Immobilization Techniques Flashcards
What is immobilization?
A method of applying restrictive measures to prevent patient/part movement
What does immobilization and communication help to reduce?
Motion on radiographs
What does the slightest movement cause on radiographs?
Blurring
What is the most significant contributing factor to unacceptable image quality?
Motion distortion
What do positioning inaccuracies contribute to?
Suboptimum image quality
What does motion distortion result from?
Involuntary and voluntary patient movement
What does motion from patients result in?
The need to repeat radiographs and increase radiation exposure to the patient
What is critical to effective immobilization?
Communication
What exposure time should be used for immobilization?
Short exposure times
What can be used to assist in immobilization?
Immobilization aids
What else can be used as an effective way of facilitating good immobilization?
Empathy for the patients condition
What is voluntary motion?
Motion that can be controlled by the patient
When does voluntary motion occur?
As a result of inadequate communication by the technologist
What is involuntary motion?
Motion due to contributing factors such as temperature, shock, neurological disorders and medication
What is the most effective means of reducing motion and ensuring the patient cooperates?
Communication
How should the technologist give instructions to the patient?
Give patient instructions in simple terms the patient can understand
What non verbal instructions can be used to communicate?
Demonstrations and other methods
What does communication with the patient also include?
Establishing good rapport and showing empathy for the patient
What is rapport?
A relationship of harmony and accord between two persons
When does rapport with the patient take place?
Begins from the introduction and continues throughout the procedure
What is empathy?
Being able to enter the patient’s emotions
How can a technologist show empathy for their patient?
By seeing things from the patients perspective or emotional state
What is empathy different from?
Different from having sympathy or feeling sorry for the patient
When is restraining done?
To prevent the patient from injuring themselves
What must immobilization and restraint devices not interfere with?
A patient’s circulation or respiration
Who is responsible for ordering restraints?
Physicians
When are restraints for adults applied?
Applied before the patient arrives in radiology department
What do restraints consist of?
Wrist and ankle bands fastened to the bed or stretcher
What features should immobilization devices possess?
- Radiolucency
- Flexibility
- Durability
- Reproducibility
- Safety and reliability
- No image artifacts
What are the two types of immobilization devices?
Simple and involved
What do simple immobilization devices include?
Sandbags and sponges used to help a patient maintain a position
What do involved immobilization devices include?
More complex devices such as spinal trauma boards that hold patients completely still
What are types of immobilization devices?
- Positioning sponges
- Sheets
- Sandbags
- Velcro straps
- Head clamps
- Commercial devices
What are some other types of immobilization devices?
- Cervical collar
- Spine board
- Splints
- Sheet restraints
- Commercial restraint devices
- Stockinettes
- Tape
What are routine applications of simple immobilization devices?
Sponges, sandbags, Velcro straps, plexiplate, compression bands and head clamps
What are complex immobilization techniques?
- Mummy wrap technique
- Securing a patient to a backboard
- Commercial restraints
When are immobilization devices applied during trauma applications?
Before the patient arrives at the radiology department
What shouldn’t radiologist remove in trauma applications?
Should never remove immobilization devices that have been applied by EMTs
When should be the only time immobilization devices should be removed?
Only after the radiologist has read the initial radiographs as negative and physician has approved
How should immobilization devices be removed?
Slowly with the necessary assistance like sponges or padding to ensure patient comfort
What qualities of trauma application immobilization devices should radiographers know about before imaging?
Which devices are radiolucent vs radiopaque
Can radiographs be taken with radiopaque immobilization devices in place?
Yes it may be necessary to leave them on which will produce artifacts on the film
What are immobilization devices used for spinal traumas?
Traction devices (backboards) and cervical collars
How are AP spine views done with radiolucent backboards?
Done with the cassette placed under the backboard
What is a backboard used for?
To keep the spine immobilized and support the body
What are features of most backboards?
Made of radiolucent materials like wood or plastic
What can backboards help facilitate?
Easy transfers of patients from the cart to the table
What image view is completed to rule out a cervical spine fracture?
