: previous surgeries, previous UGI’s, symptoms, etc. PLACE LEAD MARKERS
No overheads unless requested by doctor.
Change FPS (frames per second) according to doctor.
Small control box in room, usually on single-change to sequence. Drop down appears on the monitor-usually 1 per second.
Dr. Kyle likes 2 per second.
5 minute Barium Swallow
4/25/18
Diagnosis: Achalasia
The patient stands. Give pt. barium tablet. Then the patient ingests 100-200 ml of low-density barium (45% weight in volume) over 1 minute, with the volume ingested based on patient tolerance (The same volume of barium is used for follow-up studies.) USE LEAD MARKERS
Three-on-one spot films (35 x 35cm) are obtained 1, 2, and 5 min after ingestion, with the patient in a left posterior oblique position. The distance of the fluoroscope carriage from the patient is kept constant for all spot films. The 2-min film is optional, but fluoroscopy at 2 min is to determine the state of emptying.
The degree of emptying is estimated qualitatively by comparing the 1 and 5-min films. The degree of emptying may also be estimated by measuring the height and width for both films, calculating the rough area for both, and determining the percentage of change in the area.