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CT abdomen and pelvis with 48 hour preparation

Read more about CT abdomen and pelvis with 48 hour preparation

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This page has information for patients referred for CT abdomen and pelvis with 48 hour preparation at North Bristol NHS Trust.

Please follow these instructions to ensure adequate bowel preparation for this examination.

To prepare your bowel for your CT Colonography you will need to drink mixtures of water and Gastrografin. The instructions for this are in this leaflet. Gastrografin often causes diarrhoea. The amount of diarrhoea is very variable. Please make sure you have easy access to a toilet during this 2 day preparation period.

It is very important to drink plenty of fluid during the entire period. You may become dehydrated otherwise. For this examination to be successful, please follow these instructions.

How to prepare your Gastrografin mixture:

Pour 1 bottle of Gastrografin (20ml) into a glass.
Into the same glass, add at least 200ml or half a pint of water. You can add fruit squash/cordial if you prefer.
Stir with a spoon until mixed well.

Two days before your appointment

Prepare and drink 1 Gastrografin mixture with a meal.

One day before your appointment

Prepare and drink 1 Gastrografin mixture with a meal.

On the day of your appointment

In the morning prepare 1 Gastrografin mixture.

Drink this slowly over the 1.5 hours before your appointment.

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

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Your CT virtual colonoscopy

Read more about Your CT virtual colonoscopy

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Introduction

You have been advised by your doctor to have a Computerised Tomography investigation, more commonly called a CT scan. This leaflet explains what a CT is, the benefits and risks, and what the virtual colonoscopy CT involves. If you have any further questions please speak to the member of the team looking after you.

CT scans are done in the Imaging department - also known as Radiology or X-ray department. This is the department in the hospital that does radiological examinations such as X-rays, CT scans, and others.

Radiographers are highly trained operators that carry out CT scans with the help of radiology department assistants. They make sure the best possible images are taken while using the minimum dose of radiation. Radiologists are doctors specially trained to interpret the images when the scan is complete.

What is a CT virtual colonoscopy?

A CT scanner machine uses ionising radiation (X-rays), and a computer to produce very detailed cross-sectional images of any part of the body. The information is built up into a series of pictures for the radiologist to view.

CT virtual colonoscopy is different from other CT scans because carbon dioxide is used to inflate the colon (large bowel), via a thin flexible tube that is inserted into the back passage (anus). The CT scanner the puts together a detailed 3D model of the colon, which the radiologist uses to view the bowel in a way that simulates travelling through the bowel. This is why the procedure is called a virtual colonoscopy.

At the same time, 2D images of the colon, abdomen, and pelvis are taken without any additional radiation.

Are there alternatives to a CT virtual colonoscopy?

The alternative way of looking at the large bowel is endoscopy. Endoscopy involves using a tube with a camera on the end (colonoscope) which is passed into the back passage, an moved up and around the bowel. Although it doesn‘t use radiation, it is more invasive than a virtual colonoscopy and usually requires sedation. However, it does allow for a biopsy or removal of small polyps at the same time.

Do I need to prepare for this examination?

We will send you a special medicine before the scan. Please mix this with water and follow the instructions given to you on a separate leaflet. This medicine may cause diarrhoea, which is required to empty the bowel. It also coats the lining of the bowel so we can see it on the scan.
You will also be given a separate leaflet with what foods you can and cannot eat. Please follow these instructions carefully.
Please drink plenty of water over the 2 days before the scan.
If you are diabetic and have received an afternoon appointment, please let us know. Morning appointments are available to ensure you can follow the preparation safely.

What happens during the scan?

