Reflective Essay: Radiograph Analysis

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One would think that completing a competency on an x-ray examination, such as a chest, would be a simple task, however that is not the case. Even after completing a competency, careful considerations need to be made, in order to produce a high quality diagnostic radiograph. A patient’s body habitus, height, age, and overall health can affect the diagnostic information that is present on a radiograph. Additionally, these factors will most certainly affect the manner in which an examination is carried out. Although I have gained a competency on the standard chest examination, these factors require that myself and those around me pay close attention to the needs of the patient. But with the guidance and knowledge of the technologists at Spohn …show more content…

Although, I still do not feel like an expert and still forget some details, I have finally committed the basics of this exam to memory. Basic factors that affect a chest x-ray include: breathing instructions, proper positioning, SID, film size, and correct use of the Bucky. Chest x-rays require exposure to be taken on inspiration, this allows a minimum of ten ribs to be visualized within the lung field. Projections taken during a standard two view chest exam include a posteroanterior projection and a lateral position. This particular patient was able to stand long enough for both views to be taken in the erect position. First, the PA image was taken, this required the patient to stand with her chest against the upright Bucky. The patient’s sthenic body habitus allowed for rapid centering of the central ray and image receptor. Regrettably, due to the patient’s condition, the breathing instructions given to her during the PA image caused the her to have a coughing spasm. Next, the lateral position was taken, which entails having the patient place the left lateral side of the body against the upright Bucky. Since the lateral position requires the patient to hold their arms above the head for an extended period of time, I decided to provide the patient with an IV pole, to support and stabilize her body. This minor detail aided in improving the diagnostic …show more content…

Standard kVp ranges for a chest exam range from 110 to 125 for both a PA projection and the lateral position Although, we have not been taught the ranges for mAs in didactic instruction, in the clinical setting the range generally starts at about 10 mAs and increases with a patient’s body habitus. Considering this patient’s sthenic body habitus the kVp was kept on the low end of the range, for the PA projection. The kVp used on the PA projection was 110 and 117 for the lateral position. As for the mAs utilized in the projections an 8.9 mAs was employed for the PA projection and 25 mAs was applied to the lateral position. Radiation protection for the patient was used on both positions, via a rolling cart with a lead apron draped over it, which allows shielding to be quickly rolled in front of the patient before exposure. Protection of the technologist and myself during the examination was accomplished by standing behind a lead wall during the exposures. No repeats were necessary during this particular exam, and all the essential anatomy was demonstrated, however, there was a slight rotation of the patient’s body on the lateral image. Specific anatomy is vital for the PA projection and the lateral position in order to be considered a quality diagnostic image. This includes both lungs from the apices to the

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