Radiology Pause and Verify

A radiology time-out inspection template to confirm patient identity, procedure, laterality, contrast readiness, allergy status, and pregnancy screening before imaging.

Patient Identification

• Patient identity confirmed using two identifiers
  Confirm the patient using two approved identifiers, such as full name and date of birth, against the order and wristband.
• Order matches patient and scheduled exam
  Verify the imaging order, patient chart, and scheduled exam match the patient present in the room.
• Relevant chart or requisition available
  Confirm the requisition, protocol notes, or chart information needed to complete the exam is available at point of care.
• Patient able to participate in verification
  Document whether the patient can verbally confirm identity and exam details; if not, note the alternate verification method used.

Procedure and Laterality Verification

• Ordered procedure confirmed
  Verify the exact exam/procedure to be performed matches the order and protocol.
• Laterality confirmed when applicable
  Confirm right/left/bilateral laterality for exams where side matters, including imaging markers and order details.
• Body part / anatomic site confirmed
  Verify the anatomic site to be imaged matches the order and patient indication.
• Protocol or special instructions reviewed
  Confirm any protocol notes, positioning instructions, sedation requirements, or special imaging instructions have been reviewed.

Contrast Safety Review

• Contrast required for exam
  Document whether contrast is required for the ordered exam.
• IV access established and patent
  Confirm IV access is present, appropriate for the ordered contrast, and patent before administration.
• Contrast readiness confirmed
  Verify contrast type, dose, injector setup, and any required premedication or lab review are complete before the scan.
• Contrast allergy or prior reaction reviewed
  Review the chart and patient report for prior contrast reaction, allergy history, or premedication needs.

Pregnancy and Safety Screening

• Pregnancy screening completed when applicable
  Confirm pregnancy screening was completed according to facility policy for patients of childbearing potential and the ordered exam type.
• Pregnancy status documented
  Document the pregnancy status result or exemption reason per policy.
• Radiation or contrast safety concerns escalated
  Document whether any pregnancy, allergy, renal, sedation, or other safety concern was escalated to the radiologist or ordering provider before proceeding.

Time-Out Completion

• Time-out performed immediately before imaging
  Confirm the pause-and-verify step occurred immediately before the scan or procedure started.
• All team members acknowledged verification
  Confirm the technologist and any assisting staff verbally acknowledged the patient, exam, laterality, and safety checks.
• Proceed authorized
  Document whether the exam may proceed after verification or whether it was held for correction/escalation.