1. Stroke Module Scene C – CT Angiogram

2. CT Angiogram Introduction Mr. Jones has been prepped and is ready for his CT angiogram. Please proceed to the CT Angiogram Control Room to proceed with this procedure.

3. Dr.’s Notes Patient History Scene C 1 1. Select the “Circle of Willis Scan Parameters” option. EMREMR Protocol Scan Options: Circle of Willis Scan Parameters Routine Head Scan Parameters Sinus Supine Scan Parameters

4. Dr.’s Notes Patient History Scene C 2 2. Push “Inject Contrast Dye”. EMREMR Protocol Inject contrast dye

5. Dr.’s Notes Patient History Scene C 3 3. Push “Run Angiogram”. EMREMR Protocol Run Angiogram

6. Dr.’s Notes Patient History Scene C 4 4. Locate the aneurysm on the scan results. EMREMR Protocol CT Angiogram Results

7. Aneurysm in Anterior Communicating Artery The CT Angiogram shows an aneurysm in Mr. Jones’ Anterior Communicating Artery. Your next course of action is to look at the aneurysm closely and determine the best course of treatment.

8. Dr.’s Notes Patient History Scene C 5 5. Highlight the aneurysm and choose “see in 3 D”. EMREMR Protocol View in 3 dimensions

9. Dr.’s Notes Patient History Scene C 6 6. Determine the appropriate course of treatment for this aneurysm. EMREMR Protocol Treatment Options: Coil/embolyze the aneurysm Clip the aneurysm Aneurysm

10. Clip the Aneurysm This procedure is highly invasive and should only be done when the aneurysm is located close to the surface of the brain and on younger patients. Please think carefully before proceeding with this procedure on this patient.

11. Coil the Aneurysm Correct! This procedure is much less invasive and a better choice for this patient. Go forward with your treatment of this patient.

12. Scene C Conclusion Dr. _______, Congratulations! You found the aneurysm in Mr. Jones’ anterior communicating artery and have to decided to coil the aneurysm. In order to do this, you must first perform a catheter angiogram in order to reach the aneurysm. Mr. Jones is waiting for you in the CT angiogram room.