Adaptation Of Technique Flashcards
When should we modify from the standard projection?
(5)
When your patient is unable to obtain or maintain the optimum radiographic position
When the patient has reduced ability or conditions
Due to injury or disease, e.g. plaster cast or brace
When requested by a radiologist to demonstrate anatomy in an alternative view
When creating a person centred approach
What are commonly modified views in adults for a CXR?
(4)
AP
Erect
Supine
Semi-erect
What are examples of adaptations for x-rays?
(6)
HBL hip
HBL knee
HBL ankle
HBL spine
Stripp view of shoulder
OM facial bones
How would we position for OM (occipitomenti) facial bones?
(2)
Angle the x-ray tube instead of asking the patient to raise their chin
Do AP instead of PA if supine
Why are HBL projections important?
(4)
It allows the patient to remain in the position they presented with
It can show fluid/air lines on x-ray images
It can aid diagnosis
It can help us to understand what is going on with the anatomy
How would we position for a HBL projection?
(4)
Be careful with how the tube is angled
Look at the detector position and think about safety
Picture the required anatomy and how you will try to emulate the desired position
Annotate the image that a horizontal beam was used
Why would we use supine positions?
(2)
Due to patient injury/condition
It’s important on CXR
What should we do when doing oblique conditions?
(2)
Use the 10 point check to assess the image quality
Make the decision to repeat, but if you’re questioning whether to repeat, you probably need to
What are commonly modified views for paediatrics?
(2)
AP supine CXR
AP CXR
When would an AP supine CXR be used in paediatrics?
When babies are before the age of 4 months because they can’t hold their heads up
Why would we do an AP CXR in paediatrics?
Children around 18 months of age experience separation anxiety
They ideally need to see their primary carer
They need to be alongside the patient
Lead rubber apron and comforters worn by carers
We may need a distraction to keep the child looking forwards to avoid rotation
Why do we use immobilisation techniques on paediatric patients?
(2)
To keep them still during the x-ray exposure (with consent)
To avoid repeated exposure. Children are up to 10x more sensitive to the effects of radiation than adults
What are the types of immobilisation techniques for paediatrics?
(7)
Distraction
Verbal, e.g. singing
Swaddling
Feed and wrap
Physically holding
Sandbags
Oral sedation
When should we use immobilisation techniques?
(4)
Look at departmental protocol
Depending on the patient’s age and maturity
Can the patient come back when calm?
Can another imaging technique be used instead?
How can we use distraction techniques in paediatrics?
(5)
Switch off from the x-ray examination
Make the x-ray room less clinical
Engage the patient
Take time to establish a rapport- it lets us know when to get on with the examination
Look for characters on their clothing- Peppa Pig, SpongeBob , etc
How do we position children when swaddling them?
(2)
We can swaddle them depending on the body part being x-rayed, e.g. CXR, AXR
Their arms have to be tucked close to the body
How can we use physical restraint in paediatrics?
(2)
Sandbags
Carer/comforter
It’s used as a gentle reminder to adopt a position and remain still
