Radiographic Techniques&Procedures

RADIOGRAPHIC TECHNIQUES&PROCEDURES

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Definitions of terms

Medical Imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention and some function of the organs and tissues Radiographic techniques and procedures are the protocols used by the Radiographer to produce radiographic image.

Radiography is the process of taking radiographs to assist in medical diagnosis and treatment.

Radiograph is the end product of the radiography in visible radiographic image.

Radiographer are medical professionals who specialize in the imaging of human anatomy for the diagnosis and treatment of the pathology

Radiographic Techniques&Procedures

Projections/ views, these are used in defining the direction of the rays passing through the body e.g AP, PA, Lateral, Oblique.

BASIC PRINCIPLES OF RADIOGRAPHY

The radiographer has a duty of care to the patient and must treat them with respect and ensure their dignity is maintained.

It is essential that the radiographer establishes a rapport with the patient and carers.

The radiographer must introduce themselves to the patient/carer and inform them of their role in the examination.

They must make sure the request form is for the patient being examined and that the clinical details and history are accurate.

Radiographic Techniques&Procedures

There are 3 stages to undertaking an X-ray examination, preparation, the radiographic procedure itself and follow up from the examination undertaken.

• Preparation for the examination:
• The request form.
• The X-ray room.
• The patient, including consent for the examination and identity checks. Three P(s) must be observed during patient preparations

physical, psychological and physiological preparations.

Undertaking(During) the examination:

• Patient care.
• Radiographic procedure.
• Radiation protection

Post-examination and aftercare:

• Image quality.
• Patient aspects.
• Imaging informatics.

PREPARATION FOR THE EXAMINATION

• The request form

Ensure the examination requested is authorised and signed with a suitable rationale.

• Make sure the request card has a justifiable clinical reason for the X-ray, e.g. history of injury and pain in knee joint.
• Any examination using X-rays must affect the management of the patient.
• Check the protocol for the examination.
• Make sure you know which projections are required, e.g. AP and Lateral of the knee.

PREPARATION OF THE X-RAY ROOM

• Make sure the X-ray room is clean, safe and tidy, ensure that the floor is clear and the X-ray tube is not in a position where the patient can walk into it.
• Set a preliminary exposure for the examination, i.e. X-ray tube focus size, mAs and kV.
• Have any accessory equipment available, e.g. foam pads.

PREPARATION OF THE PATIENT

• Patient’s full name, date of birth and address.
• Correct examination requested and reason for the X-ray.
• Is the patient fit and ambulant or have any physical needs? If applicable ensure the patient is undressed and dress them in a radiolucent gown.

The patient is asked:

• If they understand the nature of the examination and if they have any questions prior to proceeding.
• For verbal permission to proceed with the examination.
• For written consent if an examination incurs a higher risk, e.g. angiography

• Understand the risk versus benefit.

• Understand the nature of the examination and why it is being performed.
• Understand the consequences of not having the examination.
• Be able to make and communicate an informed decision.

PATIENT CARE DURING EXAMINATION

At the commencement of the examination introduce yourself to the patient and ask permission to take the X-ray. If the patient has been prepared for the examination, check they have followed the instructions, e.g. undressed appropriately and in a gown, nil by mouth or any other preparation.

• Check the pregnancy status of the patient.

• Check for the patient’s infection status, to prevent cross infection by appropriate methods.
• Visibly clean hands in front of the patient before you start the procedure.
• Patient identity.

RADIOGRAPHIC PROCEDURE

• The patient is positioned accurately in relation to the examination being undertaken.
• The X-ray tube is positioned and centred to the patient and image receptor.
• The beam is collimated to the area of interest.
• Appropriate radiation protection is carried out.
• An anatomical marker is correctly applied to the image receptor
• Radiographers and other staff/carers stand behind the lead glass protective control screen and exposure undertaken after the exposure factors confirmed on control panel.

POST-EXAMINATION AND AFTERCARE

Immediately following image acquisition the image will be reviewed to ensure it is of diagnostic quality; the patient will be managed and be given instructions as to what to do next and the examination will be completed in terms of the imaging information of the X-ray procedure.

Image quality

• The image is reviewed using the ‘10-point plan’:
• Patient identification.
• Area of interest is included.
• Markers and legends.
• Correct projection.
• Correct exposure indicator

6. Optimum definition – can you see the detail of the relevant anatomy/structures, i.e. is it sharp?

• Collimation is restricted to the area of interest.
• Are there any artefacts and are they obscuring anatomy?
• Any need for repeat radiographs or further projections.
• Anatomical variations and pathological appearances

GENERAL PRINCIPLES OF RADIOGRAPHY OF THE SKELETAL SYSTEM

• Two views should be taken at the right angle to each other
• At least one joint should be included in limbs radiography
• Immobilizing the pt

The easiest and less projection should be done first

INDICATIONS FOR SKELETAL SYSTEM RADIOGRAPHY

TRAUMA

PATHOLOGICAL CONDITIONS

FORENSIC CASES