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Chapter 22 - X-rays and diagnostic radiology. After completing this chapter, students will be able to: Explain how x-rays are used for diagnostic and therapeutic purposes, compare invasive and noninvasive diagnostic procedures, carry out the medical assistant’s role in x-ray and diagnostic radiology testing,…
CHAPTER 22 X-rays and Diagnostic Radiology © 2011 The McGraw-Hill Companies, Inc All rights reserved 222 Learning Outcomes 22.1 Explain how x-rays are used for diagnostic and therapeutic purposes 22.2 Compare invasive and noninvasive diagnostic procedures 22.3 Carry out the medical assistant’s role in x-ray and diagnostic radiology testing © 2011 The McGraw-Hill Companies, Inc All rights reserved 223 Learning Outcomes (cont.) 22.4 Demonstrate the medical assistant’s duties when preparing a patient for an x-ray 22.5 Explain the risks and safety precautions associated with radiology work 22.6 Describe proper procedures for filing and maintaining x-ray films and records © 2011 The McGraw-Hill Companies, Inc All rights reserved 224 Introduction • Diagnostic radiology is a valuable tool – Screening – Clinical diagnosis • Medical assistant – Role in noninvasive and invasive procedures – Safety issues – Proper handling and storage of films – Preparation and instruction of patients © 2011 The McGraw-Hill Companies, Inc All rights reserved 225 Brief History of the X-Ray • Discovered in 1895 by Wilhelm Konrad Roentgen • Electromagnetic wave – Travels 186,000 miles/sec – Short wavelength – Penetrates solid objects – Reacts with photographic film © 2011 The McGraw-Hill Companies, Inc All rights reserved 226 Brief History of the X-Ray (cont.) • Diagnostic and therapeutic uses • Radiologist – Physician – Interprets films Radiologic technologists â 2011 The McGraw-Hill Companies, Inc All rights reserved 227 Diagnostic Radiology • Contrast medium – Purpose • Makes internal organs denser • Blocks passage of x-rays to film • Provides a clearer image of organs and tissues – Types • Gases • Heavy metal salts Iodine compounds â 2011 The McGraw-Hill Companies, Inc All rights reserved 228 Diagnostic Radiology (cont.) • Invasive procedures – A catheter, wire, or other testing device is inserted into a blood vessel or organ by a radiologist – Requires surgical aseptic techniques – Patients must be closely monitored, especially if anesthesia is used © 2011 The McGraw-Hill Companies, Inc All rights reserved 229 Diagnostic Radiology (cont.) • Noninvasive procedures – View internal structures • Standard x-rays • Ultrasonography – Do not require inserting devices, breaking the skin, or as great a degree of monitoring as invasive procedures – Uses the conventional x-ray machine or specialized instruments © 2011 The McGraw-Hill Companies, Inc All rights reserved 2210 Apply Your Knowledge electromagnetic X-rays are waves that travel at the speed of light and penetrate solid objects What is the difference in noninvasive and invasive procedures? ANSWER: Noninvasive procedures not require inserting devices, breaking the skin, or special monitoring and use conventional x-ray machines or specialized instruments to visualize internal organs Invasive procedures require surgical aseptic technique for the insertion of a catheter, wire, or other testing device into an organ or blood vessel © 2011 The McGraw-Hill Companies, Inc All rights reserved Common Diagnostic Radiologic Tests 2223 (cont.) • Ultrasound – Directs high-frequency sound waves to produce an echo of the internal organ – Produces image based on echo • Xeroradiography – X-rays developed with powdered toner on specialized paper – Less radiation exposure © 2011 The McGraw-Hill Companies, Inc All rights reserved 2224 Apply Your Knowledge True or False: ANSWER: T Fluoroscopy is used for many procedures _ Bravo! fallopian tubes F Hysterosalpingography is used to evaluate the patency of the colon _ F Cholangiography is used to detect abnormalities of the gallbladder _ bile duct F For an IVP, the radiologist injects the contrast medium through a catheter _ a retrograde pyelography T An MRI uses a combination of nonionizing radiation and a strong magnetic _ field less often due to advanced technologies F Myelography is done frequently to evaluate for spinal abnormalities _ T Thermography uses an infrared camera to record variations in skin _ temperature © 2011 The McGraw-Hill Companies, Inc All rights reserved 2225 Common Therapeutic Uses of Radiation • Radiation therapy – used to treat cancer by preventing cellular reproduction • Two types: – Teletherapy – allows deep penetration; used for deep tumors – Brachytherapy • Places temporary radioactive implants close to or directly into the cancerous tissue Requires special precautions for radiation safety â 2011 The McGraw-Hill Companies, Inc All rights reserved 2226 Radiation Safety and Dose • Reducing patient exposure – Advances in technology – Assessment of benefit-to-risk ratio • NCRP – Guidelines for protection from radiation – Prevent serious damage from radiation by limiting radiation dose levels – Reduce risk of cancer and genetic effects – Individual dose limits set © 2011 The McGraw-Hill