radiographic services Flashcards
references for radiographic policies
- vol 1: page 303
- ADA selection criteria: page 60-61 in rad book
- course outline/clinic requirements: syllabus
infection control reminders
- what items do we SHARE between cubicles that needs to be disinfected prior to each use (3)
- only press the exposure button with a ______
- wipe the ____ before and after use
- lead vest should be removed with:
communicate when sharing, break down and disinfect when in doubt
- PID, exposure panel, lead vest, etc
- only press the exposure button with a BARRIER
- wipe the SENSOR before and after use
- lead vest should be removed with: CLEAN PATIENT GLOVES
GENERAL REMINDERS:
- _____ the patient to eye level
- stand almost _______ to see
- do NOT leave the ___ infront of their face after exposure
- have ______ ready to wipe saliva
- cotton rolls can be used to:
- if a patient is having difficultly biting down, swithc to:
- for canine and mandibular central images use a:
- LOWER the patient to eye level
- stand almost DIRECTLY IN FRONT to see
- do NOT leave the PID OR SENSOR infront of their face after exposure
- have PAPER TOWELS ready to wipe saliva
- cotton rolls can be used to: stablize the bite block and in edentulous areas
- if a patient is having difficultly biting down, swithc to: sticky tabs
- for canine and mandibular central images use a: size 1
what portions of the assessment help determine the need for radiographs (reason why the rad check is after completing a periodontal assessment)
Medical/dental histories – systemic
diseases, chief complaints, date of
last radiographs, unexplained
pain/sensitivity.
Oral exam – facial symmetry, pain in
TMJ, evidence of trauma, fistulas,
lesions
Dental charting – malposition,
restorations, suspected caries,
fractures, mobility, unusual eruption, spacing
Periodontal assessment – CAL,
bleeding, periodontal issues
*explain your findings and need to the type and number of radiographs
SELECTION CRITERIA
high caries risk: (child primary, child mixed, adolescence, adult)
low caries risk: (child primary, child mixed, adolescence, adult)
high caries risk:
child primary, child mixed, and adolescence: 6-12 months
adult: 6-18 months
low caries risk:
child primary, child mixed: 12-24 months
adolescence: 18-36 months
adults: 24-36 months
Follow your ______, gather information the ____ time from your assessment
Around the time you
complete your _______, you should know what radiographs are needed
_______ is after _____ in your
sequence of care
You should have the rad form filled out _____ asking for a “rad check.”
Explain to the patient what you have ____ , the ______ and _____ of not taking the radiographs!
an instructor might ask you to fill out the rad form ______ to collect fees
Follow your SEQUENCE OF CARE, gather information the ENTIRE time from your assessment
Around the time you
complete your PERIO ASSESSMENT, you should know what radiographs are needed
RAD CHECK is after PERIO ASSESSMENT in your
sequence of care
You should have the rad form filled out BEFORE asking for a “rad check.”
Explain to the patient what you have FOUND , the BENEFITS AND RISKS of denying radiographs
the instructor may ask you to fill out the rad form EARLY to collect fees
sequence of care
- fill out rad form and discuss with pt
- obtain radiographic consent (if they refuse talk about the benefits then get the rad refusal form
- let instructor know youre ready
- fill out the long form and get faculty sig
- tx plan comprehensive services and rads
- print estimate and change status to pay
- get set up for rads then sign the sign up sheet with a TA (GET SET UP FIRST)
- sign out a sensor in the logbook
- place lead vest on pt and start with TA
what goes on the rad form
authorization part, assessment of need, radiographic consent
- type/number of rads requested
- medical/dental exposure in the last 24 months
assessment of need: caries, perio, no history, infection, etc
Y/N to radiographic consent then get patient signature!
what if a pt doesnt need radiographs
still fill out the rad form, the patient will consent “Yes” to “none”
if a client refuses:
___ patient on their need based on your findings, explain ____ and ___ of refusal.
If the patient still refuses, let your ____ know, they will decide if treatment can continue without rads.
If treatment continues, you will still fill out the Rad Tab, the
patient will answer “__” to consent at the bottom.
You will also need the patient to fill out and sign a ______, access through _____ forms.
EDUCATE patient on their need based on your findings, explain BENEFITS and RISKS of refusal.
If the patient still refuses, let your INSTRUCTOR know, they will decide if treatment can continue without rads.
If treatment continues, you will still fill out the Rad Tab, the
patient will answer “N” to consent at the bottom.
You will also need the patient to fill out and sign a RADIOGRAPHIC REFUSAL FORM, access through ADDITIONAL forms.
Present the filled-out and signed _____ to the instructor.
This would also include a signature on Rad _____ Form, if needed.
You may need to get a signature ____ after presenting to instructor if the rad prescription _____.
No radiographs may be exposed without client ____/_______! (Legal and Life)
Present the filled-out and signed RAD FORM to the instructor.
This would also include a signature on Rad REFUSAL Form, if needed.