The Radiology department assistant will explain the process and ask you to change into a hospital gown. You will then be taken into the scan room where the radiographer will again explain and answer any questions.
A small cannula will be put into your arm so that a muscle relaxant can be injected. This drug is used to relax the involuntary muscles of your bowel to reduce discomfort and decrease bowel movement on the scan.
You will be asked to roll onto your side and a small flexible tube (around the width of a pencil and 2 inches in length) will be inserted into your back passage. A lubricant is used to ease this process.
Carbon dioxide gas will then be passed through the tube and into the large bowel for the duration of the examination to maintain inflation. You will be asked to move into different positions on the scanning table (on your front, back and sides) and several scans will be taken.
The radiographers will check the quality of the images and ensure they have all the information required from each position. Occasionally, more information may be required, and the scan will also include your chest. A contrast dye will be inserted into your cannula during the scan if this is required.
During the scan you will be asked to hold your breath and retain the gas as much as possible whilst the table moves slowly. You will move in and out several times. Occasionally, a contrast dye may be given through the cannula and the scan to provide more information.
The whole examination will take around 30 minutes and is very clean. A small balloon on the tube keeps the tube in place and any faeces (poo) left inside you will go down the tube. You will not be given sedation for this examination.
Once all the images are taken the tube will be gently removed. You will then be taken into a joining room where there is a toilet and your clothes to get dressed. The team will talk to you before you go to ensure you feel ok.

What happens after the scan?

You may eat and drink as normal. Please drink plenty of water as the bowel preparation medicine may dehydrate you.

The carbon dioxide gas will naturally be absorbed by the body and the bloated feeling will subside quickly once you have passed wind and used the toilet.

The radiologist will examine the images in detail and send the written results to the consultant or GP that referred you for the scan. You will get your results from that doctor.

What are the risks and benefits of having a CT virtual colonoscopy scan?

A CT scan involves the use of ionising radiation (X-rays); we are all exposed to natural background radiation every day from radioactivity in the air, food that we eat and even from space.

Exposure to ionising radiation from a CT scan carries a small risk, however, the main benefit of having the scan is to get an accurate diagnosis so that you can get the right treatment for you. A specialist will have agreed that the benefit, of the scan, outweighs the risk of the ionising radiation and we can assure you that all safeguarding to minimise ionising radiation exposure is taken.

If there is a possibility that you may be pregnant, then please contact the radiology department prior to the scan.

During the CT virtual colonoscopy, you may experience abdominal discomfort and bloating, this is normal but if it becomes too painful then please let the radiographer know. Once the scan is complete you could become faint when sitting up, however, the team follow several steps to limit.

There is a very small risk that inflating your bowel with air could cause injury to or perforation of the bowel, however, this occurs in fewer than 1 in 10,000 patients. This will, in most cases, heal itself, however, may require medical assistance or antibiotics.

If you have had the injection of muscle relaxant, you may experience a dry mouth and blurred vision. The latter is very rare, but if it does happen, it will wear off within 30 minutes but please do not drive until your vision is back to normal. Please let the radiographer know if you suffer from angina, any heart problems or glaucoma.

Some patients may require an injection of contrast medium, also described as X-ray dye, for their scan which increases the amount of information seen on the scan. There is a small chance of an allergic reaction to the injection of contrast medium, however, the Imaging team are trained to deal with any complication, and again the risk is very small. The Imaging team will make sure you are feeling alright and have recovered before letting you leave the department.

References

CT Colonography or Virtual Colonoscopy

National Health Service: Your CT scan:
Available from CT scan - NHS [Accessed on July 2022]

United States Food and Drug Administration: Computed Tomography (CT).
Available from Computed Tomography (CT) | FDA [Accessed July 2022]

Computed Tomography (CT or CAT scan) Procedures

Radiation Dose from X-Ray and CT Exams

Imaging Department Contact Centre

If you are unable to attend your appointment please let us know as soon as possible. You can also contact the Imaging Department Contact Centre if you wish to change or discuss your appointment.

Telephone: 0117 414 8989

Blood spot testing and your child

Read more about Blood spot testing and your child

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What is blood spot testing?

Blood spot testing is a blood screening test which allows your child to be tested for 1 of 9 rare conditions. These conditions are:

Sickle cell disease.
Cystic fibrosis.
Congenital hypothyroidism.

Or these inherited metabolic diseases:

Phenylketonuria (PKU).
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD).
Maple syrup urine disease (MSUD).
Isovaleric acidaemia (IVA).
Glutaric aciduria type 1 (GA1).
Homocystinuria (pyridoxine unresponsive) (HCU).

