Mobile Radiography Flashcards
What are some common orders for Mobile X-rays in the hospital wards?
AP Sitting/Supine Chest
Chest X-ray to check for NGT placement
AP Supine Abdomen
Which departments/wards commonly requires mobile radiography?
ICUs
A&E
Isolation rooms
Orthopaedic Wards (e.g. patients on tractions)
Things to look out for/possible challenges when doing mobile radiography?
Order priority
Degree of consciousness and patient’s cooperation
Timing of X-ray e.g. patient’s rest time
Restrictions due to life support system
Urinary bags
Chest or abdominal drainage tubes
ETTs/NGTs
Catheters
ECG leads placements
Traction apparatus
Physical constraint of room size
Ward rounds and visiting hours
Blind spots
What is NGT and its function?
Nasogastric Tube.
NGT is used to deliver substances into the stomach or draw substances out.
Where is the placement of NGT inside the body?
Below the left hemidiaphragm and 10cm beyond the gastro-oesophageal junction.
What is ETT and its function?
Endotracheal Tube.
ETT is placed between the vocal cords through the tracheal to provide oxygen and inhaled gases to the lungs.
It also serves to protect the lungs from contamination, such as gastric contents and blood.
Where is the placement of ETT inside the body?
Tip of ETT is found 5 - 7 cm above the carina in the neutral neck position.
What is port-a cath and its function?
A small central venous access port placed under the skin of the right-sided chest area, attached to a catheter that is threaded along a large vein.
Functions:
Frequent taking of blood samples
Administration of IV therapies such as chemo
Direct administration of medicines into the central vein
What is CVC and its function?
Central Venous Catheter, also known as Central Venous Line. Inserted in critically ill patients for parenteral nutrition and antibiotic therapy, chemotherapy, haemodialysis, patients with difficult peripheral venous access and blood transfusions.
Where is the placement of CVC inside the body?
Tip of CVC should be in the proximity of the Cavo-atrial Junction (CAJ) where the lower 3rd of the Superior Vena Cava (SVC) and Upper Right Atrium is located.
What is the function of a tracheostomy tube?
Long-term assisted ventilation, tracheal suction or where oral or nasal tracheal intubation is not possible.
Where is the placement of the tracheostomy tube inside the body?
Tip of tracheostomy tube should lay half-way between the stoma and the carina, at the level of the T3 vertebra.
What are some preparations for mobile radiography?
Checking of X-ray requests and previous radiographs (if any)
Bringing of accessories and lead apron
X-ray machine should be fully charged
Any disturbance or tractions, ECG leads and drainages should only be removed with permission from nursing/medical staffs in charge of the patient.
Positioning of IR and movement of seriously ill patients should be undertaken with great care or under supervision from nursing/medical staff
What are some infection control measures for Mobile radiography?
HAND HYGIENE
Use of PPEs (depending on patient setting)
Cassettes to be cleaned and covered with clean cover before and after use
Wearing of gloves (sterile/non-sterile)
Clean and dirty personnel.
Equipment preferably kept on side for ICUs and isolation wards if possible, otherwise, equipment to be cleaned with antiseptic solution before and after being used.
How to ensure radiation safety in the wards during mobile radiography?
Get ambulant patients in the vicinity to move further away if possible
Get visitors to go out during exposures
Look out for pregnant staffs and ladies
ALARA - Collimation and use of appropriate exposure factors
Refrain from repeats - don’t super collimate!
LOUD VERBAL WARNINGS before exposure.
Visual checks on everyone in the vicinity before exposure.
Use of long distances (2m) and lead apron.
