Horry-Georgetown Technical College

Radiologic Technology and Radiographer Overview

  • Radiologic Technology: This is a broad healthcare profession that encompasses all diagnostic imaging technologists as well as radiation therapists.
  • Radiographer: A radiologic technologist who specifically administers ionizing radiation to perform radiographic procedures.
  • Required Skills: The role requires a combination of technical proficiency and expert knowledge in physics, anatomy, physiology, and pathology.
  • Practice Standards: These are written and maintained by the American Society of Radiologic Technologists (ASRT). They define the practice of radiography, describe necessary education and certification, and outline the radiographer's scope of practice, which includes:     * Clinical performance standards.     * Quality performance standards.     * Professional performance standards.

Ethics and Professional Conduct

  • Definition of Ethics: The profession's moral responsibility and the science of appropriate conduct toward others.
  • Standards Authority: The American Registry of Radiologic Technologists (ARRT) creates and maintains the Standards of Ethics.
  • Components of Standards of Ethics:     * Code of Ethics: Consists of 1010 statements that serve as a guide for professional behavior.     * Rules of Ethics: Mandatory rules consisting of 2222 specific regulations.

Advanced Practice Roles

  • Radiology Assistant (RA) and Radiology Practitioner Assistant (RPA): These are radiographers who provide advanced imaging services, acting similarly to Physician Assistants (PAs) within the radiology field.
  • Requirements for RA/RPA Practice:     * ARRT radiography certification.     * Additional formal education.     * Clinical experience under the supervision of a radiologist preceptor.
  • Duties: RAs can perform fluoroscopy studies and minor procedures, allowing the radiologist to focus on interpreting images. Some RAs are also trained to read basic films.

Radiographer Responsibilities and Infection Control

  • Room Maintenance: The radiographer is responsible for keeping the imaging room clean, minimizing infection transmission, and maintaining stocks of linens, contrast, folding bags, and ancillary equipment.
  • Pathogen Contamination Control: The CDC provides directives for infection control, founded on standard precautions.
  • Standard Precautions:     * Hand Hygiene: Perform hand hygiene before and after patient contact. Wash hands or use sanitizer before putting on gloves.     * Personal Protective Equipment (PPE): Use gowns and masks based on the specific precautions assigned to a patient.     * Respiratory Hygiene: Follow cough etiquette (coughing into the elbow).     * Equipment Care: Disinfect and clean patient care equipment, instruments, and devices. This includes wiping down equipment to remove makeup, lotion, and biological contaminants (termed "face gunk" in the lecture).     * Safe Injection Practices: Wear a surgical mask when performing lumbar punctures.     * Textile Handling: Handle laundry carefully; wrap sheets when moving them to prevent contamination from "hospital jerk-jerkies."     * Sharps Safety: Use proper handling for needles. Techniques include using a Kelly clamp (scissor-like tool used in suturing) to pick up needles from sterile trays to avoid direct contact.     * Needle Recapping: Never recap needles manually. If a needle has a built-in safety cap, use it, but do not replace a cap that has been removed.     * Puncture Protocol: If a needle stick occurs (clean or dirty), report it immediately to the clinical preceptor and the program director to facilitate testing for blood-borne pathogens (Hep B, Hep C, HIV) and potential prophylactic treatment.

Transmission-Based Precautions and Hand Hygiene

  • Usage: Used in addition to standard precautions for patients with known or suspected infections.
  • Hand Washing Rules:     * Mandatory if hands are visibly soiled.     * Hand sanitizer can be used if not visibly soiled, but washing is preferred after multiple sanitizer uses to avoid a "gross" feeling.     * Specific times to wash: After examining patients with communicable diseases, after contact with blood/body fluids, before invasive procedures, and before touching immunocompromised patients.     * Sterile Procedures: Radiographers must wash their hands before donning sterile gloves, though they do not need a full surgeon's five-minute scrub.

Motion and Image Quality

  • Impact of Motion: Movement during exposure ruins image quality by causing blurriness.
  • Types of Motion:     * Involuntary Motion: Cannot be controlled by the patient. Examples include heartbeat, chills, peristalsis (bowel movement), tremors, spasms, and pain. Primary Control: Use the shortest exposure time possible.     * Voluntary Motion: Can be controlled by the patient. Causes include nervousness, discomfort, excitability, mental illness, fear, age, and breathing. Primary Control: Give clear, concise instructions, provide comfort (blankets, sponges), and use immobilization if necessary.     * Equipment Motion: Movement of the X-ray tube or IR during exposure.

Image Receptors (IR)

  • Definition: A device that receives energy from the X-ray beam and forms the image.
  • Four Primary Types:     * Cassette with Film: Traditional analog method (mostly obsolete).     * PSP (Photostimulable Phosphor) Plate: Used in Computed Radiography (CR). The plate contains an emulsion film that creates light when hit by X-rays. This light is transferred into a reader that processes the digital image.     * Solid-State Digital Detectors: Used in Digital Radiography (DR). These provide nearly instant images. They can be tethered by a cord or wireless.     * Portable and Fluoroscopic IRs: Built-in systems for mobile or real-time imaging.
  • Fluoroscopy Setup: Traditionally, the radiation source is at the bottom and the IR is on top (as in a C-arm). Bringing the reader closer to