Completing this blood spot test, allows these conditions to be identified and treated, improving your child’s health.

Why does your child have to have a blood spot test?

When a child is born in the UK, blood spot testing is routinely done to rule out rare conditions in the first few weeks after birth. Because your child was born in another country, we must complete this test here. This can only be done if your child is under the age of 1.

What can you expect from your appointment?

One of our nurses will bring you and your child into one of our treatment rooms and will discuss the procedure, talking you through any questions you may have.

Your child will then have the blood spot carried out. This involves a small heel prick using a lancet (small needle) to get small drops of blood which are then applied to a card as shown in the picture. Your child may cry or become distressed when this is done, so reassurance and lots of cuddles will help.

Once the sample has been taken, this will be sent off to the lab to be processed. The results usually take a few weeks and you will be sent a letter if any of your child’s results are abnormal. If you have any questions or queries after your appointment you can contact us. Our details are on the back of this leaflet.

For further information speak to your GP or contact one of our nursing team at the Paediatric Outpatients Department.

Sources of further information

Newborn blood spot test - NHS

Blood spot - GOV.UK

Information in different langauges

Newborn blood spot screening (English and translations) | HSC Public Health Agency

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Contact Westgate House Children's Centre

Westgate House Children's Centre
Westgate House
Southmead Hospital
Bristol
BS10 5LT

Telephone: 0117 414 5807

Opening times
Westgate House clinics
Monday to Thursday 08:00 – 18:00

Sister
Katy Travis

Staff Nurse
Debra Sainsbury

Health Care Assistant
Katie Allen

Receptionist
Mia Fearnley

Blood test and your child

Read more about Blood test and your child

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Introduction

It is important your child is prepared for their blood test as they may have questions, fears, and anxieties. This page will help you explain what will happen during their short visit to the blood clinic.

How is a blood test done?

Before your child has their blood test we can use a spray that numbs the skin. It works quickly and doesn’t last very long so the bloods will be taken immediately after the child’s skin has been sprayed.
The nurse will squeeze your child's arm or wrist - this makes the vein fill up with blood and makes it easier for the blood sample to be taken.
A butterfly needle (small needle) is then inserted into the vein - the needle is connected to a syringe and the blood taken out.
When the required amount of blood is taken, the needle is removed. The nurse presses on the small wound with cotton wool for a few minutes to stop the bleeding and prevent bruising. A sticky plaster is then put on.
While the nurse puts the blood into bottles, your child will be encouraged to choose a sticker. This can help them feel they have achieved the goal of having blood taken and to reward them for their bravery.

Why are there so many bottles?

Blood can be tested for many different things. Your child’s doctor will request which tests they want us to take. Different blood bottles are used for different tests - this is why you may see your child’s blood added to bottles of different sizes and colours.

What can I do to help?

Keeping your child hydrated reduces the risk of their blood pressure dropping. A drop in blood pressure is the leading cause of fainting and dizziness during blood tests. Being hydrated makes their veins plumper and more visible making it easier for the phlebotomist to find a vein.
Keep warm. If it is winter or cold outside this can make the veins hide and make it harder to collect a sample. Your child should wear gloves or suitably warm clothing for the appointment.
If you have been told by your clinician your child should fast before your test (typically for 12 hours) then please bring something for your child to have afterwards. Sugary/sweet snacks are ideal.

Are there any complications?

Sometimes a bruise develops where the needle was put in. This is much less likely to happen if you press over the site with cotton wool for a few minutes, keeping your child's arm straight. The nurse will do this for you.
Rarely, some people feel faint during a blood test. Your child (or yourself) will be encouraged to lie down if this happens to prevent fainting.
Occasionally it can be difficult to find a vein to take the blood from and it may take more than one attempt to get a sample.

When will we get the results?

Results will be passed onto the clinician who requested the tests. They will usually wait until all the results are ready to inform you of the results. Some tests will take longer to process than others – for example, genetic screening can take between 8-12 weeks to be ready.

