Procedures and Mistakes

W3

mistakes

  • clipping structures

  • collimation

  • SID

  • incorrect obliquity

  • INCLUDE buddy finger or PA HAND and use ARROW MARKERS to indicate affected finger

W4

mistakes

  • xs collimation

  • part // IR

W5

Mistakes

  • let PT know your going to move the board

  • change pre-set tech after measuring

  • use IV pole for PT comfort

  • have elbow and shoulder joint in the same plane (open joint > OID)

  • readjust SID after angling beam

  • don’t use jargons

  • if PT in wheelchair measure part in wheelchair

W6

Procedures for W6 - Shoulders

  1. read req for special views, site protocols

  2. prep req

    • required parts + special views + site required

    • date

    • time

    • tech

    • number of images

  3. order of images:

    • AP shoulder ()

    • AP OBL shoulder ()

    • PA OBL shoulder ()

    • INF.SUP Axial shoulder ()

  4. set technique to first image as M

  5. Prep room:

    • calipers

    • tape

    • sponge

    • markers

  6. WIPE EVERYTHING pt touches

  7. bring pt in

  8. confirm pt demographic

  9. hand hygiene

  10. ask for pain hx

    • where (ST, Joint)

    • how

    • when (6/12 not trauma)

    • mobility

    • specific pathology

  11. ask for CONSENT

  12. remeasure part

  13. PRE SET TECH

  14. ask for FB

  15. AP shoulder - 24×30 (M) Landscape for SG (most often)

    • tape coracoid; CP is 1inch below

    • check site protocol for HUM ROT

    • use ARROW MARKERS for hum.rot

    • suspend breath

  16. SWITCH PLATES

  17. AP OBL shoulder - 18×24 (S) Portrait

    • CP is GHJ/coracoid

    • tape acromion

    • hum is in contact with IR and placed on abd flexed 90degrees

    • hum is int.rot = USE ARROW MARKERS (←)

    • no leaning on bucky

    • suspend breath

  18. SWITCH PLATES

  19. PA OBL shoulder - 24×30 (M) Portrait

    • CP: mid medial scapular border

    • full scapula, lat ST

    • hand doesn’t matter

    • PRONATE MARKER

    • suspend breath

  20. TAKE OUT PLATE

  21. WALL BUCKY → SWITCH FREE PLATE

  22. INFSUP AXIAL shoulder - 18×24 (S) Landscape

    • CP mid axilla

    • have pt near the edge of table

    • feet or head all the way at the end

    • if used sponge, ensure that humerus // floor and ALIGNED TO SHOULDER

    • angle beam first → SID → CP → collimate

    • put correct marker and HB

    • suspend breath

  23. move tube out of the way for PT

  24. send PT to correct place

  25. wipe everything down

Mistakes

  • pain hx

  • no use of jargon

  • pronate marker for PA OBL Shoulder

  • bring exposed plate OUT of the room

  • change pre-set tech after remeasuring

    • 1) select next projection
      2) select next technique
      3) check you're on the correct detector

      4) grab new plate

  • humerus and shoulder in same plane especially when sponge was used (INF.SUP)