Chapter 12 Patient Radiation Dose During Diagnostic X-Ray Procedures

Question 1

holistic patient care begins with _____ ______.

Answer 1

effective communication

Question 2

effective communication includes: (4 and give and example how each can help)

Answer 2

1. verbal messages and body language :
   increased cooperation, less stress, more professionalism
2. clear instructions:
   pt understands their role, more cooperative, taking time to listen to pt
3. explanation of procedures:
   inform pt, explain and answer questions, be realistic- uncomfortable?
4. repeat exposures:
   many are due to poor communication

Question 3

immobilization is more effective when accompanied by _________ _______.

Answer 3

good communication

Question 4

voluntary motion examples and how to prevent

Answer 4

can be due to age, breathing, anxiety, discomfort, excitability, fear of exam or prognosis, mental instability.

clear instructions, and immobilization devices if needed.

Question 5

involuntary motion examples and how to prevent

Answer 5

chills, tremors, muscle spasms, pain, withdrawal symptoms, heartbeat, peristalsis.

increase mA, decrease time and high speed IR.

Question 6

Intelligent positioning and shielding to reduce or eliminate dose to a body part should be considered for (4 body parts)

Answer 6

lens of eye, breasts, thyroid, gonads

Question 7

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”

Answer 7

gonadal
fetal

Question 8

the ASRT policy on shielding allows shielding for all exams other than ___________ and ____________.

Answer 8

abdomen and pelvis

Question 9

Technical exposure factors are used to ensure proper …

Answer 9

contrast
brightness
spatial resolution (recorded detail in image)
minimum distortion

Question 10

What is the importance of standard technique charts? and when is it most important?

Answer 10

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.

Question 11

_____ kVp and ______ mAs are used to reduce exposure.

Answer 11

HIGH KVP
LOW MAS

Question 12

Post processing is helpful, but will not help with _________________

Answer 12

removing artifacts - pins, ng tube, jewelry, etc.

Question 13

Quality control programs are used

Answer 13

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.

Question 14

Air Gap Technique

Answer 14

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

Question 15

what is the benefit of the repeat analysis program?

Answer 15

*helpful in determining process improvements
*minimizing patient exposure
*improving department performances

especially important in CR/DR due to dose creep and post processing

Question 16

DR repeat rate:

Answer 16

5-17%

Question 17

who orders the exam and weighs the risk vs benefit?

Answer 17

physician

Question 18

what is GSD?

Answer 18

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

Question 19

Bone marrow dose

Answer 19

described in terms of quantity called mean marrow dose defined as the average radiation dose to the entire active bone marrow

Question 20

FGP

Answer 20

Fluoroscopic Guided Positioning

using fluoro to find location prior to making an exposure - ASRT considers this to be unethical… but it is controversial

Question 21

ways to determine the possibility of pregnancy

Answer 21

-last monthly period
-pregnancy test
-10 day rule

Question 22

things to remember when irradiating known pregnant patient

Answer 22

-use lowest exposure factors for diagnostically useful image
-precise collimation
-shield pelvic area as much as possible without interfering with area of interest.

Question 23

pediatric patients are 2x more vulnerable and susceptible to _______ and ________ effects.

Answer 23

somatic and genetic

(late effects - leukemia, lung/thyroid cancer)

Question 24

pediatric considerations:

Answer 24

-radiation exposure - more likely to cause effects
-radiation dosed- lower than adults
-motion- short exposure times
-cooperation- distractions
-collimation- to reduce exposure

Question 25

image gently campaign

Answer 25

Alliance for Radiation Safety in Pediatric Imaging raising awareness of pediatric dose in all exams

Question 26

Image Wisely Campaign

Answer 26

Alliance second initiative to lower exposure in exams and eliminate unnecessary exams.

Question 27

Dual- energy x-ray absorptiometry (DEXA / DXA scan)

Answer 27

determines bone mass/ no protective shielding for patient or technologist due to low exposure