wk 10 Radiographic Safety and Patient Positioning Notes

Radiation Safety and Patient Positioning

Personal Protective Equipment (PPE)

• Required PPE:

  • Lead apron/gown

  • Thyroid protector

  • Gloves

  • Dosimeter badge (for monitoring radiation exposure)

• Safety Practices:

  • Always seek assistance (2 people can better restrain the patient and avoid scatter radiation).

  • Use positioning devices (e.g., sandbags) to facilitate leaving the room safely.

  • Proper collimation of the x-ray view is necessary to minimize scatter.

  • Sedation of the patient should be requested if needed.

Compliance and Safety Regulations

• Age Restriction:

  • Must be over 18 years to assist with x-ray procedures.

• Pregnancy Considerations:

  • Not recommended for pregnant women to assist.

  • If a pregnant woman insists on assistance, she must wear a fetal dosimeter badge.

Equipment Maintenance

• General Guidelines:

  • Proper care leads to longevity and efficiency of equipment.

  • Avoid cracks which can lead to function failure.

  • Storage:

  • Hang aprons vertically or lay flat to maintain shape.

  • Place gloves on vertical holders.

  • Regular inspections and quarterly radiographs are necessary for lead gear to check for cracks.

• New Technologies:

  • Newer radiology gowns utilize a barium compound instead of lead and are machine washable.

  • Suited for dental radiology where contamination might be a concern.

Understanding Scatter Radiation

• Definition:

  • Scatter radiation is not absorbed by the patient and comes from electrons bouncing off x-ray equipment or unintentional exposure (e.g., hands).

• Types of Radiation:

  • Primary Beam: Direct radiation focusing on the patient.

  • Secondary (Scatter) Radiation: Radiation that disperses from the primary beam.

  • Leakage Radiation: Radiation escaping from the x-ray tube housing.

Restraint Techniques

• Procedure:

  • Utilize two technicians at each end of the x-ray table for effective restraint.

  • If the patient is anesthetized or sedated, limit exposure by standing behind a lead screen or briefly exiting the room.

  • Use sandbags or foam positioners for stability with sedated patients.

Patient Positioning for X-rays

• Right Lateral Recumbency:

  • Patient lies on its right side, feet away from the wall.

  • Ideal for lateral x-rays of the thorax or abdomen.

• Ventral Dorsal (VD):

  • Patient lies on its back, belly up; x-ray beam hits the ventral side first.

  • Positioning may be assisted using a cushioned trough for comfort and security.

  • Label the x-ray accordingly to indicate the patient’s right or left side.

• Dorsal Ventral (DV):

  • Patient lies with the ventral side on the table and back up.

  • Suitable for patients unable to be placed in the VD position due to health issues.

Additional Positioning Categories

• Common Areas for Imaging:

  • Extremities

  • Pelvis/Hip

  • Skull

  • Dental

• Sedation Requirements:

  • Many positions necessitate sedation or anesthesia due to the patient's need for manipulation during positioning.

Contrast Studies

• Positive Contrast Agents:

  • Barium is used to visualize the GI tract, producing white images on x-rays.

  • Administer on an empty stomach after a fasting period (12-24 hours).

  • Can be administered as a liquid mixed with food or as a paste via tube.

• Negative Contrast Agents:

  • Uses air for organ evaluation, most commonly for bladder assessments.

Image Quality Considerations

• Key Factors:

  • Quality images depend on proper exposure (referring to technique chart) and minimal patient movement during imaging.

  • Proper restraint is essential for maintaining image clarity; movement results in fuzziness in x-ray images.

  • Adjustments may be necessary based on the specific machine or preferred techniques of the veterinarian.

References

• Sirois, M. (2021). Elsevier’s Veterinary Assisting Textbook. 3rd Edition. Elsevier Publishing.

• Sirois, M. & Schlote, J. (2018). Diagnostic Imaging for Veterinary Technicians. Blue Door Publishing.