Portable Radiography
Having completed my procedure and competency requirements for the semester before the half way point, I’m planning to work on some areas of weakness during the second half of this semester. There are several comps and objectives I need to complete in the second half of the semester, but having met my quantity requirements early, I think I can take advantage of some real opportunities to advance my confidence and abilities during this time.
During my last clinical rotation, I had a very difficult experience with portable radiography. I’m not really sure which particular aspect of it was most difficult for me, but I do believe that being rushed was a significant part of my problem. As a student, I find it very difficult to learn some concepts without adequate time to perform an exam. Most of the portable exams I have done so far are the chest and abdomen/KUB routines on patients in emergency rooms, ICU, and in regular hospital rooms. They come in a variety of flavors, including unconsciousness.
My experience with the abdomen and KUB exams was that the techs would use a slip-on grid and adjust the technique accordingly. The images usually were acceptable. For the chest, on the other hand, I never saw a grid used. A large majority of these images were severely fogged from scatter radiation. If I remember correctly, all of these x-rays were done with the grid placed crosswise behind the patient (AP Chest). I can’t recall any exams being done with the IR placed lengthwise behind the patient.
Issue 1:
I never saw an SID measurement taken. The SID was always eyeballed for accuracy but never measured. As a student, I would prefer to take a physical measurement until I become comfortable eyeballing 72″.
Issue 2:
I never saw any angle measurements taken to make sure that the central ray was perpendicular to the image receptor. This was another eyeball measurement. I saw lots of chest x-rays with the apex of the lungs severely foreshortened due to improper tube angles. I would like to be able to make sure that the tube is angled properly for the placement of the image receptor.
Issue 3:
When I was trying to perform portable radiography under the supervision of a tech, I was often pulled away from the exam for the sake of getting it done more quickly. In those instances, I really didn’t get to learn much. I would rather spend time working with portable exams where the time isn’t as critical in the beginning so I can get myself comfortable and confident with what I’m doing.
I realize that time is of the essence in some cases, especially when a stat order is placed for diagnostic imaging. In those cases, I really believe that a first-year student would be better off observing rather than performing the exam. I think there are a lot of other exams where a couple extra minutes of time in making the image would not create any issues. I need to find a way to get myself into those exams so I can begin to master the techniques and become confident and efficient enough to perform the stat exams quickly and efficiently. It does nothing for my confidence when I start a procedure and then get pulled off of it before I can assure a quality image. It’s also VERY helpful to be working with a tech who wants to help you learn, but it’s not always possible.
So… In the second half of this semester, my personal goal is to become as efficient as possible in portable radiography. I will find a tech who will work with me and help me master these techniques.