biodex Venti-Scan IV User manual

FN: 06-149 Rev G 4/19
Venti-Scan iV RadioaeRoSol
conVenience Kit
operation manual
177-091
177-092
BIODEX
Biodex Medical Systems, Inc.
20 Ramsey Road, Shir ey, New York, 11967-4704
Te : 800-224-6339 (Int’l 631-924-9000),
Fax: [phone] Emai : [email protected], www.biodex.com

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177-091 Venti-Scan IV Radioaerosol Convenience Kit,
12" tubing
177-092 Venti-Scan IV Radioaerosol Convenience Kit,
24" tubing
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The Venti-Scan IV Radioaerosol Convenience Kits (#177-091 and
#177-092) enhance delivery of radioaerosol by use of a smaller baffle
within the nebulizer. The end result is smaller particle size. The kit includes
a filter with a contour design. This increases surface area and provides
virtually resistance free breathing with exceptional trapping capacity. Used
in conjunction with the Venti-Scan IV Shielded Canister (#177-090), the
Venti-Scan IV Kit provides superior film studies and lead-shielded
protection from top to bottom.
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1. Remove the Venti-Scan IV shielded canister top.
2. Place lower shield assembly in IV pole mount.
3. Remove the Venti-Scan IV l kit from its packaging.
4. Gently insert the disposable into the canister (you can tilt the
disposable toward the patient tube while lowering).
NOTE: The nebulizer injection port should be visible through the
canister injection site.
5. Inject Tc-99m DTPA into the nebulizer injection port. Typically, 40
mCi of Tc-99m is used in approximately 2 mL. Be careful not to push
the needle through the back of the injection port elbow.
6. Replace shielded top by aligning large slot with patient breathing
tube. Push down on the cover and twist to lock. For maximum
shielding, ensure that rotating port on top of cover is fully closed.
CAUTION: Oxygen supply ust be turned OFF. Do NOT use a
hu idified oxygen source.
ATTENTION: L’ali entation d’ oxygène doit ètre arrêtéce. Ne pas
utiliser une source d’oxygène hu idifiée.

7. Adjust height of assembly on stand for patient comfort. Explain
procedure to the patient. Place disposable gloves on the patient if
handling of the tubing will be required by the patient during the study.
8. Place the mouthpiece in the patient’s mouth. After ensuring the patient
maintains a good seal on the mouthpiece, apply the nose clip and
instruct the patient to relax and breathe deeply on the system several
times to ensure proper operation and familiarize the patient with the
system.
9. Connect one end of O2tubing to the O2supply and set the flow to
10-11 liters per minute. Confirm that the patient is ready to begin the
procedure. Connect the other end of the O2tubing to the Venti-Scan IV
inlet tube to start the aerosol delivery procedure. INSTRUCT THE
PATIENT TO CONTINUE BREATHING ON THE SYSTE FOR THREE
TO FIVE INUTES TO ENSURE SUFFICIENT LUNG DEPOSITION.
10.After allowing enough time to ensure sufficient lung deposition, turn
OFF the oxygen (or air). To maximize clearance of any remaining
activity in the tubing following inhalation, and to minimize the possibility
of inadvertent contamination to the patient and room, instruct the
patient to continue breathing for five or six breaths before removing the
mouthpiece (you may also instruct the patient to expectorate into a
disposable towel to be handled as normal radioactive waste).
11. Once the patient mouthpiece has been removed, remove the nose clip
and begin imaging.
NOTE: I aging ay be perfor ed during radioaerosol inhalation.
CAUTION: To prevent inadvertent conta ination of the patient or
roo , use care and good radiation practice when re oving the patient
fro the syste .
ATTENTION: Pour éviter de conta iner le patient et la piece, suivre
les pratiques usuelles relatives aux rayons X lors de la sortie du patient
du systè e.
CAUTION: This procedure ay NOT be appropriate for uncooperative
patients or for patients who cannot aintain a good outhpiece seal.
ATTENTION: Cette technique peut ne pas être adaptée à des patients
non coopérants ou à des patients ne pouvant pas aintenir une bonne
étanchéité sur la pièce buccale.
12.Disconnect the oxygen tube. Remove the shield assembly from the IV
pole mount and transport to a radioactive waste disposal area.

13.Remove the shield top and then remove the disposable kit by tilting the
shield over and pressing the button on the bottom of the canister. You
may have to press hard on the release button the first time you use the
canister. Now gently shake the kit out of the canister without handling it
(disposable plastic bag and tie-wrap are supplied for covering the
mouthpiece and moving it to the decay barrel). The used circuit
contains significant radioactive material. Be certain to use your facility
approved procedure for disposal of all radioactive and biohazardous
waste.
NOTE: Do not atte pt to aid the re oval by pulling kit out with your
hands. It ay cause the kit to separate.
CAUTION: Do not reuse disposable nebulizer.
ATTENTION: Ne pas utiliser u hu idificateur jetable.
CAUTION: If patient re oves outhpiece, i ediately turn OFF the
oxygen supply.
ATTENTION: Si le patient retire la pièce buccale, arrêter
i édiate ent l’ali entation oxygène.