For further information

Speak to your community midwife, health visitor, GP or ask the nurse you will see in the paediatric outpatient department.

Sources of further information

Blood tests - NHS

Fainting - NHS

Bumps & Bruising - Symptoms & Treatment | St John Ambulance

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Contact Westgate House Children's Centre

Westgate House Children's Centre
Westgate House
Southmead Hospital
Bristol
BS10 5LT

Telephone: 0117 414 5807

Opening times
Westgate House clinics
Monday to Thursday 08:00 – 18:00

Sister
Katy Travis

Staff Nurse
Debra Sainsbury

Health Care Assistant
Katie Allen

Receptionist
Mia Fearnley

Managing phosphate in your diet - Information for kidney patients

Read more about Managing phosphate in your diet - Information for kidney patients

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Why do I need to eat less phosphate?

Phosphate (also known as phosphorus) is found in a variety of foods. It is needed for healthy bones. The kidneys help control the amount of phosphate in the blood and when they are not working properly, the level of phosphate in the blood can rise.

The normal range for blood phosphate is between 0.8mmol/l and 1.5mmol/l.

High levels of phosphate can cause:

Hardening of blood vessels.
Damage to your heart.
Weak bones.
Aching joints.
Itchy skin.
Sore eyes.

How can I control my phosphate levels?

You can help to lower phosphate levels in your blood by reducing foods that are high in phosphate. If your phosphate levels stay high you may be prescribed tablets called phosphate binders. These are taken with food to reduce the amount of phosphate absorbed from food. The dietitian can give you more information on how and when to take these tablets if they are prescribed.

How can I eat less phosphate?

Avoid phosphate additives where you can and eat more fresh foods.
Choose foods lower in phosphate.
Choose meals based on beans, lentils, tofu or Quorn when you can (instead of meat, fish and dairy foods).
Eat moderate amounts of dairy foods.
Eat the right amount of protein for you.

If you are following another diet please remember to continue. Your dietitian can help you with this.

Eating less processed food

Processed foods and ready meals can be high in phosphate if additives containing phosphate are used to preserve or flavour the food.
The phosphate from the additives is well absorbed by your body. Additives can have a large effect on your blood phosphate levels.
Choose fresh, unprocessed food to help you eat less phosphate from additives.

The table in the section below shows a list of additives containing phosphate.

Your dietitian can also give you a phosphate additives card to help identify these on labels when shopping.

Phosphate additives

E number	Name	Where found
E338	Phosphoric acid	Processed meat, sweets, cakes, chocolate, cola drinks
E339	Sodium phosphates	Dried milk powder, canned soup, breaded chicken and fish, UHT
E340	Potassium phosphates	Processed meats and cheeses, sports drinks, dried milk powder
E341	Calcium phosphates	Shop-bought desserts and powder dessert mixes, instant pasta mixes
E343	Magnesium phosphates	Bakery products, liquid egg, salt substitutes
E450	Diphosphates	Bakery products, processed meat and cheeses, soups and sauces
E451	Triphosphates	Processed cheese, icing sugar, flavoured syrups
E452	Polyphosphates	Processed potato products

How do I eat fewer phosphate additives?

You will always see the name of phosphate additives, or their E numbers listed on the ingredients labels where they have been used. Look out for additives with ‘phos’ in their name as these will contain phosphate. You may be able to swap to a different brand without additives.

To help you avoid phosphate additives, here are some examples of food labels showing how phosphate additives are listed on a food label.

Sausages

Sausage ingredients label with "stabiliser: E452" circled

Cake

If a food contains phosphate additives try checking other brands or similar alternatives to find one without.

Eating moderate amounts of dairy foods

Dairy foods such as milk, cheese, yoghurts and eggs contain phosphate. They are also good sources of protein and calcium which are essential for a healthy diet. It is recommended that you eat moderate amounts of these foods.

A healthy amount for most people is 2 portions per day from this list

1/3 pint or 200ml milk per day (including milk in drinks, puddings and sauces).
125g or a small pot of yoghurt per day.
1oz or 30g cheese (size of a small matchbox) per day.

