Transcript Work with mobile equipment in the Ward

Mobile Radiography Course
RAD 1304
Instructor: TAGELDIN ABUGROON
Work with Mobile Equipment in the Ward
Work with Mobile Equipment in the Ward
General Concerns
Examinations are normally complicated by a variety of
situations, which include:
The patient’s medical condition, degree of
Consciousness & cooperation.
The patient’ s treatment restrictions:
(1). life support system.
(2). Drips (I.V. line).
(3). Chest or abdominal drains. (4). ECG leads location.
(5). Traction apparatus.
Physical restrictions:
1.Room size and layout.
2.Equipment size and shape.
3. Access to adequate power supply.
ECG Monitoring
Electrode placement
for ECG monitoring
Chest Radiograph
with ECG electrode
artifact.
Pulse Oximeter
Pulse Oximeter Probe on finger
Neonatal Intensive Care Unit
Intensive Care Unit
(B) Special concerns:
1.Fully understanding of the received request, so that
the exact nature of the x-ray examination & the reason for it
are both understand.
2. Correct equipment & cassettes (cassette size, speed &
Number) are obtained, to avoid unnecessary delay &
disturbance.
3. With serious illness patient the radiographer should ask for
in-charge nurse or medical staff help, to avoid unintentional
patient’s injury or mistakes.
Standard Procedure for success Result:
(1) When the technologist arrived to the patient ward he
should first report to the nurse in-charge, this is not only
courtesy to the person in charge but will enable the
technologist to find out in which part of the ward is the
patient to be x-rayed & examination to be done.
 This also enable the technologist to explain the procedure
to the nurse & receive any special patient’s concerning
information, which will help the technologist to assess any
further help.
(2) It is kindness for technologist to go in to see the patient
without the equipment & with smiling approach, to give the
patient of what is to be the examination of what is to be
undertaken. This few minutes has great effect on removing
the patient’s fear & achieving full cooperation, this is also
will enable the technologist to assess the patient’s
capability for cooperation & any physical difficulties
presence.
(3)Now the technologist should place the equipment in
an appropriate place, then the cassette should be placed
with help & care. The tube should be positioned &
a radiograph is taken.
(4)The radiographer should preserve the patient’s privacy by
pulling around the bed curtains.
(5) After the radiographer has finished, the patient should
return back to his position & made him as comfortable as
possible.
(6) The equipment should be put away with tube column &
tube head locked in a position, which prevent any dangers
before it is taken from the ward.
(7) We should separate the exposed film from unexposed
one.
(8) Most of the requests coming from the ward or ICU to the
radiology department requesting a plain film of the chest for
adult or baby.
Patient special conditions and solution:
 Patient with Oxygen therapy.
 Patient with Intravenous infusion.
 Patient with Tracheostomy.
 Patient with Nasogastric tube.
 Patient with Drainage system.
 Patient with Traction.
Patient with Oxygen therapy
The oxygen is supplied from cylinder or through a piped
supply to the patient’s bedside .
 It is administered to patient in one of three ways:
1.By enclosing him in an oxygen tent.
2. By oxygen mask fitting over his mouth and nose..
3. By tubes inserted up his nasal passage.
Oxygen Mask
Nasal Cannula for Oxygen administration
There are two important points to remember when doing
radiography on patients who are having oxygen:
1. The risk of fire and explosion. So in order to avoid this
risk the oxygen supply should be switched off.
2. In case of very ill patient who is oxygen dependent,
the patient and positions should be ready before
the oxygen supply cut off, so that this is done for
the shortest possible time and avoid any harm to the
patient.
These should be done under the nurse supervision.
Oxygen flowmeter at wall outlet
Patient with Intravenous Infusion
 In some cases as part of the patient’s treatment it may
be necessary to give him fluid or blood by a method
other than oral administration.
 This is may be because of disability of the patient take
any thing through his mouth or due to severe fluid loss.
 The radiological technologist has no responsibility for
altering or sitting the rate of flow of an intravenous
infusion set .