You may need to get a signature RESIGNED after presenting to instructor if the rad prescription CHANGES
No radiographs may be exposed without client CONSENT/SIGNATURE! (Legal and Life)
when rads are added to the tx plan they must be approved
click the blue box at the bottom of the screen
COLLECTING THE FEE
The instructor will have to swipe your treatments ____ they can
be sent up for an estimate (will appear blue if not approved).
Send estimate to collect fees ____ rad check
You will ____ an estimate and change your patient status to ____
(your appointment box will turn green)
The ______ will come to your cubicle to collect fees - tell your patient to get their ____.
Do you have to wait for the OM before taking rads if you have printed the estimate and changed your scheduler to PAY?
If the payment has not been collected __ minutes before patient dismissal, you must escort your
patient to the ____ to make payment.
The instructor will have to swipe your treatments BEFORE they can
be sent up for an estimate (will appear blue if not approved).
Send estimate to collect fees AFTER rad check
You will PRINT an estimate and change your patient status to PAY
(your appointment box will turn green)
The OFFICE MANAGER will come to your cubicle to collect fees - tell your patient to get their WALLET.
NO
If the payment has not been collected 15 minutes before patient dismissal, you must escort your
patient to the FRONT DESK to make payment.
after hitting the “$” button, what do you write in the comments
ODU student or sr citizen for discounts
radiographic fees
4BW
1st PA
other PAs
FMS
Vertical BW 7-8
PANO
4BW: 20
1st PA: 5
other PAs: 5
FMS: 35
Vertical BW 7-8: 25
PANO: 25 (can’t take until summer, requirement not due til senior fall)
STEPS WHEN EXPOSING
Let Rad TA know you are ready to start images, and you will proceed. Rad TA will be present.
Ask for assistance if you are having
trouble, notice big retake errors, or
Dexis Errors.
Evaluate your errors (technique or
retake) as you go. Look at the image
after you expose! This can help
correct errors as you proceed!
Do not retake any images without
instructor’s authorization or instructor present!
EVALUATION OF TECHNIQUE
Once you finish exposing, Rad TA will assess radiographs for technique and retake errors.
Rad TA will use long form to record errors.
If retakes are needed, they are only taken with faculty supervision!
Technique errors are still errors, just don’t need to re-expose
are technqieu errors apart of your margin error?
yes, technique AND retake
if you recieve an N in tehcinqieu, you are only given credit for ________
images that were not retkae errors
RETAKES
- needs _______
retakes must be exposed with Rad TA or section instructor
NO RETAKES WITHOUT FACULTY SUPERVISION
toward the end of the appointment (3 steps)
- ask for USB from section faculty
- export pt images from Dexis onto the USB as BOTH DICOM, Dexis, and JPEG images
- give pt referral for any clinical findings on last appointment
When you complete radiographs
in the system, a box will pop up in
Axium asking for the number of
______.
Include ____ number of radiographs exposed plus any ___.
Ex: 4 bwx with 1 retake = 5 exposures.
When you complete radiographs
in the system, a box will pop up in
Axium asking for the number of
EXPOSURES.
Include TOTAL number of radiographs exposed plus any RETAKES.
Ex: 4 bwx with 1 retake = 5 exposures.
INTERPRETATION OF RADS
DURING:
WITHIN 2 WEEKS:
during: Images must be up on the computer monitor throughout appointment and at subsequent appointments! You may be assessed an N in professionalism if they are not displayed
within 2 weeks: Record interpretation of radiographs on the back of the Long Form (anomalies, materials, caries, periodontal disease, any other conditions etc.). Place form in dentist folder in filing cabinet in first row of middle computers for dentist grading
HOW ARE YOU EVALUATED FOR INTERPRETATION
The _____ will evaluate
your interpretation and
circle M or N
The Long Form is returned to you via _____
At next clinic session, complete ______: adding radiographic findings into Axium, making a referral (if needed), and having your section faculty check these.
The DENTIST will evaluate your interpretation and circle M or N
The Long Form is returned to you via CLINIC FOLDERS
At the next clinic session, complete Quality Assurance: adding radiographic findings into Axium, making a referral (if needed), and having your section faculty check these.
You are evaluated based on _______.
Any errors below the margin = __ any errors over the margin = __
EX: you took 4 HBWX, you had 1 technique error and 1 retake error = __
You are evaluated based on ERROR MARGINS.
Any errors below the margin = M any errors over the margin = N
EX: you took 4 HBWX, you had 1 technique error and 1 retake error = M
how to do QA
- pick up long form and record any new/confirmed findings from the dentist
- unfinished pt: add findings prior to clinic and give to instructor to complete QA, make pt referral at reassessment on their LAST appointment
- completed pt: add findings to axium, create the referral, sign for pt “seen on rads”. address an envelope to send to pt and call them letting them know
- not adding findings to the chart or not completing a referral before handing your instructor the long form will result in an N
if radiographs havent been interpreted at the pts. last appointmetn, do we still give a referral
yes, we refer for the clinical findings first then will send another referral for ALL radiographic AND clinical findings
(let pt know second referral will be sent via mail)
section instructors role in QA
Your section instructor receives your long forms after: (2)
Instructor will transfer the grade you received for interpretation and check for QA correctness
Your section instructor will complete the QA process by _______
If you do not add your findings or build referrals when necessary
before turning into your section instructor, you may be assessed
an N in ________.
