wikiRadiography - Recently Updated Pages

Mobile CXR scatter radiation

AndyC — Fri, 07 Nov 2008 04:57:46 CST

Scatter Radiation Exposure From Mobile Chest X-Rays

The calculated scattered radiation dose to persons in the proximitiy of patients receiving a chest x-ray from mobile xray units assuming the following typical operating conditions

85 kVp, 2 mAs, 3mm Al filtration
180 cm FFD
35cm x 43cm CR image receptor
Proximity of the nearest person on either side of patient is around 1 metre or more,and the primary beam is completely intercepted by the receptor and not directed towards other patients or staff.

Under these conditions the entrance exposure (air kerma) to the patient is calculated to be 52 micrograys, and the scattered radiation at one metre to either side around 0.2 micrograys. To place this in perspective it should be borne in mind that the dose from natural background radiation (to which everyone is exposed) is of the order of 2400 micrograys per year; the scattered radiation from a mobile CXR at a distance of 1 metre is therefore less than that received from one hour of natural background radiation. This is an extremely small radiation exposure and the resultant risk to staff and patients is negligible.

These calculations were performed by the
Chief Medical Scientist at Flinders Medical Centre
Division of Medical Imaging
Radiation Safety Officer

Further reading

Exposure to ionising - radiation from X-rays in the intensive therapy unit St. Vincent's Hospital

Radiation and life

Ribs

AndyC — Thu, 06 Nov 2008 18:44:46 CST

Radiographic Positioning

Adult

Other related pages of interest

Name of projection	AP Projection Below Diaphragm Ribs
Area Covered	Ribs 8 through 12 should be visualized
Pathology shown	Pathology of the ribs including fracture and neoplastic processes, is demonstrated
Radiographic Anatomy
IR Size & Orientation	35 by 43 cm (14 by 17 inches) Lengthwise or Crosswise
Film / Screen Combination	(CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or stationary grid
Filter
Exposure	75 to 80 kV
FFD / SID	40 inches (100 cm)
Central Ray	perpendicular, centeres to midway between xiphoid and lower rib cage
Collimation	collimate to outer margins of thorax
Markers
Shielding	(check your department's policy guidelines)
Respiration	Suspend respiration on expiration
Positioning	Supine preferred
Critique PACEMAN	Positioning Rotation of the thorax should not be evident Area Covered Ribs 8 through 12 Collimation Center Collimation field appropriately, including ribs 8 through 12. Exposure Optimal contrast and density to visualize ribs through lungs and heart shadow or through the dense abdominal organs if below diaphragm. No motion, as demonstrated by sharp bony markings.
Special Notes	If doing a bilateral rib examination, place IR crosswise for large patients for both above and below diapragm ribs to ensure that lateral rib margins are not cut off. This compensates for magnification caused by 40 inches (100 cm ) of SID.

Radiography as a Career

junior_radiographer — Thu, 06 Nov 2008 02:53:48 CST

(This Page requires work) Why not jump in and add to the page!

A Radiographer is a healthcare professional who creates diagnostic medical images of the body and administers therapeutic doses of radiation to help Doctors diagnose and treat illness or injury. They work in hospitals, clinics, medical laboratories, nursing homes, and in private industry.

Diagnostic Radiographers produce high-quality images of the body for doctors to interpret and diagnose injuries and diseases. For example, X-Rays, Ultrasound, Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans carried out in hospitals.

Therapeutic Radiographers use ionising radiation to help in the treatment of cancers. The X-Ray beam is directed at the tumour requiring treatment and the radiation decreases the size of the tumour by killing the cancerous cells.

Roles of a Radiographer

The Radiographer's primary role is to perform imaging as requested by referring doctors or specialists. This can include X-Rays while the patient is undergoing an operation, in the Emergency Department (ED), in the Intensive Care Unit (ICU) while the patient is unconscious and ventilated, or as an outpatient where the patient is quite mobile. The Radiographer is an integral part of the health care team, working in conjunction with all Allied Health Professionals, for the best possible diagnosis, treatment and outcome for all patients.

Modalities and Specialties

The first role of all radiographers is the general or plain X-Rays. These are the simple "photo like" X-Rays taken of patients to diagnose fractures etc.

The most common of these is the Chest X-Ray. Once a radiographer has mastered these basics, they can move on to specialise in a field of their choice.

