RAD111: Unit 1

Wilhelm Conrad Röntgen

Who discovered X-Ray?

Friday, November 8, 1895

When were X-Rays discovered?

Manmade ionizing radiation

What are X-Rays?

Ionization

Any process by which a neutral atom gains of loses an electron, thus acquiring a net charge

Radiation

Energy transmitted by waves through a space or medium

Diagnostic Radiography

Specializes in the use of X-rays to create images (Radiograph) of the body. Uses ionizing radiation

Computerized Tomography (CT)

Highly specialized equipment is used to view multi-planar images of the body using X-rays and computer generated images. Uses ionizing radiation

Sonography/ Ultrasound

Visualize structures through high frequency sound waves. Uses NONionizing radiation

Magnetic Resonance Imaging (MRI)

Highly specialized equipment uses strong magnetic field and radio waves to generate sectional computer images. Uses NONionizing radiation

Mammography

Radiographic imaging of the breast. Uses ionizing radiation

Interventional Technology

Assists the doctor during angiography, cardiac catheterizations, and angioplasty. Uses ionizing radiation

Nuclear Medicine

Injects radiopharmaceuticals into patient for diagnostic and therapeutic purposes. Usually involves imaging the patients organ function. Uses ionizing radiation

Radiation Therapy

Deliver planned treatments of high energy ionizing radiation to treat primarily malignant (cancerous) tumors

Radiologist Assistant (RA)

Advanced-level radiographer who extends the capacity of the radiologist in the diagnostic imaging environment

Board of Directors

The hospital is governed by the
______ of __________

VPs

Directors of various department report to the ____

Board

The VPs report to the _____

CEO- President

Responsible for managing the daily operations of the hospital and its entities; works directly with the board of directors to institute strategic planning for the hospital facility

Regulating Agencies (External)

Accredit hospitals and other health care institutions in the U.S.

-The Joint Commission (TJC)
-DNV

What are the two accrediting agencies?

The joint Commission (TJC)

What regulating agency regulates the quality & safety of care provided to patients?

DNV

What regulating agency has guidelines that assign responsibilities within the hospital?

" To care for others as we would care for those we love- to enhance their well-being and improve their health"

What is Riverside's mission statement?

Accreditation

Process through which an agency grants recognition to an institution for a program of study that meets specified criteria

ABHES (Accrediting Bureau of Health Education Schools)

Riverside College of Health Sciences is accredited by _______

JRCERT (Joint Review Committee on Education in Radiologic Technology)

RCHS School of Radiology Technology is accredited by _______

1. Promotes Excellence
2.Curricula & Guidelines
3. Elevate Quality & Safety of Patient Care
4. Reviews & Site Visits

The (4) purposes of JRECT includes.....

Certification

Process for development procedures to which certain private and all out-of-state post secondary institutions must adhere in order to receive approval to confer degrees, certification or diplomas in Virginia

SCHEV (State Council of Higher Education in Virginia)

Riverside College of Health Sciences is certified by _______. Which ensures quality and allows students to apply for federal financial aid

ARRT (American Registry of Radiologic Technologists)

Who certifies individuals in Radiography?

Licensure

The process by which a governmental agency (usually a state) grants permission to individuals to practice their profession

ASRT (American Society of Radiologic Technologists)

Membership provides a pathway to continued successful professional development,networking, keeps you up to date on changing technology, development of leadership skills, helps share your profession through legislation

VSRT (Virginia Society of Radiologic Technologists)

Virginia state level professional organization

Profession

A calling that requires specialized knowledge and intensive academic preparation, has a professional organization and ethical code of conduct, and serves a specific social need

Patient Bill of Rights

A document that states a patient has certain rights

ASRT Practice Standards (also known as Scope of Practice)

The standards provide role definition and identify Clinical, Quality, and Professional Standards of practice

Assault

Any willful attempt or threat to inflict injury on the person of another

Battery

any unlawful touching of another that is without justification or excuse

False Imprisonment

Conscious restraint of freedom of a person without proper authorization, privilege, or consent

Defamation

Holding up a person to ridicule, scorn, or contempt in a respectable and considerable part of the community by either Slander (spoken word) or Libel (written, published comments, pictures)

Autonomy

Theory that patients have the right to decide what will or will not be done to them

Respondeat Superior

"Let the master answer"

The "master" can be held liable for wrongful acts of the "servant," or employee, then causing injury during employed activities

Re ipsa loquitur

"The thing speaks for itself"

It becomes the radiographer's burden to disprove negligence is the patient is injured as a result from misperformance of a duty in the routine scope of practice

Invasion of Privacy

Discloses confidential information to unauthorized individuals

Informed consent

The patient is given enough information to make an educational decision about his or her health care. They are informed of the
-benefits of the procedure
-the alternatives to the procedure
-how the procedure will be performed

Implied consent

An emergency room patient is alone and unconscious, what consent is assumed?

