Merrill's Atlas Vol 1 CH 1

• Radiographer

  A radiologic technologist who administers ionizing radiation to perform radiographic procedures requested by a licensed medical practitioner
• ARRT Standard of Ethics

  Includes the Code of Ethics and the Rules of Ethics
• Code of Ethics

  Consists of 10 statements that serve as a professional behavior guide for radiologic technologists
• Rules of Ethics

  Mandatory standards of minimally acceptable professional conduct
• Tech responsibility for care of exam room

  • Keeping room and all equipment clean
  • Preparing room prior to patient arrival
• Standard Precautions

  Designed to reduce the risk of transmission of unrecognized sources of pathogens
• When techs should wash their hands

  • Before and after working with each patient
  • After examining patients with known communicable diseases
  • After encountering blood or body fluids
  • Before beginning invasive procedures
  • Before touching patients who are at risk of infections
• Types of motion

  • Involuntary (heartbeat, chills, peristalsis, tremor, spasm, pain)
  • Voluntary (nervousness, discomfort, excitability, mental illness, fear, age, breathing)
  • Equipment
• Ways to control voluntary patient motion

  • Giving clear instructions
  • Providing patient comfort
  • Adjusting support devices
  • Applying immobilization
• Imaging Receptors

  Devices that receive the energy of the x-ray beam and form the image of the body
• Types of Imaging Receptors

  • Solid State digital detectors
  • Photostimulable storage phosphor image plate (PSP IP)
  • Fluoroscopic Image Receptor
  • Cassette with film
• Image Receptor Placement

  • Lengthwise (portrait)
  • Crosswise (landscape)
  • Diagonal
• Accessory Equipment

  • Positioning aids
  • Grids
  • Compensating Filters
• Technical Factors radiographers can control

  • Milliamperage (mA)
  • Kilovolt peak (kVp) (dose amount)
  • Exposure time (seconds)
• Exposure Technique and Charts

  specifies projections performed in room and exposure factors for each projection
• Central Ray (Principal Beam)

  Central ray is always centered to the anatomy of interest and the image receptor, the general goal is for the central ray to be perpendicular to the part and IR to minimize distortion
• Source-to-Image Receptor Distance (SID)

  The distance from the anode inside the x-ray (source) to the image receptor, it affects magnification, spatial resolution, and patient dose
• SID standardized for examinations

  • 40 inches (102 cm)
  • 48 inches (122 cm)
  • 72 inches (183 cm)
• Source-to-Skin Distance (SSD)

  The distance from the anode inside the x-ray tube (source) to the patients skin
• Collimating of Radiation Field

  Radiation field must be restricted to irradiate only the anatomy of interest, to minimize patient exposure and reduce scatter radiation
• Shuttering (Black Masking)

  used to provide black background around a collimated exposure field, not for cropping
• Anatomic Markers

  • Each radiographer must include an appropriate marker that clearly identifies the patient's right or left (R) or (L)
• Radiograph

  The image recorded by exposing an image receptor to x-rays
• Image Display

  Radiographs usually viewed in anatomic position, exceptions include hands, fingers, wrists, feet, and toes which are viewed for perspective of the x-ray tube with distal ends towards the ceiling
• Required information on all radiographs

  • Date
  • Patient's name or ID number
  • Right or Left side marker
  • Institution identity
• Obese Patients

  measured by body mass index (30 to 39.9 is obese, 40+ is morbidly obese)
• Equipment Considerations for Obese Patients

  • Radiographic table has a weight limit
  • Fluoroscopy towers have a maximum diameter
  • CT and MRI scanners have diameter limits
• Transportation Considerations for Obese Patients

  • Larger wheelchairs and transport beds or stretchers needed
  • risk of injury to the radiographer and healthcare team during movement and positioning
  • Always be sure adequate personnel are available to assist
  • Transfer by sliding or high-capacity power lifts
• Communication Considerations for Obese Patients

  • Communication is key, empathic communication is essential
  • Explain personnel required to safely move and/or transfer, communicate each part of the transfer process
  • Explain positioning required for imaging procedure
• Techs are responsible for patient care during all imagine procedures

  • Properly preparing patient
  • Provide detailed explanation of procedures
  • Obtain patients clinical history
• Radiologic Practice Standards

  the necessary education and certification including the radiographer's scope of practice, written and maintained by the ASRT
• Which IR placement is used the most often

  Lengthwise (portrait)
• what are the purpose of grids

  to reduce scattered radiation to the IR
• Compensating Filters

  create more uniform image brightness due to varied tissue thickness and part density
• SID traditionally used on most examinations

  40 inches (102 cm)