Radiology Pause and Verify
Standardize the radiology pause before imaging with a clear checklist for identity, laterality, contrast readiness, and pregnancy screening. Reduce preventable errors and keep teams aligned before the exam starts.
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Built for: Healthcare · Radiology · Medical Imaging
What's inside this template
Patient Identification
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Patient identity confirmed using two identifiers
Confirm the patient using two approved identifiers such as full name and date of birth.
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Order matches patient and scheduled exam
Verify the imaging order is for the correct patient and the intended study.
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Patient armband and chart information match
Ensure wristband, requisition, and chart information are consistent.
Procedure and Laterality Verification
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Procedure name verified with patient and order
Confirm the planned radiology procedure is correct and understood by the team.
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Laterality confirmed when applicable
Verify left/right side, if applicable, matches the order and consent.
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Correct body part and site marked or identified
Confirm the correct anatomic site for the exam or intervention.
Contrast Safety Review
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Contrast required for this exam
Confirm whether contrast is part of the planned study.
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Contrast allergy history reviewed
Check for prior contrast reactions or relevant allergies.
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Premedication or mitigation plan verified if needed
Confirm any required premedication, alternative agent, or physician approval is documented.
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IV access and contrast administration readiness confirmed
Verify IV patency, access type, and readiness for contrast administration.
Pregnancy and Safety Screening
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Pregnancy status screened when applicable
Confirm pregnancy screening was completed according to policy for patients of childbearing potential.
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Pregnancy test result reviewed if required
Verify a valid pregnancy test result is available when indicated.
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Additional safety concerns addressed
Document any other relevant safety concerns, such as implants, mobility limitations, or sedation needs.
Time-Out Completion
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Team pause and verbal time-out completed
Confirm the team verbally paused to review the patient, procedure, laterality, and contrast plan.
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All concerns resolved before proceeding
Verify any discrepancies or concerns were addressed before the exam started.
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Inspector signature
Signature of the person completing the verification.
Common use cases
Frequently asked questions
What does this template help verify before imaging?
It guides the team through patient identification, procedure and laterality checks, contrast safety review, and pregnancy screening when applicable. This helps catch mismatches and missing safety steps before the exam begins.
Who should use this radiology pause and verify template?
It is useful for radiology technologists, nurses, and imaging supervisors who need a consistent pre-scan verification process. It also supports teams that perform contrast studies or laterality-sensitive exams.
Can this template be adapted for different imaging modalities?
Yes. You can customize the checklist for CT, MRI, X-ray, fluoroscopy, or other imaging workflows by adjusting the contrast and safety fields. The structure stays the same while the exam-specific details change.
Does this template support documentation of the time-out?
Yes. The final section includes time-out completion, resolution of concerns, and inspector signature. That makes it easier to document that the required verification steps were completed before proceeding.
When should pregnancy screening be included?
Pregnancy screening should be included whenever it is clinically relevant based on the exam type and patient status. The template provides a place to record screening, test results if required, and any additional safety concerns.
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