CT is one of the more common modalities radiographers can specialise in. This is a method of imaging that produces "slices". This modality can easily image both the bone and soft tissue structures of the body, and with the assistance of contrast (X-Ray dye) clearly demonstrates the blood vessels.
MRI is another specialty for radiographers. This is one of the newest modalities in radiology. The images produced by an MRI are very similar to a CT but the MRI does not use radiation to produce them. MRI relies on the bodies own natural magnetic field to acquire the images. This field usually requires further study to be fully qualified to operate the MRI.
Mammography, or imaging of the breast, is a highly specialised field of Radiography. In the United States of America gender is not a consideration in choosing this as a speciality. However, in Australia it is usually only undertaken by female radiographers, and requires extra training and study to become a Mammographer.
Ultrasound, or Sonography, is another highly specialised field of radiography. A Sonographer usually may need to have first worked for a few years as a Radiographer before they can return to University to study the field. There are cases of Nurses, Nuclear Medicine Technicians, Physiotherapists, anatomists and even pilots, retraining to be Sonographers. This is another field that does not use radiation to produce it's images, but instead uses sound waves. This is why it is most commonly used during pregnancy as it has shown no negative effect on the unborn child. Pregnancy scans are probably the most known scans, but ultrasound is able to image all the soft tissues of the body extremely well.

Education

In the United States, radiography training may be completed in a 2-year hospital based certificate program, a 2-year Associate of Applied Science Program or as a four-year University based Bachelor degree program. Certification programs in additional modalities (Mammography, CT, MRI, bone densitometry, sonography) are available at many of the same institutions that offer the initial radiography training.
In Australia, radiography is usually a 3 year university course. A list of the universities offering radiography is below. In most universities, it is called a Bachelor of Applied Science, although the "major" varies in name. The exception to both these rules is Monash University, which offers a 4-year Bachelor of Radiography and Medical Imaging course, and the University of South Australia which offers the 4-year Bachelor of Medical Radiation Science (Medical Imaging).
Once the course is completed, graduates are "provisionally accredited" with the Australian Institute of Radiography, our governing body. Graduates must complete a qualification year to acheive full accreditation. In most states, this year is called the Professional Development Year (or PDY) is completed, although in VIC it is called an Intern Year and in QLD it is called the Foundation Year. During this year, the graduate radiographer is supervised by the qualified radiographers to ensure they meet the required professional standard before they receive full accreditation. For most graduates, passing this qualification year is an easy task. Failure is uncommon.
Sonographers gain their qualifications by returning to university. They can study either a graduate diploma or a masters in medical ultrasound.

Australian Universities offering undergraduate courses in radiography

NSW

Charles Sturt University - Bachelor of Applied Science (Medical Imaging)
University of Sydney - Bachelor of Appplied Science (Medical Radiation Science)
University of Newcastle - Bachelor of Applied Science (Diagnostic Radiography)

VIC

RMIT - Bachelor of Appplied Science (Medical Radiations)
Monash - Bachelor of Radiography and Medical Imaging

WA

Curtin - Bachelor of Science (Medical Imaging Science)
SA

University of South Australia - Bachelor of Medical Radiation (Medical Imaging)

QLD

Queensland University of Technology - Bachelor of Applied Science - Medical Radiation Technology (Medical Imaging Technology)

Salaries

At the moment in Australia there is wide variance in the salaries for radiographers depending on the state in which you are working. It can also vary depending on whether you are employed in the private or public sector and just to complicate things more, the more qualified you are or if you have done a specialisation, you will receive a higher hourly rate.

Public Award	2008
NSW	See award
VIC
QLD	See award
SA	See award
NT	See award
WA

Below are short videos describing the field of Medical Imaging :

General Radiography

junior_radiographer — Thu, 06 Nov 2008 02:45:13 CST

Heres just a selection of the hundreds of articles- Its best to use the Search on the top left of screen

Basic Skills

Radiographic Anatomy

Applied Radiography - by M.J.Fuller

MJ Fuller has written extensive image interpretation articles. These are an excellent resource for both student and professional.

Check them out on the Applied Radiography Page

Paediatrics

General Information

Tools of the Trade

Radiation Safety

Radiation Safety Glossary

Mobile CXR scatter radiation

Surface Anatomy

Lines

Arterial Lines

Central venous catheters

PICC Lines

Vas Cath

Physics

Pregnancy

Pathology

Image Evaluation

Ideas & Inspiration

junior_radiographer — Thu, 06 Nov 2008 02:42:02 CST

Want to contribute but not sure how you can help?