Tip – cottage, ricotta, and cream cheese are lower in phosphate. Your dietitian can advise you on appropriate portion sizes.

Eggs

A healthy amount for most people is 4-6 per week. Your dietitian may advise on a different amount for you.

Choosing foods lower in phosphate

Food	Lower phosphate foods - Your dietitian can advise you on amounts to eat.
Meat	Fresh meat e.g. beef, lamb, pork, chicken, turkey
Fish	Fresh fish e.g. haddock, cod, salmon, trout. Tinned tuna, salmon or mackerel - without bones
Shellfish	Tinned crab
Cheese	Eat in moderation. See above
Milk	Eat in moderation. See above
Potato products	Any fresh potatoes
Nuts/seeds	Chestnuts
Snacks	Popcorn, breadsticks, prawn crackers, corn snacks, pretzels, potato crisps
Breakfast cereals	Weetabix, cornflakes, porridge, rice krispies
Bread	White, wholemeal, granary bread, pitta, croissants, english muffins
Cakes	Madeira cake, doughnuts, meringues, jam swiss roll, danish pastry (without nuts), jam tart, iced bun
Biscuits	Plain biscuits, cream biscuits, shortbread, plain crackers e.g. water biscuits, cream crackers
Confectionary	Fruit pastilles, boiled sweets, sherbet, peppermints, marshmallows, chewing gum, turkish delight, fruit gums
Drinks	Tea, coffee, herbal tea, drinking chocolate made with water, fizzy drinks (except cola), fruit squash, fruit juice. Spirits, sherry, cider, white wine
Miscellaneous	Jam, marmalade, honey

Higher phosphate foods to limit

Food	Higher phosphate foods
Meat	Liver, liver sausage, liver paté, saveloy sausage
Fish	Sardines, pilchards, whitebait, fish paste
Shellfish	Scampi, fresh crab
Cheese	Cheese spread, processed cheese e.g. cheese triangles
Milk	Condensed milk, evaporated milk, coconut cream, coconut milk, dried milk powder
Potato products	Frozen, chilled, dried potato products e.g. chips, waffles, instant mashed potato
Nuts/seeds	All other nuts, seeds, pine nuts
Snacks	Twiglets, oriental mix
Breakfast cereals	Muesli, cereals with nuts or chocolate
Bread	Naan bread, crumpets
Cakes	Scones, muffins, chocolate cake, packet cake mixes
Biscuits	Biscuits with nuts, seeds or chocolate, oat cakes, cereal bars
Confectionary	Chocolate, marzipan, fudge
Drinks	Cocoa, Ovaltine, Bournvita, Horlicks, milk shakes, cola, drinking yoghurts. Guinness, stout, red wine
Miscellaneous	Marmite, peanut butter, pesto

Useful websites

Patients Know Best

An easy-to-use online service that allows you to monitor your own blood test results. You can find out more and register to use it at:

Kidney Kitchen

Kidney-friendly cooking and eating, information, recipes and Kidney Kitchen videos.

Kidney Kitchen | Kidney Care UK

Next steps: what I can do to help control my phosphate

It can be helpful to write down what you can do to help control your phosphate.

Contact your dietitian if you need further help.

Contact Nutrition & Dietetics

Kendon House
Kendon Way
Southmead Hospital
Bristol

Telephone: 0117 414 5428 or 0117 414 5429

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Overnight polysomnography (with MSLT)

Read more about Overnight polysomnography (with MSLT)

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Please read this information carefully before coming in for your overnight polysomnography.

What is a polysomnography?

Polysomnography (also known as sleep studies) is a test used to diagnose sleep disorders. Electrodes and sensors are placed on the body and head to record different information that allow your sleep to be studied in detail for 1 or 2 nights. A video recording is taken during the study to help diagnose your sleep problem.

Why do a polysomnography?

The main reason is to try to classify (work out exactly) the problem you are having with your sleep so that the referring doctors can treat it more effectively.

What happens during the test?