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• If using a tank, replace unit if the remaining pressure drops to 25% of
the air/O2in the tank.
• If you use wall oxygen, have maintenance check pressure at the wall
inlet to ensure you are getting the 30 to 55 psi needed for good
particle spallation, (approximately one micron DD). Be aware that
the pressure can drop at times if others are using the system.
• Occasionally check one aerosol unit by putting in 1 mL of water for
injection or saline and turning the system ON. You should see a
plume of mist reaching three to four inches from the mouthpiece.
(You can use the unit with a patient after checking, simply by adding
an additional 2 mL of Tc-99m DTPA containing 40 Ci.)
•Always inject DTPA before turning on air/oxygen.
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• Patients should not smoke for 24 hours prior. (Smoke particles in
lungs act as magnets for Tc-99m DTPA and may cause a mottling
effect in the scan.)
• Be aware that shallow breathers tend to get more upper airway
deposition. Try to have patient take slow, deep breaths.
• Patients with false teeth or no teeth, or a large amount of hair in the
nose, need to be monitored closely. They may move the mouthpiece
around and have mist squirt out sides of mouth, or they may breathe
through the nose which reduces the amount going to the lower lungs.
Be sure nose is clamped properly.
• If the patient is in a seated position, you may see more radioaerosol
deposition in the lower (basal) sections of lung.
• Instruct patients to raise a hand if they want to swallow. Turn the
system OFF, then have the patient spit into a napkin or tissue.
• Typically, 40 Ci of Tc-99m DTPA is used in 2 mL volume for either
pre or post vents. Remember, only 1 to 3 Ci of Tc-99m DTPA
reaches the lungs - the remainder is in the nebulizer or filters out and
is discarded.
• The techs get more radiation exposure from the patient’s chest walls
than from the tubing of the vent device.
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• Try to keep patients as calm as possible. Show them the system and
explain how it functions. Let patients know that they’ll feel a cool mist
of water when they breathe. Assure them that the time will pass
quickly. If necessary, add one cc of water and show them how the
system works, or allow them to breathe in the system to allay fears.

•Always inject Tc-99m DTPA before turning on air/oxygen pressure. If
not, excessive DTPA can find its way to the bottom of nebulizer,
making for an inefficient vent.
• Patients must breathe as deeply as possible for approximately five
minutes.
• Take care that patients do not contaminate you or themselves. The
gamma camera doesn’t differentiate between the activity being
counted in the patient’s lungs or on the patient’s chest.
• Some doctors feel a good vent only requires 200K counts, others
want darker images. From your perspective, the fewer, the better.
• In emergencies, you can vent with a concentration as low as (18 Ci
in 4 cc’s.) This may, however, require the patient to breathe a little
longer.
• If milking a generator, make certain you have no molly breakthrough.
• Tank pressure is crucial to getting a good scan. Low pressure
invariably causes excessive upper air deposition. 100% of all
nebulizers are tested to ensure 45 psi of pressure. When the tubing
is connected and used by the patient the pressure drops to about 28
psi. This is still ample to get small partial vents (1 to 1.2 micron mass
mean aerosolized diameter).
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• Try to reduce the amount of Tc-99m AA to 1 or 1.5 millicuries.
• Scan from 200K to 300K counts. The image should be clear enough
for the doctor to detect defects. (You can develop a 200K - 300K or
500K scan and let the doctor choose which one is preferred.) The
fewer the counts, the quicker to get the needed vent counts.
• Following the perfusion study, you can vent in a number of ways:
- If the patient breathes away from the camera, check the patient’s
chest wall with a geiger counter. ( ake sure the clicker is OFF or you
might scare the patient.) This is your baseline count from residual
perfusion.
- Vent the patient for three to five minutes to ensure sufficient lung
deposition. Typically, 40 millicuries of Tc-99m DTPA is sufficient. Turn
OFF oxygen supply after five minutes and check patient’s chest wall.
If counts increase by 25% to 50%, you have enough from venting to
image.

- If you don’t have a geiger counter, vent for five minutes and scan.
- If your final perfusion count rate was 1000 cps, you should be getting
1250 to 1500 cps after venting. By this method you know the air sac
side of the lungs received activity. Then proceed to do your total vent
count.
• If you vent while the patient is under the camera, breathe the patient
for a few minutes and see if the defect starts to fill in. If so, you have
your mismatch or possible PE. If not, the patient may have COPD.
NOTE: The ca era ust not have a cooling fan near the crystal
head. If the patient coughs, talks or spits out the outhpiece, you
could flood your crystal head with Tc-99 fro the escaping ist
plu e.
• Conclusion: Venting an average patient for five to six minutes should
deposit enough counts in the air sac side of the lungs to override the
counts from the perfusion study. (Using 40 Ci of Tc-99m DTPA
injected into the nebulizer.)
Authorized European Co unity Representative:
Emergo Europe
Prinsessegracht 20
2514 AP, The Hague
The Netherlands
EC REP

BIODEX
Biodex Medical Systems, Inc.
20 Ramsey Road, Shir ey, New York, 11967-4704
Te : 800-224-6339 (Int’l 631-924-9000),
Fax: [phone] Emai : [email protected], www.biodex.com
MADE IN
U. S. A.
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