A cross-table lateral view of the cervical spine
What are the next steps if a lateral view is questionable?
Additional views of the c-spine can be taken with the collar on
When should a cervical collar be removed by a radiologist?
It should NEVER be removed before the radiologist has cleared the patient and R/O a spinal fracture
What other situations are cervical collars used in?
During radiographic skull examinations
How is movement affected by immobilization collars?
Movement of the patient is restricted and equipment must be moved instead
What are ways equipment can be manipulated during head trauma exams?
Tube can be moved without turning the patient
What may be evident with head traumas?
Bleeding from the nose or ears
What devices may be present on extremity traumas?
Traction devices
What are features of traction splints?
They are not always radiolucent
What immobilization devices may be present in cases of abdominal trauma?
An anti-shock garment
What are anti-shock garments used for?
To slow the rate of hemorrhage
What are features of anti-shock garments?
Are always radiolucent
What communication tactics be used with children?
Using terminology the child will understand
What should be established with children when imaging them?
Trust and security
How should department policies be used when pediatric situations are in play?
Should be observed on an individual case basis
What should children never think of immobilization devices?
Should never think they’re being used as a form of punishment
How should restraints be applied to children?
Should be applied gently without threats and force
What is mummification?
An effective, simple and inexpensive and reliable method of restraining or immobilizing an infant
What does mummification consist of?
Gently wrapping the small child in a sheet which limits motion
What age range should mummification be used in?
Children who are too young to understand cooperation
What are commercial upright restraints?
Pig-o-stat and Pedia-poser
What do upright commercial restraints allow?
Allow the child to be rotated 360 degrees in the upright position
What are upright restraints useful for?
Useful for taking CXR and ABX in upright positions
What are commercial restraint boards?
Circumcision boards, Brat boards and Octastop boards
What do restraint boards allow for?
Allow for rotation of the child in the recumbent position
Which type of radiographs can be obtained with restraint boards?
AP, Oblique and laterals
What should be used with tape restraints?
Cloth between the sticky side of tape and skin
What is a stockinette?
A stretchable cotton fabric int he shape of a sleeve that is pulled over an extremity before a cast is placed
What are stockinettes good for in imaging?
Good for immobilizing upper limbs above and behind the child’s head with tape
What geriatric applications should be applied when it comes to immobilization?
- Blankets for warmth
- Radiolucent table pads and pillows for comfort
- Sponges to reduce back strain
What tips should be used for immobilizing patients?
- Always explain and talk to your patient
- Never cause harm by immobilizing
- Make sure immobilization is not too tight
- Immobilize for a short period of time
- Never use the sticky side of tape directly on the skin
- Never rely on immobilization alone to hold a patient
- Seek first aide if injuries are sustained by use of immobilization
What are reasons for immobilizing patients?
- Protect the patient from bodily harm
- Reduce the possibility of motion
- Reduce radiation exposure
- Ensure proper positioning
What is a cervical spine often called?
Cspine
How is a cross-table lateral cervical spine conducted?
- Patient remains supine and immobilized
- Xray tube is lowered and turned so that the CR is horizontal
- Cassette is placed at the side of the patients head (below the shoulder) at a right angle
What might a physician do to un-superimpose the shoulders in a cspine image?
Pull the patients arms down slightly
What must be visualized in a LAT cspine?
All seven cervical vertebrae
What are forms of noncommercial restraints?
- Plexiglas
- Velcro straps
- Tape
- Stockinette
What is ambulatory?
Able to walk
What is an artifact?
Substance or structure not naturally present but of which an authentic image appears on an image
What are compression bands?
Waist immobilizers or safety straps
What is flexion?
Act of bending or condition of being bent
What is geriatric?
Pertaining to the treatment of the aged
What is neonate?
Newborn infants
What is pediatric?
Pertaining to the branch of medicine that treats children
What is a pig - o - stat?
An upright restraint for children
What is C7?
7th cervical spine
What is CR?
Central ray
What is EMT?
Emergency medical technician
What does F stand for?
Female
What does M stand for?
Male
What is OFD?
Object film distance
What is y/o or Y/O?
Year old
