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Discussion: measuring patients
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goldenj2003 |
measuring patients
Feb 25 2010, 5:32 PM EST
I am an aspiring technician who really wants to measure patients but no one in my area measures. Is this common practice or does anyone out there measure their patients anymore.
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Keyword tags:
exposure
measuring
patient care
technique chart
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eliseleblanc |
1. RE: measuring patients
Feb 26 2010, 8:18 PM EST
I too am a student radiological technologist and, although we have calipers in some of the radiography rooms, I have never seen anyone use them. I have, however, heard some of the older technologists who were trained about 30 years ago talk about using them when they were students. I too have often wondered why this practice has fallen out of use. Maybe it has something to do with the CR and DR systems not being as sensitive to small changes in exposure, or maybe something to do with patients feeling uncomfortable being measured. I really have no idea why they are not used anymore and am curious about it, too. The only experience I have had with "measuring" a patient before imaging them is in the OR, when the patient is draped, sometimes the technologist would use the weight of the patient to base the exposure on. 1 out of 1 found this valuable. Do you? |
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ERICBLACK |
2. RE: measuring patients
Feb 28 2010, 6:48 PM EST
I am also a student and I do not measure my patients, but what I have found helpful was measuring myself. This way I have a baseline of what an 8" arm looks like in comparison to my patients, so I may adjust technique more accurately.
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goldenj2003 |
3. RE: measuring patients
Feb 28 2010, 7:12 PM EST
I really like this and definetly will try it out...thank you
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rolanmanio |
4. RE: measuring patients
May 27 2010, 3:19 PM EDT
i agree with eliseleblanc, regarding the DR, now a days they can easily enhanced the image even if it is under or over facotor and it is an easy job for the radiographer but not for the patients, when i am on my internship we were advice to used the caliper measuring the part being examined, but when you are experienced you will familiarise everything, then that is the time caliper will never been used
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goldenj2003 |
5. RE: measuring patients
May 27 2010, 4:17 PM EDT
I have been measuring my patients lately (at least whenever i get a chance to...not many people like it due to the fact that it takes extra time) I have found that CR and DR actually do have alot more latitude. I noticed that in one of my clinical sites you could use the same amount of mAs for about 3-4 cm tissue change and still achieve the same exposure index...although the latitude on the CR/DR systems is high i still think measuring could be a great skill to develop due to the fact that it keeps dose down and provides the radiologists with a consistent radiograph quality....
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bfradtek1994 |
6. RE: measuring patients
Jun 3 2010, 8:20 AM EDT
"I have been measuring my patients lately (at least whenever i get a chance to...not many people like it due to the fact that it takes extra time) I have found that CR and DR actually do have alot more latitude. I noticed that in one of my clinical sites you could use the same amount of mAs for about 3-4 cm tissue change and still achieve the same exposure index...although the latitude on the CR/DR systems is high i still think measuring could be a great skill to develop due to the fact that it keeps dose down and provides the radiologists with a consistent radiograph quality...."because of the emerging technologies now a days i.e,CR/DR using caliper in measuring patient thickness is obsolete. If my memory is right some of the clinics I experienced were using VARIABLE-KVP-CHART. In my old text it has 4 Principal Type of Exposure Charts. If I get it right "thickness of anatomic part varies with kilovoltage" or in short (2kvp / centimeter). The measuring mechanism in the patient body is done simply in the thorax which vertical-upright position of the caliper i.e.,obese patients measured in 34 cm. Using said thickness of 34 cm multiply it by 2 then add 30 is the constant of the machine. The result is 98 KVP. Do you find this valuable? |
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goldenj2003 |
7. RE: measuring patients
Jun 13 2010, 1:36 PM EDT
We have learned the kVp rule but i think that a fixed kVp and a variable mAs is alot more effective...i dont think that calipers are obsolete i just think that people dont remember how to use them honestly...i think that for very small changes in anatomy it is true that you dont have to change your mAs at all but for large changes like you see in the thorax or the abdomen the use of calipers can make for more uniform exposure indexes....
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babesagun@yahoo.com |
8. RE: measuring patients
Jun 18 2010, 1:29 AM EDT
measuring body thickness using caliper before imaging them is very useful for technical factor purposes . because it will give you exact kVp for proper penetration and conrast. for producing quality images....BABES!
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bfradtek1994 |
9. RE: measuring patients
Sep 9 2010, 6:41 PM EDT
yup' I appreciate your comment however it all depends to your patient body profile or type of exam if it is barriatic/obese or average type of body. A fix kvp and variable mas is quite handy but not an absolute.