Companies, Inc All rights reserved 2227 Radiation Safety and Dose (cont.) • Personnel safety – Always wear a radiation exposure badge – Make sure equipment is working properly – Anyone present when equipment is operating should wear lead shield © 2011 The McGraw-Hill Companies, Inc All rights reserved 2228 Apply Your Knowledge What are the two types of radiation therapy? ANSWER: Teletherapy allows for deep penetration and is used for deep tumors Brachytherapy involves the implantation of temporary radioactive implants close to or directly into cancerous tissue What should the physician consider before ordering radiologic testing for a patient? ANSWER: The benefit-to-risk ratio Super! © 2011 The McGraw-Hill Companies, Inc All rights reserved 2229 Storing and Filing X-rays • Keep fresh film on hand • Maintain new and exposed film in good condition at proper temperature and humidity • Prevent pressure marks • Keep expiration dates visible • Use oldest film first • Open all packages or boxes in darkroom • Do not store near acid or ammonia vapors © 2011 The McGraw-Hill Companies, Inc All rights reserved 2230 Storing and Filing X-rays (cont.) • Document x-ray information – Patient record card or record book – Verify that film is labeled correctly • File correctly – Film-filing envelope – Use “out-card” when removing file © 2011 The McGraw-Hill Companies, Inc All rights reserved 2231 Electronic Medicine • Telemedicine technology • Advances in radiology – Rapid video – Computer-based communications – Stereotaxis – magnetic neurosurgery technique – 3D/4D ultrasound – “live-action” images • Digital imaging – Eliminates traditional x-ray films – Decreased exposure to radiation – DICOM – communication protocol © 2011 The McGraw-Hill Companies, Inc All rights reserved 2232 Apply Your Knowledge How you store new and exposed x-ray film? ANSWER: X-ray film should be stored at proper temperature and humidity Packages should be stored on end and not stacked What is DICOM? ANSWER: DICOM is a communications protocol for handling, storing, printing, and transmitting information in medical imaging © 2011 The McGraw-Hill Companies, Inc All rights reserved 2233 In Summary 22.1 An x-ray is a high-energy electromagnetic wave that travels at the speed of light and can penetrate solid objects X-rays can be used for diagnosis by producing images of internal body structures Therapeutically, x-rays are used to treat cancer by preventing cellular reproduction 22.2 Invasive procedures require a radiologist to insert a catheter, wire, or other testing device into a patient’s blood vessel or organ through the skin or a body orifice Noninvasive diagnostic procedures not require inserting devices, breaking the skin, or the degree of monitoring needed with invasive procedures © 2011 The McGraw-Hill Companies, Inc All rights reserved 2234 In Summary (cont.) 22.3 A medical assistant can work directly with a radiology facility to assist the radiologist or technicians in performing diagnostic procedures Providing preprocedure and postprocedure care are duties a medical assistant can perform in a medical or radiology facility 22.4 The medical assistant can prepare the patient for radiological testing by thoroughly explaining preprocedure care and care during and after the procedure © 2011 The McGraw-Hill Companies, Inc All rights reserved 2235 In Summary (cont.) 22.5 The greatest risk associated with a radiology facility is the potential for radiation exposure to patients and health-care workers To eliminate this risk, certain safety precautions should be followed These include careful evaluation by the physician to determine the medical necessity of radiology testing, avoiding x-rays altogether if a patient is pregnant, and requiring all personnel who work in a radiology facility to wear a dosimeter © 2011 The McGraw-Hill Companies, Inc All rights reserved 2236 In Summary (cont.) 22.6 Proper procedures for filing and maintaining x-ray films and records include documenting the patient’s name, the date, the type of x-ray, and the number of x-rays taken in the patient record card or in the record book; properly labeling the film with the referring doctor’s name, the date, and the patient’s name; placing the processed film in a film-filing envelope; and filing the envelope according to office policy © 2011 The McGraw-Hill Companies, Inc All rights reserved 2237 End of Chapter 22 Words can be like Xrays if you use them properlythey'll go through anything. You read and you're pierced.” ~ Aldous Huxley © 2011 The McGraw-Hill Companies, Inc All rights reserved ... effects – Mild to severe – Localized to systemic – Check for allergy to fish • Examples – Angiography – Arthrography – Barium swallow or enema – Cystography – Myelography – Retrograde pyelography –. .. is a valuable tool – Screening – Clinical diagnosis • Medical assistant – Role in noninvasive and invasive procedures – Safety issues – Proper handling and storage of films – Preparation and instruction... Assistant’s Role in Diagnostic Radiology 22 11 • Assist with or perform procedures – Based on scope of practice for state – Pre- and postprocedure patient care – Patient education © 2011 The McGraw-Hill