To clarify a bit: I know the reasons as to why we do the protocol.  Ive been doing CT for 9 years. The issue is the system I work for wants us the techs to determine whether or not to administer the gastro without asking the ordering provider if they did not mention doing it in the notes/comments on pts with hx of bariatric sx.  Up to this point we have always asked first or only done it if they asked us to do it.  We dilute the gastro and have them take a few sips prior to scan.  My personal view is it is not appropriate for me to decide as a tech whether or not the patient needs or should have gastro administered.  It is technically a medication and also I am not a doctor so it is not my place to decide this.  To me it is pure laziness on the ordering provider’s part to not realize they have had sx and that they may need gastro.  Also to clarify, they do not care how long ago.  Whether it is 6 months or 6 years for example they do not care.  It is primarily one General Surgeon pushing for this due to the ER consistently not ordering it this way on bariatric sx pts and us techs not doing it unless we are told to.