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Katiejane |
10. RE: measuring patients
Sep 24 2010, 4:56 AM EDT
"i agree with eliseleblanc, regarding the DR, now a days they can easily enhanced the image even if it is under or over facotor and it is an easy job for the radiographer but not for the patients, when i am on my internship we were advice to used the caliper measuring the part being examined, but when you are experienced you will familiarise everything, then that is the time caliper will never been used"Don't EVER be fooled into thinking that CR and DR can easily enhance an under or over exposed image. It can't. In under exposure the image will be too noisey and although it may look ok on the review monitor, it will be awful on the PACS monitor. With over exposure, you will 'burn' through some of the less dense areas. Always refer to your Exposure Index number. If it's outside the recommended range, it more than likely needs repeating. Seek advice from a senior or double-check it on a bigger monitor before repeating though! Do you find this valuable? |
vitharana |
11. RE: measuring patients
Sep 25 2010, 12:23 AM EDT
| Post edited: Sep 25 2010, 12:25 AM EDT
Interesting discussion. At the beginning it is advisable to measure the patient to calculate the correct exposures. But with experience you become familiar with the equipment and the techniques, so that you hardly need to measure to judge the exposures. You will be able to set the correct exposure just looking at the patient. The students follow the seniors. That may be the reason why the measuring the patient is not frequent now. 2 out of 2 found this valuable. Do you? |
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rolanmanio |
12. RE: measuring patients
May 21 2011, 3:30 AM EDT
i am just curious about this measuring, we can provide optimum quality radiograph by means of using the caliper by multiplying by the thickness being radiograph and add 30 constant of the machine, using caliper era is also the era of manual processing? how about if your dev and fixer solutions were too old, is measuring still be effective? any comments highly appreciated....
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mrenfinger |
13. RE: measuring patients
May 22 2011, 12:05 PM EDT
"Don't EVER be fooled into thinking that CR and DR can easily enhance an under or over exposed image. It can't.I agree 100% with Katiejane: It is true that CR/DR have a wider exposure latitude (or dynamic range), but we still need to be diligent in the practice of obtaining optimum technical factors. Here are some things to consider to back up her statements: 1) Underexposure - the software may "fix" your underexposed image with automatic rescaling, or adjusting the density to appear optimum. However, if you are underexposed, you are missing anatomical information/data. The image may appear noisy depending on how underexposed you are, and remember, you will not see subtleties at the QC station that will show up on the high resolution monitors in the Radiologist's reading room. Determine the purpose of the exam before repeating... and if you need the ability to visualize fine detail, it should be repeated. 2) Overexposed images will retain enough patient data to not require a repeat, with one exception. On EXTREME overexposed images, loss of image contrast can be possible. I'm speaking of 5-7 times the optimum density here. When you reach plate saturation, or in other words, areas of your image receptor become bombarded with radiation through the pertinent anatomy that are non-recoverable by window/level, then you need to repeat. This usually occurs with AEC and wrong bucky selection or other extreme operator errors. Do you find this valuable? |
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mrenfinger |
14. RE: measuring patients
May 22 2011, 12:12 PM EDT
I recently taught in a Radiography program in which calipers were used by the students for every exam utilizing the 4cm rule and a technique chart with optimum technical factors. Using this method appropriately, I never saw an exposure indicator outside the optimum range, except for when the equipment was out of calibration, which was rare. The con to doing this with every patient is that it is time consuming. Efficiency is greatly decreased in most busy departments. I would suggest, if this is the case, to create a technique chart using this method, and then frequently measure and compare to your chart. As you gain experience as a technologist, you will be able to look at someone's body part, know the pathology or fat to muscle ratio, and be able to apply technical factors without measuring. But it's a great way to introduce yourself into the art of appropriate technical factor calculation. Also remember that with CR/DR systems, the primary controlling factor of image contrast is the processing algorithm (no longer kVp). Keep this in mind when you create a technique chart. You can use higher kVp and have more uniform part penetration with the same scale of contrast - handy for x-tbl lateral hips, visualizing C7-T1, etc. Just be careful not to use a mAs value that is too low, or you will have noisy images. You can see some textbook references under a "high fixed kVp" technique chart. Do you find this valuable? |
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mrenfinger |
15. RE: measuring patients
May 22 2011, 12:14 PM EDT
One more thing to keep in mind (sorry, the thoughts are just racing through my brain right now)... make sure that you are not adjusting your image prior to sending it to PACS. You can adjust at the QC station, and reset to the original captured image prior to sending, but if you do not reset it, you are removing data from your image, which will leave the Radiologist with less of an ability to adjust in the reading room. Alright... done with threat hijacking ;-)
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