Rehab administrators answer questions regarding Barium Use and Ordering. IPRC archives information collected by the Pediatric Rehab Administrator’s ListServ as a public service to the entire Pediatric Rehabilitation Community. All information is posted in summary format and has been de-identified. Search through past queries for responses to rehabilitation related questions.

Original Question:

The department is analyzing our current process for ordering and use of barium during MBSS/VFSS to determine what regulatory improvements can be made. 

• Does your facility use Varibar for MBSS/VBSS?  Any other barium products that are used?
• Does barium require a medication order at your facility?  What does the process look like to get barium ordered?
• Where are unopened containers kept or stored?  In the therapy department or in Radiology?
• Where are opened containers stored?  In the therapy department or in Radiology?
• Who prepares barium for the study?
• Is this a Radiology tech, SLP, or other team member?
• Does your therapy team follow a standard protocol (in terms of order of barium presentation/amount of barium) for each study or is this left to clinical decision of the therapist making based on patient presentation?
• Does the therapist document amount of barium consumed during study (i.e, 30mL thin liquid, 15mL mildly thick liquid)?
• If yes, is this in the therapy evaluation report?  Or does this live in another section of the EMR?
• Some Varibar ingredients are contraindicated for ketogenic diet.  What accommodations do you make for patients on a ketogenic diet who need a MBSS?

Summary of Responses