PATIENT CARE IN RADIOGRAPHY

1
PATIENT CARE IN RADIOGRAPHY

• CLASS 1
• REFERENCES
• ERHLICH

2
RADIATION!!!!!!!!!!!!!!!!!

• When the term radiation is used, it generally
  evokes concern and a sense of danger
• Introduction to Radiology Technology and Patient
  Care, Adler and Carlton 1999

3
HISTORY NOV. 8, 1895

• WILHELM CONRAD ROENTGEN
• SIR WILLIAM CROOKS
• X
• WILLIAM COOLIDGE
• H.C.SNOOKS
• THOMAS EDISON
• CLARENCE DALLY
• GEORGE EASTMAN

• DISCOVERED X-RAYS
• CATHODE RAY TUBE
• UNKNOWN ENERGY
• HOT CATHODE RAY TUBE
• ELECTRICAL SUPPLY
• FLUOROSCOPY
• ROENTGEN MARTYR
• PLASTIC FILM

4
RADIATION INJURIESEARLY 20TH CENTURY

• SKIN BURNS
• HAIR LOSS
• ANEMIA
• TO BOTH PT AND DOCTOR

5
HISTORY OF RADIOGRAPHERS

• PHYSICISTS
• OJT (TECHNICIANS)
• HOSPITAL BASED PROGRAMS
• COMMUNITY COLLEGES

6
OVERVIEW OF RADIOLOGY AND RADIOGRAPHIC
PROCEDURESWHAT DO YOU ALREADY KNOW?
7
HOW ARE X-RAYS PRODUCED?http//www.oucom.ohio.edu
/dbms-witmer/anatomy_immersion.htm
8
X-RAY PRODUCTIONAN OVERVIEW

• VACUUM TUBE----WHY?
• SOURCE OF ELECTRONS (TUNGSTON)WHY?
• TARGET (TUNGSTON) WHY?
• HIGH POTENTIAL DIFFERENCE(VOLTAGE) WHY?

9
RAD. TERMS/FACTS

• ELECTRON CLOUD
• SPACE CHARGE
• 99 HEAT
• 1 X-RAY
• WAVELENGTHS
• AMPLITUDE
• FREQUENCY
• SHORTER THE WAVELENGTH ,THE HIGHER THE FREQUENCY

10
ELECTROMAGNETIC RADIATION

• GAMMA
• X-RAY
• VISIBLE LIGHT
• MICROWAVES
• RADIO WAVES
• COMPARE THE WAVELENGTH (SHORTER OR LONGER?) THE
  FREQUENCY (LONGER OR SHORTER) OF THESE ENERGIES
  TO X-RAYS

11
X-RAY VS VISIBLE LIGHT

• TRAVEL IN STRAIGHT LINES
• AFFECT PHOTOGRAPHIC EMULSIONS
• CAN PRODUCE HARMFUL EFFECTS TO BODY

• TRAVEL IN STRAIGHT LINES
• AFFECT PHOTOGRAPHIC EMULSIONS
• CAN PRODUCE HARMFUL EFFECTS TO BODY

12
X-RAY VS VISIBLE LIGHT

• WHAT IS THE DIFFERENCE?

13
IONIZATIONITS NOT AS BAD AS IT SOUNDS!!!!
14

• Ionization is the process of when a neutral atom
  loses or gains an electron. When the loss or gain
  occurs, a net charge is produced. Ionization
  can disrupt matter.

15
SOURCES OF IONIZING RADIATION Bushong, pgs 5-6

• MAN-MADE
• X-RAYS
• NUCLEAR POWER /WASTE

• NATURAL
• COSMIC
• RADIOACTIVE MATERIAL IN EARTH
• POTASSIUM 40

16
THE X-RAY BEAM

• Small area of target
• Cone shaped
• Primary beam
• Radiation field
• Central ray
• collimator

• Scatter
• Why is called that?

17
RETURN TO SCAVENGER HUNT RESULTS AND REVIEW

• Add the following to your scavenger hunt notes
• DISTANCE
• SID AND OID
• DENSITY
• mA, mAs
• CONTRAST
• kVp

18
UNITS OF MEASUREMENT IN RADIOGRAPHYTRADITIONAL
SI UNIT

• ROENTGEN
• RAD
• REM
• CURIE
• MILLI- 1000TH OF A UNIT

• COULOUMB
• GRAY
• SIEVERT
• BECQUEREL

19
Weighting Factor

• Useful for measuring occupational dose
• Look at the table 1-3 on page 29which of these
  ionizing radiation do you think would produce the
  most harm?
• Why?

20
Brief overview of radiobiology

• Laws of Bergonie and Tribondeau pg 30 in Ehrlich
• Age
• Differentiation
• Metabolic rate
• Mitotic rate
• Effects
• Short term/Long term somatic
• Genetic

21
KEEPING SAFE

• We just discussed a method of recording
  radiationhow do we keep this exposure to its
  lowest level
• QUIT THE PROGRAM??????
• Nothere are better ways!!!!!

22
MEASURING RADIATION FOR THE RADIOGRAPHER

• FILM BADGE
• TLD
• OSL
• CONTROL
• 5 rem per year
• 1 rem x age is cumulative dose limit

23
Cardinal principles of protection

• TIME
• DISTANCE
• SHIELDING
• DESCRIBE HOW THESE APPLY TO BOTH PATIENT AND
  OCCUPATIONAL WORKER?
• PRIMARY BEAM AND CR

24
ALARA

• AS
• LOW
• AS
• REASONABLY
• ACHIEVABLE

25
PATIENT PROTECTION

• ERRORS
• REPEATS
• COLLIMATION
• HIGHEST KVP. WHY?
• FAST SCREEN/FILM
• AT LEAST 40 SID

26
Patients are frightened about radiation

• What can we say or do to educate them?

27
OCCUPATIONAL PROTECTION

• YOU TELL ME!
• .5MM LEAD SHOULD ATTENUATE 90 OF RADIATION AT 75
  kVp
• Thyroid shields

28
ROSE AEHLE RT (R,M)

• Appendix A

29
WHAT DO RADIOGRAPHERS DO?

• WHAT IS OUR SCOPE OF PRACTICE?

30
CHAPTER 12, EHRLICH

• In addition to radiographers being trained in the
  OR, in trauma radiography and in mobile
  radiography they can cross train in
• SPECIAL IMAGING MODALITIES
• CARDIOVASCULAR AND INTERVENTIONAL RADIOGRAPHY
• CT
• MRI
• MAMMOGRAPHY
• DIAGNOSTIC MEDICAL SONOGRAPHY
• NUCLEAR MEDICINE
• POSITRON EMISSION TOMOGRAPHY

31
THE PROFESSION

• ACRONYMS YOU NEED TO KNOW
• PACS
• ASRT
• ARRT
• ACR
• CARE
• JCAHO
• JRCERT

32
DESCRIBE THE TYPE OF PATIENT YOU MAY HAVE TO X-RAY

• BODY HABITUS
• PHYSICAL CONDITION
• EMOTIONAL CONDITION
• AGE
• OTHER FACTORS