Once QA is completed by your section instructor, they will return
the Long Form to the student.
what do we do with the long form after recieving it back?
where should they be kept
Your section instructor receives your long forms after: you add findings in axium and make needed referrals
Instructor will transfer the grade you received for interpretation and check for QA correctness
Your section instructor will complete the QA process by SIGNING LONG FORM
If you do not add your findings or build referrals when necessary
before turning into your section instructor, you may be assessed
an N in PROFESSIONALISM.
Once QA is completed by your section instructor, they will return
the Long Form to the student.
what do we do with the long form after recieving it back: KEEP IT FOR FINAL GRADE CONFERENCES
where should they be kept: AT SCHOOL/LOCKER
INTRA/EXTRA ORAL PHOTOS
always planned after ______ and before ____
if taking intra AND extra photos, treatment plan ______, ____.
always planned after COMPREHENSIVE EXAM and before OHI
if taking intra AND extra photos, treatment plan D0350, ONCE
INTRAORAL WAND INSTRUCTIONS:
Check out camera from ______
Place all _____ in cubicle and sheath on _____.
Wear all ___ (gown, gloves, mask, safety glasses).
retract with: _______ or _________
Keep camera ______ to ______ or area where you are taking a photo.
Use ___ and ____ to minimize saliva.
If patient is helping retract, they must wear ______.
after use, wipe down wand camera
with ______ but do not wipe the
______!
Check out camera from STERILIZATION
Place all BARRIERS in cubicle and sheath on CAMERA.
Wear all PPE (gown, gloves, mask, safety glasses).
retract with: GLOVED HANDS or COTTON ROLLS/DRAY ANGLES
Keep camera PARALLEL to OCCLUSION or area where you are taking a photo.
Use AIR and SUCTION to minimize saliva.
If patient is helping retract, they must wear GLOVES.
after use, wipe down wand camera
with CAVI WIPE but do not wipe the
LENS!
extraoral instructions
Check out camera from _____ and sign out equipment in _______ in the drawer with the cameras.
Obtain ______ (plastic, metal, mirrors).
If _______ the SDL and phone, wear all PPE (gown, n95 safety glasses). No ___ as camera equipment cannot be _____ or ______.
As camera operator, you should not be ______ the patient
Retractor in full PPE with _______.
You must use retraction and _____ patient and retractor.
Patient can help retract, but they must wear _______.
Retractor can be a ______ who does not have a patient or the patient themselves. Office Assistant can be used only if ______ is given by the clinic supervisor or clinic session faculty.
Once you obtain your photos, you have ___ weeks to edit and upload into Dexis and send email to Prof Ludwig. After Spring semester, the two-week deadline still applies but ________ will be grading the photos in _____.
Check out camera from sterilization and sign out equipment in logbook
in the drawer with the cameras.
Obtain retractors (plastic, metal, mirrors).
If OPERATING the SDL and phone, wear all PPE (gown, n95 safety glasses). No gloves as camera equipment cannot be sterilized or disinfected.
As camera operator, you should not be touching the patient
Retractor in full PPE with gloves.
You must use retraction and direct patient and retractor.
Patient can help retract, but they must wear gloves.
Retractor can be a student who does not have a patient or the patient themselves. Office Assistant can be used only if authorization is
given by the clinic supervisor or clinic session faculty.
Once you obtain your photos, you have two weeks to edit and upload into Dexis and send email to Prof Ludwig. After Spring semester, the two-week deadline still applies but section faculty will be grading the photos in clinic.
EVALUATION OF INTRA AND EXTRA PHOTOS
Your set of __ intraoral wand photos are _____ graded by your section faculty in clinic that same day.
For Junior Spring semester only: _____ photos will be graded by Prof Ludwig.
Once completed, send an email to Prof Ludwig with the subject “________” in the body, put the ______ ONLY found right next to the patient’s name when the chart is open.
After Spring semester is over, _______ will grade extraoral photos in clinic once they have been edited and uploaded into Dexis.
Your set of 4 intraoral wand photos are ALWAYS graded by your section faculty in clinic that same day.
For Junior Spring semester only: EXTRAORAL photos will be graded by Prof Ludwig.
Once completed, send an email to Prof Ludwig with the subject “PHOTOS READY FOR GRADING” in the body, put the DEXIS CHART ID ONLY found right next to the patient’s name when the chart is open.
After Spring semester is over, FACULTY will grade extraoral photos in clinic once they have been edited and uploaded into Dexis.
Intraoral error margin:
extraoral error margin:
intra: all 4 must be acceptable for jr/sr year; if all four are not, then simply retake
extra: junior year 3/5 must be acceptable and graded by ludwig in the SPRING not summer. senior year: 4/5 grading by section instructor
