Portable - Online Lecture

Define mobile.

• Capable of being moved

• When pt’s condition is too critical, or their injuries are too severe, mobile (portable) x-ray machines may be used to take x-rays in the pt’s room

• Can be performed on any part of body

Define trauma.

Is an injury that can be caused by an outside force

Define emergency.

A medical condition requiring immediate treatment

Portables all emit _____ ______ during exposure.

ionizing radiation

• no led line walls

Describe a C-arm (list 3 types).

All emit ionizing during exposure

• Mini C-arm

• C-arm

• O-arm

Describe a C-arm.

Must have a technologist immediately present

Describe a mini C-Arm.

Can set up and leave it for the doctor to run

Describe an O-arm.

Must have a technologist immediately present

• Most efficient

What are the 5 main features of a portable?

Power source, safety, drive control, IR holder (s), exposure switch with 6-ft cord

What are the features of the power source of the portable?

Battery power (rechargeable battery)

High frequency generator

• more consistent kVp @ mAs reading

• more affordable

• smaller, trending now

• allows for lower dose

What are the features of safety of the portable?

a. Circuit breaker

b. Break

What are the features of drive control of the portable?

a. Touch sensitive handle

Where is the IR holder?

The exposure switch is connect to a ___ foot cord.

6

What are the other features of the portable near the screen?

1. Light button

2. Collimator controls/knobs

3. Tower locks/release

What are some positioning aides?

Decubitus board (build off mattress when doing decub), sponges, or medical tape

What are the 3 cardinal rules for radiation protection?

Time, distance, shielding

Describe the cardinal principle of time.

• Decreasing time near/around radiation reduces your overall dose

• Students should NEVER hold pts

• Exposure & dose = directly related

Describe the cardinal principle of distance.

• Increasing your distance away from the pt is the MOST EFFECTIVE way to reduce your dose

• Inverse square law

Describe the cardinal principle of shielding.

• Each portable should have at least one lead apron

• Ask visitors & other non-essential staff to leave room during exposure

• Shield pt when protocol allows

• Always announce your exposure prior to taking the exposure

• Lead aprons only work if you use them

What are the technical factors for a portable chest (AP & decub)?

• 72” SID

• Grid recommended

• 14×17 portrait or landscape

• CR: 90-95 kVp @ 4-6.5 mAs (no grid) & 125 kVp @ 5-12.5 mAs (Grid)

• DR: 90 kVp @ 2-3 mAs (no grid) & 117 kVp @ 3-8 mAs (Grid)

What is the pt position for an AP portable chest?

• Supine/semi-erect on cart

• Roll pt’s shoulders forward if condition allows

What is the pt position for a decub portable chest?

• Cart or bed is locked

• Cardiac board/radiolucent pad/sponge directly under pt’s side

• Lying on side indicated RLD = lie on R side, LLD = lie on left side

• Chin extended

• Both arms raised above head

• Coronal plane parallel to IR

• AP: back against IR

• PA: Chest against IR

What is the part position for an AP portable chest?

• IR behind pt, align center of IR to CR (top of IR about 1.5 inches above shoulders

• Center pt to CR & IR

• Roll pt’s shoulder’s forward if condition allows

What is the part position for a decub?

• IR height centered to thorax

• Adjust pt and cart to midsagittal plane & level of T7

• Top of IR approximately 1 inch above vertebra prominens

• Pts must lie on their side for 5 mins before exposure

Where is the CR for an AP portable chest?

• CR is perpendicular to long axis of sternum directed to T7 (3-4” below jugular notch) perpendicular to IR

• Supine pt: angle CR 3-5 degrees caudal

Where is the CR for a decub portable chest?

• CR is horizontal directed to center of IR at level of T7 (3-4”) inferior to level of jugular notch

• Top of border of light at vertebra prominens

What is the collimation for an AP & decub portable chest?

Tight collimation 4 sides to area of lung fields

• Use BB marker or supine marker (if supine) or upright marker (semi-erect)

• Mark the side up for a decub

What is the respiration for an AP & decub portable chest?

Make exposure at end of second full inspiration

What are the technical factors for an AP Supine & LLD abdomen?

• 40” SID

• Grid

• 14×17 portrait or landscape

• CR: 80 kVp @ 50-100mAs

• DR: 80 kVp @ 8-40mAs

• Include decub and upside markers, mark side up

What is the pt position for an AP portable Supine Abdomen?

• Supine on cart

• Arms abducted from body

What is the pt position for a LLD portable abdomen?

• Cart or bed is locked

• Cardiac board/radiolucent pad/sponge directly under pt’s L side

• Pt lying on L side

• Both arms raised above head

• Coronal plane parallel to IR

• AP: back against IR

• PA: Chest against IR

What is the part position for an AP portable Supine Abdomen?

• Center IR at level of iliac crests

• Ensure both sides of abdomen are equal distances from edge of IR

• May need to place something under parts of IR to ensure IR is perpendicular to CR

What is the part position for a LLD portable abdomen?

• IR height centered to the abdomen

• Adjust pt and cart to midsagittal plane at approximately 2” above the level of the iliac crests

• Top of IR approximately axilla

• Ensure the diaphragm and upper abdomen are included

• Ensure IR is perpendicular to CR

• Pt must like on side for 5 mins before exposure

Where is the CR for an AP portable Supine Abdomen?

• CR is perpendicular to level of iliac crests and to center of IR

• Check for IR tilt (autofirm button)

Where is the CR for a LLD portable Abdomen?

• CR horizontal directed to center of IR

• Center of CR should be 1-2” above iliac crests

• Ensure no rotation

What is the collimation for an AP Supine portable abdomen?

• Collimate to field of view or collimated on all 4 sides to anatomy of interest

• Must include symphysis pubis

• Use marker with BB’s or supine marker

What is the collimation for a LLD portable abdomen?

• Collimate to field of view or collimate on all 4 sides to anatomy of interest

• Must include elevated side of abdomen

What is the respiration for an AP Supine/LLD portable abdomen?

Make exposure at end of expiration

What are the technical factors for a portable AP pelvis?

• 40” SID

• Grid Recommended

• 17×14 light field

• CR: 80kVp @ 20-32mAs

• Dr: 80-85kVp @ 25mAs

What is the pt position for a portable AP pelvis?

• Supine with arms abducted from body

• CR perpendicular to center of IR and pelvis

• MSP center to bucky or IR

What is the part position for a portable AP pelvis?

• Top of IR should be 1” above iliac crests

• Ensure no rotation — both ASIS should be same distance from IR

• Rotate lower limbs internally 15 degrees if possible

What is the CR for an AP portable pelvis?

• Cr perpendicular to IR, centered midway between level of ASIS and the symphysis pubis (this will be approximately 2 inches inferior to level of ASIS)

• Top of light field 1 inch above iliac crests

What is the collimation for a portable AP pelvis?

Tight collimation 4 sides to area of pelvis

What is the respiration for an AP portable pelvis?

Suspend respiration during exposure

Trauma examples slides 29-31