Transcript patient care in radiography

PATIENT CARE IN
RADIOGRAPHY
CLASS #1
REFERENCES;
ERHLICH
RADIATION!!!!!!!!!!!!!!!!!
“When the term ‘radiation’ is used,
it generally evokes concern and a
sense of danger”
Introduction to Radiology Technology and Patient Care, Adler and Carlton 1999
HISTORY NOV. 8, 1895
 WILHELM CONRAD
ROENTGEN
 SIR WILLIAM CROOKS
 ”X”
 WILLIAM COOLIDGE
 H.C.SNOOKS
 THOMAS EDISON
 CLARENCE DALLY
 GEORGE EASTMAN
 DISCOVERED X-RAYS
 CATHODE RAY TUBE
 UNKNOWN ENERGY
 HOT CATHODE RAY TUBE
 ELECTRICAL SUPPLY
 FLUOROSCOPY
 ROENTGEN MARTYR
 PLASTIC FILM
RADIATION INJURIES
EARLY 20TH CENTURY
SKIN BURNS
HAIR LOSS
ANEMIA
TO BOTH PT AND DOCTOR
HISTORY OF RADIOGRAPHERS
PHYSICISTS
OJT (TECHNICIANS)
HOSPITAL BASED PROGRAMS
COMMUNITY COLLEGES
OVERVIEW OF RADIOLOGY AND
RADIOGRAPHIC PROCEDURES
WHAT DO YOU ALREADY KNOW?
HOW ARE X-RAYS PRODUCED?
http://www.oucom.ohio.edu/dbmswitmer/anatomy_immersion.htm
X-RAY PRODUCTION
AN OVERVIEW
VACUUM TUBE----WHY?
SOURCE OF ELECTRONS
(TUNGSTON)WHY?
TARGET (TUNGSTON) WHY?
HIGH POTENTIAL
DIFFERENCE(VOLTAGE) WHY?
RAD. TERMS/FACTS
ELECTRON CLOUD
SPACE CHARGE
99% HEAT
1% X-RAY
WAVELENGTHS
AMPLITUDE
FREQUENCY
SHORTER THE WAVELENGTH ,THE HIGHER THE
FREQUENCY
ELECTROMAGNETIC RADIATION
GAMMA
X-RAY
 VISIBLE LIGHT
 MICROWAVES

RADIO WAVES
 COMPARE THE WAVELENGTH (SHORTER OR
LONGER?) THE FREQUENCY (LONGER OR
SHORTER) OF THESE ENERGIES TO X-RAYS
X-RAY
VS VISIBLE LIGHT
 TRAVEL IN
STRAIGHT LINES
 AFFECT
PHOTOGRAPHIC
EMULSIONS
 CAN PRODUCE
HARMFUL EFFECTS
TO BODY
 TRAVEL IN
STRAIGHT LINES
 AFFECT
PHOTOGRAPHIC
EMULSIONS
 CAN PRODUCE
HARMFUL EFFECTS
TO BODY
X-RAY
VS VISIBLE LIGHT
WHAT IS THE DIFFERENCE?
IONIZATION
IT’S NOT AS BAD AS
IT SOUNDS!!!!
Ionization is the process of when a neutral
atom loses or gains an electron. When the
loss or gain occurs, a net charge is
produced. Ionization can disrupt matter.
SOURCES OF IONIZING RADIATION
Bushong, pgs 5-6
 MAN-MADE
 X-RAYS
 NUCLEAR POWER
/WASTE
 NATURAL
 COSMIC
 RADIOACTIVE
MATERIAL IN
EARTH
 POTASSIUM 40
THE X-RAY BEAM
 Small area of target
 Cone shaped
 Primary beam
 Radiation field
 Central ray
 collimator
 Scatter
 Why is called that?
RETURN TO SCAVENGER HUNT
RESULTS AND REVIEW
Add the following to your scavenger hunt
notes
DISTANCE
SID AND OID
DENSITY
mA, mAs
CONTRAST
kVp
UNITS OF MEASUREMENT IN
RADIOGRAPHY
TRADITIONAL
SI UNIT
 ROENTGEN
 COULOUMB
 RAD
 GRAY
 REM
 SIEVERT
 CURIE
 BECQUEREL
 MILLI- 1000TH OF A
UNIT
Weighting Factor
Useful for measuring occupational dose
Look at the table 1-3 on page 29…which
of these ionizing radiation do you think
would produce the most harm?
Why?
Brief overview of radiobiology
Laws of Bergonie and Tribondeau pg 30
in Ehrlich
Age
Differentiation
Metabolic rate
Mitotic rate
Effects
Short term/Long term somatic
Genetic
KEEPING SAFE
We just discussed a method of recording
radiation…how do we keep this exposure
to its lowest level
QUIT THE PROGRAM??????
No…there are
better ways!!!!!
MEASURING RADIATION FOR THE
RADIOGRAPHER
 FILM BADGE
 TLD
 OSL
 CONTROL
 5 rem per year
 1 rem x age is cumulative dose limit
Cardinal principles of protection
TIME
DISTANCE
SHIELDING
DESCRIBE HOW THESE APPLY TO
BOTH PATIENT AND OCCUPATIONAL
WORKER?
PRIMARY BEAM AND CR
ALARA
AS
LOW
AS
REASONABLY
ACHIEVABLE
PATIENT PROTECTION
 ERRORS
 REPEATS
 COLLIMATION
 HIGHEST KVP. WHY?
 FAST SCREEN/FILM
 AT LEAST 40” SID
Patients are frightened about radiation
What can we say or do to educate them?
OCCUPATIONAL PROTECTION
YOU TELL ME!
.5MM LEAD SHOULD ATTENUATE 90%
OF RADIATION AT 75 kVp
Thyroid shields
ROSE AEHLE RT (R,M)
Appendix A
WHAT DO
RADIOGRAPHER’S DO?
WHAT IS OUR SCOPE OF
PRACTICE?
CHAPTER 12, EHRLICH
 In addition to radiographers being trained in the
OR, in trauma radiography and in mobile
radiography they can cross train in
 SPECIAL IMAGING MODALITIES
CARDIOVASCULAR AND INTERVENTIONAL
RADIOGRAPHY
CT
MRI
MAMMOGRAPHY
 DIAGNOSTIC MEDICAL SONOGRAPHY
NUCLEAR MEDICINE
POSITRON EMISSION TOMOGRAPHY
THE PROFESSION
 ACRONYMS YOU NEED TO KNOW
PACS
ASRT
ARRT
ACR
CARE
JCAHO
JRCERT
DESCRIBE THE TYPE OF PATIENT
YOU MAY HAVE TO X-RAY
BODY HABITUS
PHYSICAL CONDITION
EMOTIONAL CONDITION
AGE
OTHER FACTORS