mobile radiography

what are possible reasons for mobile imaging

•Any medical condition the clinician indicates as a threat to patient stability or deterioration to health status

•Post operative

•Post resuscitation

•Severe trauma

•Haemodynamically unstable

•Ventilated patient

•Intubated

•Multi-organ failure

•Multiple co-morbidities

what are the different levels within the special care baby unit (SCBU/NICU)

1)SCBU – Low dependency

  Treat low temp/blood sugar

  Help with feeding

  Jaundice

  Monitoring and oxygen

  Babies unwell after birth

2) Local neonatal unit

  Short term intensive care

3) NICU   Neonatal Intensive Care

  Ventilated patients

  Surgical patients

what are patient considerations in the ICUU/NICU

Patient in ICU = Physiological crises threatening 1 or more body system / life

•Care centred on supporting failed systems

Patients often experience stress:

•Physiological – on the body due to the illness

•Psychological – result of negative emotion

Both stimulate the fight or flight response;

•Increased HR

•Increased respiration rate

•Fluid retention

how can you reduce patient anxiety

•Empathic touch - not Sitting patient forward, Gripping patient, Pushing IR

•Control of environmental stressors - not cold IR or loud voice

•Providing choices to enhance control - did we ask the patient first?

•Music

•Relaxation techniques

anti - anxiety medication

what is a person centred approach?

•SOR guidelines include 15 core values

•Introduce yourself, tell me who you are and what your role is

•Treat me as an individual, explain the purpose of the procedure in reference to my case

•Find out what is important to me

•What are my concerns

•Talk to me in a language I understand!

•Provide me with patient information and check I am informed enough for consent

•Ensure I understand your role and make me feel confident and safe in your care

Consider my dignity and modesty

what are the steps to prep prior to undertaking a mobile exam

• •READ X-RAY REQUEST FORM

• •CHECK DETAILS ARE CORRECT

• •CHECK THAT IT IS SIGNED

• •LOOK AT PREVIOUS X-RAY FILMS / REPORTS

• •RING WARD PRIOR TO LEAVING THE DEPARTMENT TO CHECK THAT IT IS CONVENIENT TO GO UP

• •CHECK TO SEE WHERE MOBILE MACHINE IS LOCATED - STATE WHERE YOU ARE MOVING IT TO

• •TAKE REQUIRED NUMBER OF IR FOR THE EXAMINATION & OTHER ACCESSORY EQUIPMENT e.g. foam pads

• •REPORT YOUR ARRIVAL TO WARD SISTER

• •CHECK LOCATION OF THE PATIENT

• •CHECK IDENTITY OF PATIENT

• •TELL THE PATIENT WHO YOU ARE AND WHAT YOU ARE GOING TO DO BEFORE BRINGING IN THE MOBILE MACHINE

• OBSERVE ASEPTIC PRECAUTIONS

summary

•Receive the request and justify

•Check previous images & contact ward

•Preparation

•Arrival on the ward: inform staff, assess & communicate with patient

•Set up equipment & get help (if required)

•Consider infection prevention & radiation protection - collimate beam and record exposure factors

•Position patient & equipment

•Evaluate image

how do you angle the tube

The light beam diaphragm should be parallel to the IR with a slight caudal tilt

what is the centring point

Centre: midway between sternal notch & xiphisternum

 

   (= approximately middle of plate, if positioned correctly)

  Central ray: midline and perpendicular to the patient and  the median sagittal plane