Small discs (electrodes) are applied to your scalp, around your eyes, and under your chin. These will be attached with special glue, so they do not fall off in your sleep.

2 belts will be placed around your chest and abdomen that measure your breathing, with additional boxes attached where the wires are connected. A nasal cannula will rest in your nose to also measure breathing. 2 sticky pads will be placed: 1 on your shoulder and 1 on your hip to detect your heart rate. A pulse oximeter will be placed on your finger to detect blood oxygen saturation. A movement sensor is placed on your arm and 1 on each of your legs to detect any movements in your sleep.

The equipment will stay in place until the end of the test, and it is removed by a neurophysiologist.

The night-time recording is started as close to your normal sleep time as possible. Wake time is usually before breakfast at around 08:30.

It may be necessary to do a Multiple Sleep Latency Test (MSLT). This involves settling down to sleep at specific sections of the day. These periods are about 20-40 minutes and are about 2 hours apart. You will be woken up at the appropriate time by your neurophysiologist.

Preparation for the test

Follow these instructions carefully for the MSLT

Do not consume any alcohol, coffee, or stimulating drugs (medication) the night before or morning of the test.
Stop smoking at least 30 minutes before each test.
Do not doze off in-between the test sessions.

General preparation for polysomnography

Please follow the guidance provided by your consultant neuropsychiatrist about reducing or stopping medications before coming for the test. This information should be in the clinic letter following your appointment. Please call 0117 414 1048 or 0117 414 0452 if you have any concerns or questions.
You must arrive with clean, dry hair with no grease, gel, wax, or other hair products.
You will be set up in the clothes you sleep in, and won’t be able to change during the test. Please make sure you bring suitable nightwear such as shorts, pyjamas, t-shirt, or tracksuit bottoms. Nighties are not suitable.

Are there any side-effects?

You will not feel anything during or after the recording. The machine records the normal natural activity seen during your sleep. After the equipment is removed, great care will be taken to remove as much of the glue as possible from your hair. Applying a hair conditioner and combing through your hair before having a shower or bath will help soften any glue left.

How long until I get my results?

The results will be sent to your GP/consultant. You will not receive any results during the test. Your consultant may send you a letter with the results or see you again for a follow-up appointment. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on 0117 414 1048 or 0117 414 1052 and a member of staff will be happy to help.

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient.

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

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Actigraphy leading into an overnight polysomnography (with MSLT)

Read more about Actigraphy leading into an overnight polysomnography (with MSLT)

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Please read this information carefully before coming in for your actigraphy leading into an overnight polysomnography.

What is an actigraphy?

Actigraphy is a non-invasive way to find out your sleep patterns by monitoring your rest and activity cycles over 1 or two weeks.

Why have an actigraphy?

If you are having problems with your sleep such as irregular sleep and wake times, or excessive sleepiness, you may be referred for an actigraphy test.

What happens during an actigraphy?

Actigraphy monitors movement over days or weeks in real life situations. It involves wearing a device like a watch which has an accelerometer that detects movements.

You will wear the watch on your wrist at all times for around 2 weeks and complete a diary sheet of your daily activities and sleep times. You must only remove the watch when you shower, bathe, or wash and then log this on the diary sheet. It is important that you remember to re-attach the watch after this.

You will press a button on the watch when you go to bed and when you wake up. This will be fully explained to you by the clinical neurophysiologist at your initial appointment. During this appointment, you will be given some diary sheets to write down your daily activities whilst wearing the watch.

After you have completed your period of actigraphy you must return the watch in person at the time specified in your letter. These watches are in high demand for use by other patients and failure to return at the specified time may result in the cancellation of other patient’s appointments.

Preparing for the test

You can eat and drink as normal before the test.
Please follow the guidance provided by your consultant neuropsychiatrist about reducing or stopping medications before coming for the test. This information should be in the clinic letter following your appointment. Please call 0117 414 1048 or 0117 414 0452 if you have any concerns or questions.
You will be asked if you understand this information and whether you consent to the test before we start. You are welcome to ask the neurophysiologist doing the test to give you any further information or to explain more about the procedures.
Your appointment should take around 10-15 minutes.