This page has ideas for pages you can create

If you would like a page created just add it to the list

Suggested pages

Update the system time so that it is Australian, not American
Surviving your PDY -done
The spleen the forgotten organ
Radiation reduction
X-ray case of the week
Radiographer discussion forum
Digital rad/ computerized radiography
Interventional procedures
Physics
Request form Acronyms eg PFO, FFFT,
Medical abbreviations see Wikipaedia, this is well covered
X-ray techniques
Trauma Radiography
Pathology
Markers
Exposure Factors
Processor QA/QC

Paediatric Chest Projections

junior_radiographer — Thu, 06 Nov 2008 02:40:53 CST

---Under Construction ----

There is no difference in the diagnostic value of an antero-posterior (AP) projection compared to the postero-anterior (PA) projection of the chest in a child less than 4 years of age as the thoracic cage is essentially cylindrical in young children and magnification of mediastinal organs is insignificant (Blickman, J.G. (1994) Pediatric Radiology: The Requisites. Mosby, London). However, the AP projection is associated with a higher radiation dose to the developing breast, sternum and thyroid, and radiographers should take this into consideration when choosing the radiographic projection. In children under 4 years of age, the AP projection is often preferred due to ease of positioning and immobilisation. Young children like to see what is going on around them and positioning for an AP projection allows the child to watch the radiographer. A disadvantage of the AP projection is the likelihood of lordosis.

Antero-Posterior AP (Supine)

The patient is positioned supine with the median sagittal plane at 90° to the image receptor. A 15° foam pad is placed under the upper chest and shoulders to prevent lordosis. The chin is raised and the arms are flexed and held on either side of the head to prevent rotation. Sandbags and lead rubber are placed over the hips and legs to provide immobilisation of the legs or alternatively, the legs may be held at the knees by another radiographer or guardian. The primary beam should be centred to the area of interest thereby ensuring that effective collimation can be applied and dose reduced.

Antero-Posterior AP (Erect)

This projection can be performed with the patient standing or seated erect. For younger children, correct positioning and immobilisation are easier to maintain with the child seated. The patient is positioned initially with the posterior aspect of the chest in contact with a cassette. A 15° foam pad is then placed behind the upper chest and shoulders to prevent lordosis. The chin is raised and the arms are flexed and held on either side of the head by another radiographer or guardian to prevent rotation.The primary beam is centred to the middle of the area of interest and collimated to within the area of the cassette. Devices often used for this view are the "Fuller Chair" or "Pig O Stat".

Postero-Anterior PA (Erect)

This projection can be performed with the patient standing or seated. The patient is positioned with the anterior aspect of the chest in contact with a cassette and their arms around it. Both shoulders should touch the cassette to ensure that there is no rotation. The cassette is positioned to include both apices and the patient’s chin is rested on the cassette top. It is often easier for a young child to maintain this position rather than the more traditional position of the hands being placed on the back of the hips. However, if you are satisfied that the child will maintain the adult position then this should be used as it is more likely to help clear the scapulae away from the chest. The primary beam is centred to the middle of the area of interest and collimated to within the area of the cassette.

Lateral

Lateral chest radiography is often easier to perform on young children if they are seated. The child sits or stands with the side under investigation closest to an appropriately sized cassette. The cassette is positioned to include the whole of the chest. The patient’s chin is raised and the arms are flexed at the elbow and held on either side of the head by a suitably protected radiographer or guardian to prevent rotation. The primary beam is centred to the middle of the area of interest and collimated to within the area of the cassette

Go back to Paediatric Radiography page

Health Effects of Morbid Obesity

junior_radiographer — Thu, 06 Nov 2008 02:28:56 CST

Morbidly Obese Patients

-------- This page is under construction -----

Other pages of interest

Medical imaging departments are facing the impact of the morbidly obese. The increasing prevalence of obesity in the western world with the associated health problems, coupled with the growing popularity of bariatric surgery have led to increased imaging of these patients.

The morbidly obese segment of society puts a considerable strain on medical imaging departments. Current imaging technology has limited ability to accommodate these patients and provide the desired quality of images required for diagnosis, transport and movement of these patients is exceptionally difficult and departmental patient throughput is significantly hampered creating longer waiting times and inefficient use of expensive equipment.

