Final- MI 237

medical intensive care unit (MICU)

critically ill pt

surgical intensive care (SICU)

post surgery for long stay pt

intermediate unit (IMU)

step down unit from ICU

pt is closely monitored

PACU

after anethesia

NICU

neonates w/ life threatening issues or premature infants

column

what is #1?

telescoping arm

what is #2?

kVp/mAs setting

what is #3?

cassette or wireless IR

what is #4?

touchscreen computer

what is #5?

light box & collimators

what is #6?

tube

what is #7?

portable techniques

flip book located in the bin w/ detectors

use calipers to measure body thickness

change kVp by 2 every 1 cm in body thickness

what is the varibale kVp technique we use on portables?

touch screen

techniquess default (will have to reset)

what to do when the detector enters sleep mode?

through central ray/body the same direction as beam will travel

how to measure using the calipers?

bottom

what number do u read when measuring w/ caliper?

39.4’’

what is the SID conversion for 1M?

59”

what is the SID conversion for 1.5 M?

78.7’’

what is teh SID conversion for 2 M?

shimadzu/philips

what portable has beam restriction w/ the SID marked in meters?

> or equal to 30 cm

what is the shimadzu port chest measurement guidline for a grid?

> or equal to 10 cm (minimum kVp of 60)

what is the ASRT extremity measurement guidline for portables?

always add a grid, unless its a ped pt

what is the rule for port abdomen projections?

high frequency

what type of generator is a portable?

minimum of 6ft (2m)

when possible right angle to pt/primary beam away from tube

where to stand when doing portables?

tube must be perpendicular & center

technique must be increased

what are the grid rules?

mAs

what do u multiple to get the correct technique when going from no grid to grid?

inverse square law → distance

what is the most effective means of protection?

min SSD 12’’ (30 cm)

what is the pt protection for mobile imaging?

every day

when should the portable equiment be cleaned?

obtain RN for help

if the pt is in restrains, what is an addition step in the processing of getting images?

verify pt info using wrist bracelet

communicate w/ pt throughout the procedure

what to do if the pt is unconscious, sedated or confused?

ask MD/RN before every removing any splints/immobilizers

use blankets, pillows or sponges to support limbs

what to do if pt has limited mobility or painful range of motion?

use two people to hold/lift part & place on IR carefully

what to do if pt has a known fracture?

never move a collared pt w/out a nurse or physician present or hold pt head

what is the number 1 rule when doing a spinal precautions on trauma pt?

never leave the detector under the pt during cardiac arrest

what the rule if pt goes into a code during the process of doing a moblie study?

newborn

what does neonate mean?

born before 37 weeks gestation

what is the general timeframe for a premature infant?

30 seconds

how long should u wash ur hand before caring for a NICU pt?

use a pump of avaguard (surgical hand sanitizer)

after washing ur hands, what else do u need before handling NICU pt?

air in the lungs

pneumothorax

air

if the chest tube is on the higher end of the lung, what is it mostly used for?

fluid

if the chest tube is on the lower end of the lung, what is it mostly used for?

must be wiped down

when it comes to equipment, what must u do before entering NICU?

9 X 11

what is the size of the digital detector for NICU?

1-2’’ above carina

where should a ET tube placement be?

right main bronchus (wider & straighter)

if placed incorrectly, where does the intubation tube end up?

superior vena cava (SVC)

where does a PICC end?

cephalic, median cubital, brachial

what are the veins where a PICC line can be enter?

disposable

what type of markers do we use in the NICU?

pt are RPO 15 degrees

mark side down

must include shoulder

SID 45’’

what is the positioning notes for a PICC line x-ray?

in tray or directly under the pt

where do u place the IR for a NICU study?

subcavlian

what is the most common vein to insert a central line?

laterally

for a supine NG tube chest, in which direction do u want to pull out the wires?

national emergency

a state of emergency resulting from a danger or threat of danger to a nation from foreign or domestic sources & usually to be in existence by governmental authority

natural & technological disasters

major transportation accidents

terrorism

nuclear, biological, chemical & radiologic events

what are examples of local emergencies?

emergency operations plan

facility’s documentation of their strategies for dealing w/ disasters

should be address each phrase of disaster

communication, resources & assets, safety & security, staff responibilities, utilities, clinical activities

what should be include in a good EOP?

mitigation, preparedness, response, recovery

what are good EOP phrase of disaster management?

leadership, nursing, radiology, security

what are institutional roles in emergencies?

leadership

activates command center, allocates resources

nursing

pt triage, monitoring, communication

radiology

rapid imaging for trauma & screening

security

crowd control & internal movement

8222

what is the extension to contact sercurity command center?

the SCC

what does the elevator emergency button & outside blue kiosk go to?

charles sullivan auditorium

where is the SHS designated interior evacuation area?

upper parking lot

where is the SHS designated exterior evacuation area?

employee cafteria

TJ auditorium

where is the main hospital campus designated evacuation area?

faculty will notify you

should keep the faculty aware of ur location at all time

do not return to the campus unless instructed

if an event occurs & ur at an outpatient, you should?

remain on campus

faculty will notify u & provide further direction

if an event occurs & you are on campus, you should?

remain on campus

follow the direction of the scheduled instructor

if an event occurs & u are attending class at the school, you should?

trauma

a physical injury or wound caused by external force & violence

sudden, unexpected, dramatic, forceful or violent event

trauma center

a regional hospital capable of providing care for critically injured pts

surgical team is on-site 24 hours basis

radiologic technologists

pt cannot move into the usual routine positions

major adaptation of CR angles & IR placement is needed

level 1

most comprehensive multidisciplinary emergency medical care available

all staff are immediately available 24/7

university based → research facility or large medical center

level 2

initiates resuscitation & stablization for all pts

specialists may not be available on site

NOT a research or teaching facility

level 3

ED staff immediately available to provide initial evaluation

→rapidly initiate;s resuscitation & stablization

prompt availability of surgeons for emergency operations

medical/surgical inpatient service available to pts who can be maintained w/out specialized care

transfer to higher level facility after stabilization

level 4

often small & located in rural areas

provide initial care & stablization while arranging transfer to high level facility

pediatric trauma center

highest level of care for peds w/ complex injuries

same as level adult 1

CHOP, Hershey, St. Chris (tower health) → philadelphia

examples of peds trauma centers

speed

produce quality image in the shortest amount of time possible

accuracy

accurate images w/ as little distortion as possible

quality

do not use pt’s condition as an excuse for poor images

attention to detail

continually asses the pt

observe for signs of impairment or change in mental status or vital signs

status can change quickly

anticipate

know what view will most likely be needed & get ready

quality image performed in a timely manner are essential

care is taken when working around O2 tubing, IV tubing, ventilators, etc

positioning

minimum of 2 views (90 degrees)

ideally all views if possible

adhere to standard precautions

gown, gloves, masks, goggles as needed

cover IR/sponges

professionalism

HIPPA

communication

verbal/non-verbal

obtain history from pt, doctor, nurse or paramedics

if the pt is conscious→ explain the exam in detail & maintain eye contact

immobilization

do NOT remove from ED/trauma pt w/out physician/RN’s ok

remember to document if it stays on

ace bandages or slings

what are immobilizations can we remove w/out doctor’s permission?

pt’s ROM prior

before removing ace bandages or slings, what should be checked?

contusion

a “bruise” type injury w/out a fracture or a break in the skin

abrasion

scraping away of skin or mucous membrane

laceration

a cut or open wound in the flesh

sprain

forced wrenching or twisting of a joint resulting in partial rupture or tearing of supporting ligaments

fracture

break in a bone

compound (open) fx

broken bone breaks through the tissue