procedures per patient
prep the room
ensure room is clean
- no dirty linens
-everything wiped down
-clean linens on bed
-positioning aids available
-pull up patient in the computer
procedures per patient
image receptor
AKA detector,plate, cassette
-device that captures x ray as it leaves the patient
-3 IRs in imaging
1) digital imaging ( common)
2) computed radiography (phasing out)
3) film (obsolete)
procedures per patient
IR sizes
selection based on body part size.
always use smallest plate possible for the body part being imaged
most common CR plate sizes
8” X10”
10” X 12”
14” X 17”
digital plate sizes
10 X 12
14 X 17
17 X 17
procedures per patient
confirm patient
before examining the pt verify you have correct pt
-check name and DOB
-compare wrist band to requisition
-verify exam
-gain consent
-obtain pt history relative to exam (for radiologist)
procedures per patient
explain exam
every exposure will have specific breathing and positioning instructions needed
-where do they lay/ stand
-how should they lay/ stand
-how long in the dept
-is rotation needed/ how much
-are breathing instructions needed
procedures per patient
prepare and change patient
remove all obscuring items
- clothing or jewlery that will create artifacts on the area of interest
-all metal objects show up as bright white on the x-rays
procedures per patient
set technique factor
xrays are produced from very high energy interactions within the xray tube
technical factors include
-kVp (voltage)
-mAs (current)
procedures per patient
set distance
distance based on inherent geometric properties of anatomy being imaged
-common SID (Source to Image Distance)
40”
72”
procedures per patient
align CR and IR
CR= central ray
-center of x-ray beam
IR= image receptor
-image detector or plate
Improper alignment may result in image artifacts and poor exposure/ quality
procedures per patient
position the part
xrays are 2 dimensional images of a 3 dimensional part
-2 or more images at 90 degrees from eachother are often required to get a comprehensive exam
-specific to anatomy being imaged
procedures per patient
collimate
box like structure attached to the x ray tube housing with light source
-contains lead shutters
-shutters can change the size and shape of xray beam
-critical role in image quality and radiation safety
collimation best practices
only expose the ROI (region of interest)
-use smallest possible feild size
-re-collimate for each new patient or projection
-ALARA standard
procedures per patient
side marker
lead marker
-legally must be placed on every x ray image at time of exposure
-should indicate anatomic side
-always view in anatomical position
procedures per patient
shielding
lead shields provide protection for the patient’s gonads
-all pts of child bearing age should be shielded
procedures per patient
breathing instructions
suspend
suspend on inspiration
suspend on expiration
-minimizes motion
procedures per patient
expose
after instructions are given, make exposure
- techs should always keep eyes on the patient during exposure
procedures per patient
evaluate image quality
radiographer should ensure the image is good before releasing the patient
procedures per patient
send image
after evaluation send image to PACS
=picture archival and communication system
-system where all images and radiologist reports are housed
procedures per patient
return and clean
ensure patient has everything they need prior to leaving room
- answer any questions you can
-clean the room before you leave = linens in bin, sponges put away, wipe all equipment