-The patient must be of legal age
-The patient must be of sound mind
-The patient must give consent freely
-The patient must be adequately informed of the procedure about to take place

For informed consent to be valid, the (4) conditions are....

YES
But we are not able to let them see it, refer them to their physician

Can a patient view his/or her chart?
YES or NO?
And are we able to let them see?

Patient date of birth
Patient name

The most commonly preferred method to identify a patient for a radiography exam

-Name and MRN
-Patient DOB
-Date of Exam
-Rt or Lt maker

For medicolegal reasons, images are required to include (4 things)

HIPAA (Health Insurance Portability and Accountability Act)

Passed to improve the efficiency and effectiveness of the health care system in processing health care information to provide privacy, security, and electronic transmission of certain patient health information

FERPA (Family Educational Rights and Privacy Act)

A federal law that protects the privacy of student education records

Anode

Positive end (no free electrons); contains the target to stop electrons

Cathode

Negative end (electrons negative); contains the filament

Filament

Source of electrons

Attenuation

Process by which primary radiation is changed (partially absorbed or scattered)

Collimation

Limiting the beam- Result in reduced patient dose, less scatter, and better deal

Contrast

The visible difference (variation) between adjacent densities

Density

The overall darkness (blackness) of the image or the amount of light that can shine through

Detail

Distinct representation of an objects true borders

Distortion

Misrepresentation of objects size or shape

Image Receptor (IR)

Intercepts the X-ray photons that exit the patient (captures the image)

Inverse Square Law

Mathematic formula that describes the relationship between radiation intensity and distance from the source of the radiation

Grid

Device consisting of thin led strips designed to permit primary radiation to pass while reducing scatter radiation by absorption

Kilovolt Peak (KvP)

Energy or x-ray beam. Measure of electrical pressure forcing current through tube. Controls penetrable ability

Millampere-seconds (mAs)

Amount of x-radiation produced in tube (Quantity)

Photon

Particle of radiant energy

Primary Radiation

Prior to reaching the patient

Radiolucent

Allows x-rays to pass through easily

Examples: Air in lungs, Skin, and very thin body parts

Radiopaque

Not easy for x-rays to penetrate and pass through

Remnant Radiation

The part of the beam that passes through the patient

Scatter Radiation

Interacts with the patient and changes direction

Source-to-image Distance (SID)

Distance between point of x-ray exiting tube and image receptor (IR)

Object-to-image Distance (OID)

Distance between patient and image receptor (IR)

X-ray Tube

Where are x-rays produced

Roentgen (R)/ Coulombs per kilogram)

The amount of radiation exposure in air

Rad (rad) / Gray (Gy)

Radiation absorbed dose

Sievert (Sv)/Rem (rem)

Radiation dose equivalent

Curie (Ci) / Becquerel (Bq)

Radiation activity

As Low As Reasonably Achievable

What does ALARA stand for?

Time, Distance, Shielding

What are the Cardinal Rules of Protection?

Lead walls, Aprons, Glasses, Thyroid shields, Gloves

What are the 5 types of protective equipment used by radiographers?

DISTANCE

What is the best measure of radiation protection?

Annual 50 mSv

What is the annual dose limit for the Occupational population?

Annual 5 mSv

What is the annual dose limit for the General population ?

OSLD (Optically Stimulated Luminescent Dosimeter)

What is used to monitor radiation dose?
sensitive to as low as 1 mrem (10 micro SV)

Fluoroscopic Imaging

Uses x-ray to make a real time dynamic (action) image rather than a static image uses x-ray to make a real time dynamic (action) image rather than a static image

Digital Imaging: Cassette based (CR- computed radiography)

Where an image is captured and stored

Non-Cassette based (DR-direct digital (capture) or flat panel)

Where an image and captures with no Cassete & no reader, quickly viewed (less than 1 second)

Competency exams

Performed by students under supervision of any registered tech

Direct supervision

___________ supervision, when the technologists is in the room

Indirect supervision

_________supervision, when the technologist is close by ( out of view of student,) but is able to assist if necessary

Define a radiographic exam

An image of a patients anatomic part(s), as produced by the action of x-rays on an image receptor

What is a PA chest x-ray?

CR enters at a posterior surface and exits at the anterior surface

What is a true PA/AP?

- No rotation
- CR perpendicular to the coronal body plane and parallel to the sagittal plane

What is an AP chest x-ray?

CR enters at an anterior surface and exits at a posterior surface

What is an AP oblique projection?

CR enters the anterior surface and exits the posterior surface of the body or body part

What is a PA oblique projection?

CR enters posterior surface and exits the anterior surface of the body or body part

AP Chest

What x-ray is this?

PA Chest

What x-ray is this?