The prevalence of obesity is increasing in Australia and around the world. According to the Centers for Disease Control and Prevention, approximately 20% of Australian adults are morbidly obese and over 30% of American adults are morbidly obese with the number rising each year.
It has been recognised by the World Health Organsiation that the effects of being morbidly obese are

Diabetes

Hypertension

High cholesterol

Sleep apnea

Chronic headaches

Venous stasis disease

Urinary incontinence

Liver disease

Arthritis

Degenerative Arthritis of Weight-Bearing Joints

Obesity Hypoventilation Syndrome

Asthma and Bronchitis

Gallbladder disease

Abdominal discomfort

http://www.aph.gov.au/library/intguide/SP/obesity.htm

BMI, or body mass index, is a simple and widely used method for estimating body fat. BMI was developed by the Belgian statistician and anthropometrist Adolphe Quetelet. It is a height to weight ratio calculated by dividing the subject's weight by the square of his/her height, typically expressed by

BMI = kg / m2

Where kg is the subject's weight in kilograms and m is the subject's height in metres.

Commonly

A BMI less than 18.5 is underweight
A BMI of 18.5–24.9 is normal weight
A BMI of 25.0–29.9 is overweight
A BMI of 30.0–39.9 is obese
A BMI of 40 is morbidly obese

A BMI of 35.0 or higher in the presence of at least one other significant comorbidity is also classified by some bodies as morbid obesity

Obese patients present a number of challenges, which generally fall into one of three areas: size, mobility, and image quality. Many of these obstacles fall upon the radiographer.

Issues that need to be considered

larger beds
hovermats for sliding
Larger wheel chairs
Lifting devices
Use of Grids

Links to other wiki pages

Hold your Breath

junior_radiographer — Thu, 06 Nov 2008 02:26:19 CST

Please add to this page:

Other pages of interest

One of the most commonly used phrases in radiography is "Breathe in and hold your breath" followed by "Breathe away". The breath-hold technique is used to minimise movement unsharpness or to inflate the lungs completely with air. With thousands of languages in the world (Papua New Guinea has over 700), it is not uncommon to find yourself with a patient who does not speak your language.

Lets develop this page with the phrase "Breathe in and hold your breath" in as many languages as possible!

Language	The Written Word	Phonetic Translation	Audio File
English	"Breathe in and hold your breath" "Breathe away"	Breathe in and hold your breath Breathe away
Italian	"Respirare e tenere il fiato" "Respirare lontano"
Greek	“Пάρται την ανάπνοι και κράτατην” “Συνεχίστε ανάσα”
German	"Einatmen und Luft anhalten." "Ausatmen."
Spanish	"Respire profundamente y mantenga la respiración" o "Inspire" "Espire" o "Expulse el aire"
French	"Respirez et retenez votre souffle" "Respirez l'écart"
Arabic	وعقد في تنفس نفسا الخاصة بك تنفس بعيدا
Portuguese	"Respire e mantenha na sua respiração" "Respire afastado"
Dutch	"Inademen en vasthouden" "Doorademen"
Pidgin Papua New Guinea	Pulin Win Pasin Win	pull en win pass in win
Swahili	Fruta hewa alafu ushike hapo Poa hewa
Slovenian	Vdihnite Izdihnite	vdee hnee teh izdee hnee teh
Bahasa Malaysia (Malay)	Tarik nafas , Tahan! Nafas Biasa
Chinese	Sook Hey - Tahan! Mow Tau Hey
Tamil	Mooche Elange - Tahan Mooche Udunge
Russian	"Вдох и провести дыхание" "Вдох вдали"
Sinhalese (Sri Lanka)	"Husma Ihalata aran nawathaganna" "Husma pitakaranna."	"Husma Ihalata aran nawathaganna". "Husma pitakaranna."
Hindi (Fiji)	Lamba sas andar "ghicho aur roko" Baraabar sas lo

Go back to the General Radiography Section

wikiRadiography - Recently Updated Pages

Links

Anatomy

CT

General

MRI

PACS

Ultrasound

Ultrasound images

X-ray

Mobile CXR scatter radiation

Scatter Radiation Exposure From Mobile Chest X-Rays

Ribs

Radiographic Positioning

Radiography as a Career

Roles of a Radiographer

Modalities and Specialties

Education

Salaries

General Radiography

Basic Skills

Applied Radiography - by M.J.Fuller

Paediatrics

General Information

Tools of the Trade

Radiation Safety

Surface Anatomy

Lines

Physics

Pregnancy

Pathology

Image Evaluation

Links

Ideas & Inspiration

Paediatric Chest Projections

Antero-Posterior AP (Supine)

Antero-Posterior AP (Erect)

Postero-Anterior PA (Erect)

Lateral

Health Effects of Morbid Obesity

Morbidly Obese Patients

Hold your Breath

Please add to this page: