UNIT 3: Introduction to Fluoroscopy Flashcards
About Fluoroscopy
- Permits viewing of dynamic images or “live” x-rays, in motion Utilizes an image intensifier to acquire images
- Can record images digitally “spots” and/or take “overhead” films
- Radiologist or Fluoro tech may perform fluoroscopic portion of exam
- Direct ingestion or instillation of the contrast media
- Monitor its progression through the desired portion of the GI tract with fluoro
- Timer is set to alarm every 5 minutes of activated fluoro
Room Preparation: Tech Responsibility
- Room prep should be completed prior to patient entering
- Exposure controls should be set
- The room should be clean and well stocked with sheets, towels, contrast media, ancillary equipment, cups, basins, aprons, gloves, paddle, lead drapes
- The equipment should be checked to be sure it is operational.
- Anticipate overhead images and ensure you have a sufficient number of IRs available to complete the exam.
Patient Communication
- Introduce yourself
- Verify patient identity:
-First AND Last Name
-Date of Birth
-Medical Record/ Facility ID - Does patient know why they are here and what type of exam they are having?
- Explain details & procedure of exam to patient
-Be clear & honest
-Use simple terms
-Explain taste of barium
-Any possible discomfort associated with procedure
-How the table might move
-Lights turn on and off
-How equipment will be used during procedure
-Patient will be moving around
-Where and how tip will be inserted for BE (Barium Enema)
-Verify patient understands and has opportunity to ask questions
-Patient appropriately changed into a gown.
-Jewelry and foreign objects removed
Pre-Procedure: Tech Responsibility
- Take the patient’s medical history
- What are current medical issues?
- How long has problem(s) existed?
- Has the patient ever had this type of exam before?
-If so, when and where and what were the findings?
-Any problems/concerns - Any previous surgeries to the gastrointestinal tract?
- Obtain scout film
- Inform radiologist patient is ready and give him or her the patient’s history
- Upon entering the room, the radiologist should be introduced to the patient
T or F: Many studies of the GI tract employ both positive & negative contrast agents simultaneously
True
•POSITIVE contrast agents
BARIUM and GASTROGRAFIN: coat the internal lumen of structures
NEGATIVE contrast agents
-AIR: used to distend the lumen of the organs allowing visualization of the internal surfaces
-CARBON DIOXIDE
Positive contrast: BARIUM SULFATE
A water insoluble salt, is universally employed for exams of the GI tract. Available either in dry powder or liquid form.
Positive Contrast: GASTROGRAFIN or HYPAQUE
A water soluble iodinated contrast media. This medium is usually employed when perforations or obstructions of the bowel are suspected.
How does Contrast Media appear on images?
White
Instillation of Contrast Media: UPPER GASTRO-INTESTINAL (UGI)
-Patient drinks the contrast medium
-Or it may be instilled through a feeding tube called a nasogastric (NG) or a DOBB-HOFF tube.
Instillation of Contrast Media: LOWER GI or COLON (BE)
-Requires instilling the barium through an enema tip in rectum.
-Or a patient may have a tube/ostomy that leads from a portion of the GI tract to the outside. Contrast media may be instilled through these tubes to delineate specific portions of the GI tract
Erect and Recumbent Fluoroscopy
• Anatomical structures are evaluated
-Size and shape
• Motility of the contrast media through the GI tract
• Evidence of pathology or pathological processes documented
-Radiologist will make multiple exposures in an effort to document the study.
-Documentation will vary according to the exam, radiologist’s preference and /or equipment capabilities.
-Spot films or digitally acquired images are the recording medium
What is your role as the x-ray tech?
• Assist the radiologist as necessary
• Anticipate what they will need next and have things ready
• Comfort and talk with patient during exam
• Help patient into a desired position
• Mix and administer the contrast agent
• After radiologist acquires fluoro images, radiographer may be asked to take “overhead” images with IR
• Restrict the primary beam by using proper collimation to include ONLY primary anatomy
Radiation Protection
• Patient receives radiation every time fluoro is on
• Beam restriction should be utilized at all times
• Use proper collimation to include ONLY the primary anatomy of interest
• Practice the Cardinal Principles
-TIME
-DISTANCE
-SHIELDING
