Mobile and Theatre Radiography

Question 1

Why Mobile X-Ray

Answer 1

Used for those who are unable to be transported to general/A&E safely.

‘Mobile’- can be moved.

X-ray on wheels… with brakes!

Question 2

Where do we do mobiles?

Answer 2

‘Resus’
NICU/SCBU
ITU/ICU
HDU
CCU
Wards/Theatre

Question 3

Common Mobile Requirements

Answer 3

CXR- common
Should be erect
Check with nursing staff prior to moving.
Try to remove wires from FOV.
Use a cassette cover

Question 4

Common Mobile Requirements

Answer 4

Landscape orientation…
Straighter the patient=reduced angle
Inspiration still required
If patient is unconscious, check breathing pattern.

Question 5

Mobile AP Chest X-Ray Considerations

Answer 5

Non ambulant patients.
Status of patient, careers or acute staffing needs
Safety regarding medical equipment
Trauma patients

Question 6

Mobile AP Chest X-Ray Considerations

Answer 6

Patient comfort
Post surgery?
Infection control – barrier nursing
Staffing numbers or resources, night shift?

Question 7

Impact of SID on Dose (Moonkum et al., 2022)

Question 8

Impact of SID on Dose (Moonkum et al., 2022

Question 9

Considerations- Inspiration v Expiration

Question 10

Considerations- PA v AP

Question 11

Considerations- Supine v Erect

Question 12

Considerations- Markers

Answer 12

AP / PA
Erect / Sitting or Supine or Decubitus
Left / Right
Location, eg MOBILE ICU
Exposure factors
Time of day

Question 13

Mobile Trauma Series- C-Spine, Chest, Pelvis…CT?

Question 14

Mobiles- Radiation Protection

Answer 14

Controlled Area
Lead aprons
2m from patient where practicable
Primary beam
Check area- you are responsible!

Question 15

Mobiles in NICU/SCBU- Risks

Answer 15

Infection Control
Exposure Factors
Identification
Lead aprons
Movement
Leads

Question 16

NICU Imaging

Question 17

NICU Imaging

Answer 17

NGT
Used to confirm the tip is correctly in place
Tip is usually lowest point required to be included… check!
Rotation?

Question 18

NICU Imaging

Answer 18

Chest drain insertion
Helps drain blood/air/fluid from the pleural cavity

Question 19

Digital Mobiles
Advantages and Disadvantages?

Question 20

Theatre Imaging- Where?

Answer 20

Orthopaedics
Interventional Radiology
Cardiac Cath Lab
Urology

Question 21

Theatre Radiography

Answer 21

Write down as many examples as possible of types of procedures/specialisms that may use radiographic guidance.

FOR EXAMPLE- ORIF

Question 22

Theatre Imaging- Where?

Answer 22

General
Spinal
Pain Clinic
Breast Biopsies

Question 23

Theatre Equipment- ‘C-Arm’

Answer 23

Consists of the c-arm and independent monitor set.
Can be moved in many planes.
Usually kept near theatres
Requires PACS access.

Question 24

Theatre Equipment- Fixed Equipment

Answer 24

c-arm
xray source
image intensifier
monitors
xray table

Question 25

Theatre Roles and Responsibilities

Answer 25

Appropriate attire! Be aware of theatre lists Early set-up and ID Infection control Radiation protection Communication

Question 26

Theatre Roles and Responsibilities

Answer 26

Teamwork Storing images Recording doses Keeping things sterile Know your capabilities! Change!

Question 27

Challenges to Radiographer’s role in Theatre (Naylor and Foulkes, 2017

Answer 27

Communication errors Patient safety (WHO surgical safety checklist) Preparation of equipment “Hierarchy” Conflict

Question 28

Theatre- Radiation Protection

Answer 28

Lead protection Time and Distance Patient ID- Pregnancy? Keep records Transferring images Inverse square law

Question 29

Theatre- Radiation Protection

Question 30

Radiation Protection in Theatre (Dorman et al., 2023)

Question 31

Common Orthopaedic- ORI

Question 32

Common Orthopaedic- DHS

Question 33

Session Aims

Answer 33

By the end of this session, students should: Be familiar with some of the common reasons radiological imaging might be implemented in a theatre or mobile setting. Start to recognise some of the differences in equipment types and techniques in the mobile and theatre settings. Gain an implementable knowledge and understanding of radiation protection as applied to the mobile and theatre setting. Gain awareness of some of the differences from the general department