Radiography Lumbar Spine Study

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The student discusses the stages involved in a computed radiography lumbar spine examination for a 35 year old male, with English as his second language, who was sent to the x-ray department following an appointment with his General Practitioner (GP). The clinical details read: “Recent road traffic accident 4 weeks ago, locking pain and stiffness in lumbar region, with bony tenderness. X-ray lumbar spine to rule out fracture”
Prior to evaluating the clinical details, the request card was checked that it contained the relevant information which would identify the patient once they entered the x-ray room. Additionally it confirmed that the correct patient was to be exposed to a dose of ionising radiation and that the interaction could be accurately
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The exposures were 85 and 96 Kilovolts (kV), for the AP and lateral projection respectively, using an oscillating grid coupled with an Automatic Exposure Control (AEC) with a central chamber. The Kilovoltage determined the penetrating power of the x-ray beam, (Hays and Hughes 1983) and the milliampere-seconds (mAs) determined the intensity of the electron beam; how many electrons in the beam flowing per second (Ball, Moore, Turner 2008). The oscillating grid absorbed scattered secondary radiation whilst transmitting the maximum amount of primary radiation, reducing noise and increasing radiographic contrast (Carroll 2007). Due to the heterogeneous energy of the x-ray beam, some electrons could be attenuated by the patient’s body more easily than others. The AEC measured this low intensity and delayed the end of the exposure until enough x-rays reached the cassette in order to produce a diagnostic image (Carter, …show more content…
Having informed the patient of how the examination was to proceed, informed verbal consent was obtained. This was essential to legally validate the x-ray examination, (Royal College of Radiologists, 2012) and to give him an active role, working alongside the student should he have felt he wanted to contribute, a key principle of patient-centred care (Health Foundation, 2014). He confirmed his name, date of birth and address according to the employer’s procedures (Trust X, 2011). Due to the patient being male, the last menstrual period was not checked with Trust X’s Last Menstrual Period Policy, which states that the last date of the patient’s most recent period should be recorded between the ages of 12-50 (Trust X, 2009). It was decided that gonad protection would not be used: although it would have offered him radiation protection for reducing his radiation dose, the risk of covering relevant anatomy, given that he had no previous images and potentially repeating the examination was far greater. The patient’s mobility was assessed by the student upon entering the room where limping was noted. It was only when the student had asked the patient to describe his pain that it became evident that he was not fluent in English, thus heightened methods of verbal and non-verbal communication were adopted to explain to him what he was required to do.

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