Portables Flashcards by Alyssa Dosch

What is the most effective way to reduce radiation (ALARA)?

distance
at least six feet

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When are you NOT able to give breathing instructions to a patient?

if they are intubated

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How do you know when to expose for an intubated patient?

watch their chest for inspiration/expiration

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Most common portable x-ray

Chest x-ray

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Why might an exam be done portably?

doctor’s choice
isolation status
patient condition (bedridden or too ill or intubated)

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Preferred position for CXR portable, why?

erect, air fluid levels

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hardest aspect of a PCXR

proper angulation

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how do you know your CR angle?

match the angle of the sternum

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if your using a grid, how should your technique be adjusted

increase kvp

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In what cases would you increase your technique

larger patient
using a grid

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What body part thickness should you use a grid?

10 cm
4 inches

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If a patient has a femoral line, you cannot sit them up more than ____ degrees

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If a patient is receiving tube feeding through an NG tube, why do you not lay them supine?

aspiration risk

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What is typical chest XR portable technique? Without a grid

85 kvp at 3-5 mas

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What is average chest XR portable technique with a grid?

110-120 kvp at 2 mas

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straight and horizontal clavicles indicate what on a portable CXR?

angled tube too cephalic

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V shaped and low clavicles indicate what on a portable CXR?

angled tube too caudal

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How long should a patient lie on their side for a decub image?

5 minutes

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If looking for air, the affected side is ______ (up/down)

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If looking for fluid, the affected side is _____ (up/down)

down

why should you utilize a sponge in a lateral decub exam?

put under the side down so you can fully visualize that side of the chest/abdomen

If you need to change your technique, what factor do you increase/decrease?

mas

List the two primary types of mobile xray units.

battery powered, motor/battery driven
standard power, non-motor driven

Which type of mobile unit is lighter in weight?

standard power

Explain the concept of ALARA

avoiding unnecessary exposure that has no benefit to imaging

What is the most effective radiation protection rule in reducing occupational exposure

distance

T/F you can use AEC on a portable machine

false

T/F a battery operated portable machine must be plugged in to make an exposure

False

the cord that connects the remote to the machine must be how long?

6 feet

A patient with very low white blood cell count is considered to be in what type of isolation/transmission-based precautions?

Neutropenic

Describe the 3 principles for portable/trauma radiography:

Two projections 90 degrees from each other Entire body part/structure is on IR Safety precautions of the patient, healthcare workers, and public

What is the best position to perform an AP portable chest in and why?

erect to see air fluid levels

List and describe three clinical indications why you would do an AP chest

hemothorax - blood in pleural space pneumothorax - air in pleural space pleural effusion - excessive fluid (non blood) in pleural space

Technical factors for AP portable chest

110-120 kvp @ 2 mas (with grid) 80-90 kvp @ 2-5 mas (no grid)

patient position for AP portable chest

erect as possible chin raised shoulders rolled forward if possible

CR transverse centering for AP portable chest

T7 or 3-4 inches below jugular notch

When evaluating an AP portable chest how can the clavicles help determine the correctness of the tube angle?

Too cephalic of an angle: clavicles will be too high and horizontal Too caudal of an angle: clavicles will be too low and dipping into a “V”

What is an Endotracheal (ET) tube?

Breathing Tube

What x-ray do we perform to confirm ET tube placement?

AP Chest

Where is correct placement of an ET tube?

Approximately 5cm above carina

Why do we perform lateral decubitus chest projections?

To evaluate air fluid levels when a patient cannot stand

Describe how you would set and perform a portable lateral decubitus chest projection:

Patient is on side for 5 minutes Arms up and out of the way Side of interest – which side needs to be down depending on looking for air or fluid

Which position or projection best demonstrates free intra-abdominal air for the patient who can not stand or sit erect?

Left Lateral Decubitus

Why do we routinely perform Left Lateral Decubitus abdomens?

To evaluate for abnormal densities in the liver or looking for free air or fluid in the abdomen

Where do you center for a LLD abdomen?

2 inches above iliac crest and MSP

To ensure the joints are open on an AP portable foot, how is the CR aligned?

perpendicular to the IR with a slight cephalic angle (5-10 degrees)

If a patient cannot be positioned properly for an AP thumb, can you do a PA? If so, what is the disadvantage of performing a PA rather than AP projection?

yes magnification

Define NG and describe NG tube purpose:

NG = nasogastric tube Feeds or suction of stomach contents

What portable x-ray would be performed to determine NG tube placement?

Upper abdomen/chest