IV Fluids are packaged in bottles & in plastic bags
IV Infusion Set up
Remove protective cover from
access port. Avoid contamination
With tube clamped off,
insert drip Chamber firmly
Into access port.
Invert bag or bottle & suspend
from pole
Setup is ready for
attachment
IV Flow Control Practice
improves Precise regulation
of drip rate
IV pumps regulate
infusions & permit self
administration of
IV medications
Veins used for venipuncture. A. Veins of anterior aspect of forearm.
B. Superficial veins of dorsal aspect of hand
 While the technologist dealing with the patient who has
intravenous infusion, he should observe the following
points:
1. If the needle become dislodge from its site in the vein &
a swelling occur around the needle site this can indicate the
needle is in the tissue then the in-charge nurse must be
reported immediately.
2. If the infusion stops because of tubing kinked
the radiological technologist should straight the tubing then
call the in-charge nurse.
3. If the infusion stops then make sure that bandages
&clothing on the limb are not tight, then call the in-charge
nurse.
4. If the infusion stops because of the needle maybe
against the vein wall, so the radiological technologist should
straightening the limb then call the in-charge nurse.
5. If the infusion stops because of the head of the pressure
is too low then the radiographer should raise the bottle,
then call the in-charge nurse.
6. If the infusion stops because of blockage in the tube by a
clot, this should be aspirated by a medical officer using
sterile syringe.
 During the x-ray equipment movement, the technologist
must notice the position of the infusion stand & avoid any
strike. This stand can be moved about a little if care is
taken to see that no strain is put on tubing, but the bottle
should not be lowered from it’s position.
 If the bottle is seen to be nearly empty the attention of
the ward should be drawn to this fact.
Patient with Tracheostomy
What is Tracheostomy?
 A tracheostomy is a surgical opening in the upper trachea
and a tube is passed, keeping the patient’s airway open
and having an easy access to the patient trachea to
bypass his nose, mouth and pharynx.
 Tracheostomy is indicated for
1.To overcome any obstruction in the upper airway route
(e.g. mouth obstruction).
2. To allow secretions to be removed from the trachea and
bronchi easily by suction tube (in patient who can’t cough
effectively).
3. To improve effective ventilation of the lung.
Tracheostomy Open
Attached to respirator
4.To prevent the inhalation of the food, fluid and secretions
by a patient whom has paralysis of the muscles involved
in swallowing (by separating the larynx and the pharynx).
5. In unconscious, paralyzed and traumatic injury patient.
 These patients can’t speak, so communication skills
technique should be concerned with this kind of patient
(pencil and a writing pad should be provided).
 These patients need regular suction of the accumulate
lungs secretions by the nurse in charge.
 The patient should be positioned in semi-erect of his
back, to avoid any uncomfortable position.
 The radiological technologist should avoid any
obstruction of the tube airway.
Patient with Nasogastric tube
 What is Nasogastric Tube?
 It is a tube passed through the nose and reaches
the stomach.
What is the purpose of Nasogastric tube?
 This tube used for patient’s feeding.
 The radiological technologist should avoid any dislodge
or tension on the tube.
Nasogastric Tube Placement
Nasogastric Tube in
small bowel. Note that
iodine Contrast Media
has been injected
through tube to outline
intestine.
AP Abdomen radiograph
demonstrates Nasogastric
Tube feeding tube in
the stomach (arrow)
Patient with Drainage system
 What is drainage system?
 It is a length of plastic tubing inserted into whichever
cavity it is required to drain and has a plastic bag at the end
to measure the draining fluid (e.g. urine drainage system).
 The radiological technologist should avoid striking it or
compressing or kinking the tube during moving the X-ray
equipment or during the movement of the patient.
Chest Tube placed to
drain fluid from
pleural space
Disposable Commercial Drainage System
Measuring Urinary Output
Patient with Traction
 What is the purpose of traction?
 It is used usually for fracture treatment (e.g. correct
overriding bone fragment). This can be achieved by
applying weight.
 The radiological technologist should avoid any releasing
weight. He/She should be aware of the X-ray equipment
position.
 The radiological technologist should avoid any
movement of the effected limb.