Chapter 12 Patient Radiation Dose During Diagnostic X-Ray Procedures Flashcards
holistic patient care begins with _____ ______.
effective communication
effective communication includes: (4 and give and example how each can help)
- verbal messages and body language :
increased cooperation, less stress, more professionalism - clear instructions:
pt understands their role, more cooperative, taking time to listen to pt - explanation of procedures:
inform pt, explain and answer questions, be realistic- uncomfortable? - repeat exposures:
many are due to poor communication
immobilization is more effective when accompanied by _________ _______.
good communication
voluntary motion examples and how to prevent
can be due to age, breathing, anxiety, discomfort, excitability, fear of exam or prognosis, mental instability.
clear instructions, and immobilization devices if needed.
involuntary motion examples and how to prevent
chills, tremors, muscle spasms, pain, withdrawal symptoms, heartbeat, peristalsis.
increase mA, decrease time and high speed IR.
Intelligent positioning and shielding to reduce or eliminate dose to a body part should be considered for (4 body parts)
lens of eye, breasts, thyroid, gonads
In 2019, the American Association of Physics in Medicine (AAPM) stated that, “patient _______ shielding and ________ shielding during diagnostic imaging procedures should be discontinued as routine practice”
gonadal
fetal
the ASRT policy on shielding allows shielding for all exams other than ___________ and ____________.
abdomen and pelvis
Technical exposure factors are used to ensure proper …
contrast
brightness
spatial resolution (recorded detail in image)
minimum distortion
What is the importance of standard technique charts? and when is it most important?
helps avoid dose creep, aids in determining factors with different pathologies and different levels of sensitivity of tissue, and equipment maintenance /age
especially important with digital imaging and imaging with multiple types of equipment.
_____ kVp and ______ mAs are used to reduce exposure.
HIGH KVP
LOW MAS
Post processing is helpful, but will not help with _________________
removing artifacts - pins, ng tube, jewelry, etc.
Quality control programs are used
for highly technical equipment/ to identify problems that will affect the image quality/ calibration and quality control to prevent system errors
*notify someone if you think there is a problem.
Air Gap Technique
used in place of a grid to reduce scatter radiation.
comparable to 8:1 grid
increase SID as much as OID
not as effective @ 90kVp or higher
what is the benefit of the repeat analysis program?
*helpful in determining process improvements
*minimizing patient exposure
*improving department performances
especially important in CR/DR due to dose creep and post processing
DR repeat rate:
5-17%
who orders the exam and weighs the risk vs benefit?
physician
what is GSD?
Genetically Significant Dose
// suggests that the genetic consequences of substantial dose of gonadal radiation become significantly less when averaged over an entire population vs. just a few members. //
EqD to reproductive organs that, if received by every human, would be expected to bring about an identical gross genetic injury to the total population, as does the sum of the actual doses received by exposure to individual members of the population
Bone marrow dose
described in terms of quantity called mean marrow dose defined as the average radiation dose to the entire active bone marrow
FGP
Fluoroscopic Guided Positioning
using fluoro to find location prior to making an exposure - ASRT considers this to be unethical… but it is controversial
ways to determine the possibility of pregnancy
-last monthly period
-pregnancy test
-10 day rule
things to remember when irradiating known pregnant patient
-use lowest exposure factors for diagnostically useful image
-precise collimation
-shield pelvic area as much as possible without interfering with area of interest.
pediatric patients are 2x more vulnerable and susceptible to _______ and ________ effects.
somatic and genetic
(late effects - leukemia, lung/thyroid cancer)
pediatric considerations:
-radiation exposure - more likely to cause effects
-radiation dosed- lower than adults
-motion- short exposure times
-cooperation- distractions
-collimation- to reduce exposure
image gently campaign
Alliance for Radiation Safety in Pediatric Imaging raising awareness of pediatric dose in all exams
Image Wisely Campaign
Alliance second initiative to lower exposure in exams and eliminate unnecessary exams.
Dual- energy x-ray absorptiometry (DEXA / DXA scan)
determines bone mass/ no protective shielding for patient or technologist due to low exposure