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Swirler ® Applications Assistance
In the event of a persistent concern that is not addressed by our “Helpful Hints”, please complete the following form and click on "Submit" for technical assistance.
Contact: Title:
Facility: Department:
Address: City :
State or Province: Zip Code:
Country:
Please describe your current applications concern, then answer the questions that follow:
1. Patient dosing location: Against camera Away from camera
2. Patient position while dosing: Upright Supine
3. Patient position while imaging: Upright Supine
4. The ventilation studies : Pre-perfusion Post-perfusion
5. Ventilation pharmaceutical used (type, dose, volume & activity) :
6. Length of dosing time:
7. Survey meter reading at lungs achieved with this dose:
8. Length of time between dosing and imaging:
9. Gamma Camera used: Number of detectors: 1 2 3 4
10. Collimator choice:
11. Collimator distance from patient:
12. Length of time for each image:
13. Gamma camera field of view count achieved for each image:
14. Mouthpiece used: supplied Tru Fit #1030 other
15. Was a Nose clip used: Yes No
16. Type and length of extension tubing used:
17. Oxygen / Air Regulator flow rate and pressure:
18. Describe the patients breathing technique during dosing:
19. Additional Comments:
Revised 11/20/02