CT Consent

1. OBJECTIVE OF THE MEDICAL PROCEDURE

This document will explain the medical procedure you will undergo, its risks and benefits, the conditions it will be carried out under and your role in them as well as the expected results and special circumstances that could occur. Your signature in this document implies your consent and authorization for this medical centre to carry out said medical procedure. You may refuse the medical procedure and/or withdraw your consent at any point before the procedure has begun. Your signature does not oblige you to go ahead with the procedure and your refusal or withdrawal of consent does not suppose any negative consequence for your remaining treatment. This document collects the information you will have been given by your doctor; it is very important you read it carefully and ask your doctor if you have any doubts or questions or should you need any further information.

2. DESCRIPCIÓN DE LA ACTUACIÓN MÉDICA

The procedure that will be carried out is called a CT scan or Computed Tomography Scan. This is a diagnostic technique that makes use of computer-processed combinations of many X-ray measurements to produce a series of cross-sectional images of the patient. When evaluated together by a doctor, they offer an impressive amount of three-dimensional anatomical information. This makes it possible to study the details of the bones, muscles, blood vessels etc. with great precision. For this test you will lie down on a stretcher/ mobile table which inserts itself into the circular opening in the machine. You will be continuously monitored by the technicians and nurses who carry out the test and you will be able to communicate with them. The scan will be carried out by a team composed of a Radiologist, Nurse and Specialist Technician. They will need your collaboration and you must follow their instructions when they indicate: how and when you should breathe or hold your breath (if necessary). This is important for the results of test to come out correctly. In some cases (when the exploration is of the abdomen) you will have to drink a sweet flavoured drink or water before beginning the test. In order to carry out the test correctly it may be necessary to inject a contrast dye containing iodine intravenously to increase visibility in the X-rays. For this reason, you must: Inform the medical team if you are allergic to iodine. Inform the medical team if you have had any negative reaction to a contrast dye in any previous radiological procedures. Inform the medical team if you are pregnant, or could be pregnant, as the test is not recommended during pregnancy. Inform the medical team if you suffer from diabetes, conditions of your thyroid or kidneys, severe asthma, chronic urticaria…

3. RISK OF THE MEDICAL PROCEDURE

The ionizing radiation can produce effects depending on the exposition time and the dose of radiation received. These affects can appear naturally or can be caused by other factors. Your doctor has recommended you undergo the procedure on the basis that it is an effective technique for a correct diagnosis and the benefits obtained from it greatly outweigh the possible risks that may occur. During the procedure all the necessary radiological protection measures will be adhered to as set out in the RD 1976/1999.

4. DURING THE TEST

From the moment of your appointment it will be clearly explained to you what preparation you will need to do before the procedure and the precautions necessary to take beforehand and afterwards. Some CT scans do not need any type of preparation. In other cases, it will be necessary to fast for at least 5 hours beforehand and/or for your subsequent evaluation in the case of both/either an intravenous or oral contrast agent being administered. Our administration will inform you should this be the case. When symptoms exist for a digestive examination, your presence will be required between an hour and an hour and a half before you take the oral contrast agent. Our administration will inform you should this be the case.

5. RISKS OF THE MEDICAL PROCEDURE

All medical procedures carry some element of risk. The majority of times these risks do not materialize nor will there be any negative side effects or damage. However, sometimes this is not the case and it is therefore important to be aware of the possible risks of the procedure. MOST COMMON RISKS Radiation: The procedure uses ionizing radiation (X-rays) and should therefore be avoided by pregnant women. in the rest of the population a CT scan will only be carried out when specific symptoms are present due to the high dose of radiation produced. This is especially true in the case of children owing to their greater sensitivity and longer life expectancy. The puncture of the vein can also present problems. These occur rarely and are usually nothing more than a mild irritant in the puncture zone. However, some can be more serious: Bleeding in the area of the puncture (hematoma). Leakage of the contrast agent during the injection which may cause pain or swelling. These small complications are treated as soon as they appear. UNCOMMON RISKS Adverse reaction to the contrast agent: As previously stated, in order to obtain more information, the administration of a contact agent may be necessary. As this agent containS iodine, it may cause reactions the majority of which are mild. However, in some circumstances, reactions may be more serious. The following are the characteristics: Mild reactions: These may consist of unpleasant effects such as the sensations of heat, a bad taste in your mouth, nausea, vomiting, itching or a rash. These can be easily treated with the correct medication. Serious reactions: These need to be dealt with by more complex treatments and can cause harm. Reactions include breathing difficulties, cardiac arrhythmia, convulsions, kidney failure or loss of consciousness. The possibility of such a reaction is in the order of about 0.04% (four out of every ten thousand patients). Fatal complications are extremely rare at around 1 for every 100,000 – 150,000 scans. The possibility is much lower in children as they have not had previous sensitization. Personal risks These risks may be greater in some circumstances and is therefore important that you warn the medical team before beginning the scan if you have ever previously undergone a study with an iodine contrast agent and had any type of reaction. You must also inform them of any known allergies you have to other products or any illnesses that could aggravate the procedure such as kidney failure, asthma or heart conditions.