What is a polysomnography?

Polysomnography (also known as sleep studies) is a test used to diagnose sleep disorders. Electrodes and sensors are placed on the body and head to record different information that allows your sleep to be studied in detail for 1 or 2 nights. A video recording is taken during the study to help diagnose your sleep problem.

Why do a polysomnography?

The main reason is to try to classify (work out exactly) the problem you are having with your sleep so that the referring doctors can treat it more effectively.

What happens during the test?

Small discs (electrodes) are applied to your scalp, around your eyes, and under your chin. These will be attached with special glue, so they do not fall off in your sleep.

2 belts will be placed around your chest and abdomen (tummy) that measure your breathing, with additional boxes attached where the wires are connected. A nasal cannula will rest in your nose to also measure breathing.

2 sticky pads will be placed: 1 on your shoulder and 1 on your hip to detect your heart rate. A pulse oximeter will be placed on your finger to detect blood oxygen saturation. A movement sensor is placed on your arm and 1 on each of your legs to detect any movements in your sleep.

The equipment will stay in place until the end of the test, and it is removed by a neurophysiologist.

The night-time recording is started as close to your normal sleep time as possible. Wake time is usually before breakfast at around 08:30.

Preparation for the test

Follow these instructions carefully for the MSLT

Do not consume any alcohol, coffee, or stimulating drugs (medication) the night before or morning of the test.
Stop smoking at least 30 minutes before each test.
Do not doze off in-between the test sessions.

General preparation for polysomnography

Please follow the guidance provided by your consultant neuropsychiatrist about reducing or stopping medications before coming for the test. This information should be in the clinic letter following your appointment. Please call 0117 414 1048 or 0117 414 0452 if you have any concerns or questions.
You must arrive with clean, dry hair with no grease, gel, wax, or other hair products.
You will be set up in the clothes you sleep in, and won’t be able to change during the test. Please make sure you bring suitable nightwear such as shorts, pyjamas, t-shirt, or tracksuit bottoms. Nighties are not suitable.

How long until I get my results?

Are there any side-effects?

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on the numbers below and a member of staff will be happy to help.

0117 414 1048
0117 414 1050

Your responsibility as a patient

What if I am unwell or need to change my appointment?

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

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Visual Evoked Potential (VEP)

Read more about Visual Evoked Potential (VEP)

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Please read this information carefully before coming in for your Visually Evoked Potential (VEP).

What is a VEP?

VEP is a test that assesses the functioning of the visual system, from the eye to the brain along the optic nerve. A VEP is a non-invasive, painless procedure, that records the electrical activity of the brain in response to an alternating checkerboard screen.

Why do a VEP?

If you are experiencing changes to your vision in 1 or both eyes, a VEP may be requested to determine whether there is a problem with how the visual pathways are functioning.

What happens during a VEP?

Your VEP will take around 60-90 minutes. First your head will be measured and several small electrodes will be attached with sticky paste to your head. 2 other discs will be placed to the side of your eyes and 2 further sticky pad electrodes will also be attached below the lower eyelid of each eye.

You will be asked to sit comfortably in a chair and look at a black and white checkerboard screen which will be moving from side to side.

Full-field VEP

At first you will have both eyes open and look at the alternating screen whilst focusing on a red dot. As the test continues 1 eye and then the other will be covered with an eye patch. You will be asked to watch the screen for several minutes so that plenty of responses can be collected and averaged, which will give us a good understanding about how the optic nerve pathway is working. The brain will respond to the moving checkerboard stimulus and these waveforms will be recorded.

Half-field VEP

This is an extension of the first test. Again your eyes will be covered 1 at a time by an eye patch but at the same time half of the checkerboard screen will also be covered.

Flash VEP

Sometimes you may be asked to complete a third part to the test. A strobe lamp will be placed a short distance away and you will be asked to watch this lamp as it flashes. Once the recording has finished all electrodes will be removed and your head wiped with warm water.

