A Step by Step Guide to a Typical Radiographic Examination:
- Request form
- Request form and patient
- Escort patient to changing cubicles
- Pre-examination preparation
- The examination/procedure
- Assessing the radiograph
- Aftercare of patient
Common Elements of a Radiographic Examination
- Indication for imaging
- Patient Identification
- Anatomical markers
- Source-to-image distance
- Patient preparation
- Radiation protection
- Patient Positioning
- Critique of the radiographic image
- Chest, vertebral, cranial, shoulder and hip
- Finger, wrist and forearm
- Elbow and humerus
- Toe and AP and oblique foot
- Lateral foot, ankle, lower leg and femur
- Decubitus chest and abdomen
- Axio-lateral shoulder and hip
Assessing the resultant radiograph
Mandatory Medico-legal considerations;
- Correct patient identification
- Correct anatomical marker
- Correct technique / positioning
- Evidence of collimation.
- Radiographic image quality
- Exposure Index
- Correct Brightness
- No artefacts
- Is there any need for repeats?
Consideration of anatomy and pathology.
- Are there any anatomical variations / pathologies
- Is there any need for further projections?
General Patient Care
- Always show courtesy and respect to the patient and their relatives
- Refer to patients by name
- Always give the patient enough time
- Face the patient squarely when talking or listening
- Keep good eye contact
- Show interest and concern
- Show empathy/sympathy
- Use open body language
- Try to be at the same eye level as the patient
- Comfort the patient
- Share a sense of humour with our patients
- Encourage patients to talk of their fears and concerns
- Be aware of the patient’s physical problems and/or limitations
- Be aware of the psychological problems associated with illness, examinations, hospitals
What Is Going Through the Patient’s Mind?
- What is wrong with me?
- Do you know my diagnosis?
- Am I going to get better?
- Will I suffer any pain
- With the illness
- With the investigations?
- Will I look any different?
- Will I feel any different?
- Why has this happened to me?
- Will you answer all my questions?
- Will you think of me as an individual in my own right?
- Will I remember all of your instructions?
- Will you think I’m stupid if I forget what you have told me?
- What if I can’t do what you have asked me to do?
- Will I have to come again?
- Always introduce yourself to the patient and state your profession
- Explain the procedure and the patients role
- Rehearse any breathing manoeuvres (or similar) if the patient has a limited ability to co-operate
- Check the patient has complied with any preparation e.g. removing any relevant clothing or jewellery
- Ask if the patient has any questions or concerns
- After the examination, inform the patient of what they should do next and check they understand the advice given
- The request must be justified according to IR(ME)R and the departmental protocols
- The patient must be correctly identified using department protocol. The patient should be asked to confirm their full name, date of birth (DOB) and their address; this should be cross referenced with the request form
- Informed consent must be gained by verbal permission
- Always prepare the X-ray room prior to the patient entering the room
- Follow the department protocols for the procedure
- Always collimate to the area of interest as excessive field sizes reduce image quality and increase the patient dose
- Apply a radiographic marker within the primary beam and prior to making the exposure