Preparing for the test

You should arrive with clean, dry hair with no grease, gel, wax, or other hair products.
Continue taking all regular medication and eat as normal before the test.
You will be asked if you understand this information and whether you consent to the test before we start. At your appointment you are welcome to ask the physiologist doing the test to give you further information or to explain more about the procedure.

How long until I get my results?

Contact details

0117 414 1048
0117 414 1050

Your responsibility as a patient

What if I am unwell or need to change my appointment?

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

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Somatosensory Evoked Potential (SEP)

Read more about Somatosensory Evoked Potential (SEP)

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Please read this information carefully before coming in for your Somatosensory Evoked Potential (SEP).

What is an SEP?

SEP stands for somatosensory evoked potential. It is a test that assesses the function of the sensory nerve pathways from the arms and legs to the brain, rather than taking images as you would see following a scan. It is a non-invasive procedure, that records the electrical activity of the brain in response to a series of small electrical impulses on your wrists and ankles.

Why do an SEP?

If you are experiencing numbness, weakness, or other problems in your arms and legs you may be referred for a SEP to see if there are any problems affecting your sensory nerve pathways to the brain.

What happens during the test?

The SEP is usually split into 2 tests; an upper limb SEP where your wrist will be stimulated, and a lower limb SEP which involves ankle stimulation.

Each test will take around 45-60 minute. First your head will be measured, then a few small metal discs will be attached to your head, neck, collar bone, stomach, lower back, and behind your knees using a sticky paste, tape and possibly some glue.

Once everything is attached you will be asked to relax comfortably on a couch. Felt, stimulating pads are then attached either to the wrists or ankles. A small electrical impulse will then be applied to each wrist which will cause your thumb to twitch, this will then be repeated on each of your ankles causing your toes to twitch.

The series of impulses will continue for several minutes until all appropriate responses have been collected and recorded on the machine.

After the procedure the metal discs will be removed, and your head will be cleaned with warm water. If glue has been used, then some acetone (nail varnish remover equivalent) will be used to remove the discs.

Preparing for the test

Wear loose fitting clothing to give easy access to your neck, back, arms, and legs when applying the metal discs.
You should arrive with clean, dry hair with no grease, gel, wax, or other hair products.
Continue taking all regular medication and eat as normal before the test.
You will be asked if you understand this information and whether you consent to the test before we start. At your appointment you are welcome to ask the physiologist doing the test to give you further information or to explain more about the procedure.

Contact details

0117 414 1048
0117 414 1050

Your responsibility as a patient

What if I am unwell or need to change my appointment?

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

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Overnight polysomnography

Read more about Overnight polysomnography

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Please read this information carefully before coming in for your overnight polysomnography.

What is a polysomnography?

Why do a polysomnography?

The main reason is to try to classify (work out exactly) the problem you are having with your sleep so that the referring doctors can treat it more effectively.

What happens during the test?

Small discs (electrodes) are applied to your scalp, around your eyes, and under your chin. These will be attached with special glue, so they do not fall off in your sleep.

The equipment will stay in place until the end of the test, and it is removed by a neurophysiologist.

The night-time recording is started as close to your normal sleep time as possible. Wake time is usually before breakfast at around 08:30.

Are there any side-effects?

Preparing for the test

Please follow the guidance provided by your consultant neuropsychiatrist about reducing or stopping medications before coming for the test. This information should be in the clinic letter following your appointment. Please call 0117 414 1048 or 0117 414 0452 if you have any concerns or questions.
You must arrive with clean, dry hair with no grease, gel, wax, or other hair products.
You will be set up in the clothes you sleep in, and won’t be able to change during the test. Please make sure you bring suitable nightwear such as shorts, pyjamas, t-shirt, or tracksuit bottoms. Nighties are not suitable.
You will not be able to shower or bath during the monitoring period while the equipment is attached. This will be 1 or 2 nights and the equipment will stay in place for the whole time (including during the day).

Contact details

How long until I get my results?

Your responsibility as a patient

What if I am unwell or need to change my appointment?

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

Support your local hospital charity

See the impact we make across our hospitals and how you can be a part of it.

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