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Patient Care in Radi

Patient Care Ch 9-10-11

Guidlines for trauma patients that differ from inpatients. Trauma may have single injury or multiple injury. Each situation must be analyzed accordingly.
What precautions are used in trauma? Universal precautions for whatever the situation calls for.
Patience and skill is required by the technologist, how do we proceed with trauma? To accomplish the procedure without extending present injuries or increasing patients discomfort.
Does the RT have to assess the patient before starting the procedure? Rt should assess pts. neurologic status and level of consciousness before starting & reassess every 5-10 minutes.
Can you remove any bandages or splints to do the procedure? No, do not remove any dressings or splints and especially any impaled objects.
Is a trauma a routine procedure? Two 90 degree laterals to each other, to the degree the patients condition permits,approach routine positioning with the cassette as close to the body part as possible.
Dealing with spinal injuries? Using the log roll,transfer patient with as much help as possible to the table.
In case of skull and cervical spine injuries, what do we do first? A crosstable lateral cervical spine must be obtained first and approved by the Dr. before moving the patient in any way.
What is standard procedures on trauma patients? Each body part requirres at least two radiographs taken at 90 degree angles to one another.
True or False? Central ray entrance and exit points should be as close to routine as possible. True
For long bone radiography in the trauma patient? Always include the joint nearest thr trauma and the joint farthest from trauma should be included, if possible, otherwise separate views should be taken of that joint.
Do you need to modify technique for splints and bandages? Wet casts need to increase mAs not kVp to avoid scatter.
Do you need to explain to patient if he is "out of it"? Explain your movements clearly in order to gain whatever cooperation is possible, allow pt. as much control over movement as possible.
How do you take several exams at once? Take all AP's at once in an uninterrupted sequence, then lateral positions, etc.
How does it help to take x-rays in sequence of all AP's then Laterals etc.? It reduces the number of times you have to move the tube, allows overall procedure to be completed more quickly.
What are some of the necessary equipment needed for safety and precaution to health workers? Provide lead aprons for anyone who may need to be in the room caring for the critically injured patient.
Is it OK to submit a poor radiograph because the patient was difficult to get? No, inability of the patient to move or get in position should never be an excuse for a poor radiograph.
How to approach the pediatric patient? Sensitive approach, positive manner,keep distance, explain procedure, eye level
NICU Neonatal Intensive Care Unit-procedure? 2 min. hand scrub for medical asepsis.Special clothing, disinfect portable machine,prevent chilling of infant, careful not to dislodge catheters and drains. Prevent intoduction of infectious microorganisms.
Older Children approach? Respect privacy, be direct and honest, child may return to role of young child, be more comfortable with parent.
How to transport infants? It is safe to carry infants and small children a short distance. Long distance use crib, or gurney for older children with rails and sides up. Never leave alone.
Restraints and Immobilizers for the anxious child? Folding a sheet, commercial restraints, held in position by assistants(protective gear)
Special care with retraints and immobilizers? Be careful not to pinch or bruise skin or interfere in circulation. Explain that it is not for punishment and be safe and quick as possible.
Members of the elderly population may be classified into two groups? The healthy elderly and the frail.
Is the number of elderly people on the rise or decline? On the rise.
What is gerontology? The study of all aspects of aging.
What are some of the common changes due to aging? Decreased in the following, swallowing, bladder control, circulation,vision & hearing, sense of smell, muscle mass & osteoporaosis.
In the elderly patient what can mimic senility? Dehydration can cause dizziness and other conditions that look like senility.
What are some adaptations in the radiology dept. to aid the elderly? Remove rollers from chairs and stools, providing blankets, placing radiolucent pads on the table for comfort and handles on step stools for ease of use.
In elderly patients, they often have less lean body mass, would you increase or decrease kVp? decrease kVp for the leaner patient.
In elderly patients, poor expansion of the lungs during CXR's may be due to what? A decrease in alveolar elasticity.
Name some of the geriatric patient breakdown? Less swallowing reflux, decrease in bladder control, lung capcity and coronary blood flow. Inability to lie flat for long periods.
How to treat an elderly patient? Address them by their title and full name., give simple and direct instructions. Treat with full respect as any other patient.
AAD (Acute Abdominal Distress)causes: Injuries that hemmorrhage,appendicitis, bleeding ulcers, ectopic pregnancy,cholecystitis,pancreatitis,bowel obstr.
On pt. w AAD, 3 reasons for a scout film? 1. pathology(stones etc),Check technique, anatomy positioning
AAD Clinical manifestations: Poss. abrasions laceration from seatbelt or entry/exit would from bullet, Rigid abdomen, severe abd. pain, N/V, extreme thirst, poss. hypovolemic shock.
Facial injuries usualy include? Blow-out fracture - Malar bone (cheekbone) and the maxillary sinus.
How should a facial trauma be treated? As a basal and spinal cord injury, because it is close to the base of the skull and spinal cord.
AAD (Acute Abdominal Distress)causes: Injuries that hemmorrhage,appendicitis, bleeding ulcers ,ectopic pregnancy,cholecystitis,pancreatitis,bowel obstr.
1. pathology(stones etc),Chk technique, anatomy positioning
AAD Clinical manifestations: Poss. abrasions laceration from seatbelt or entry/exit would from bullet, Rigid abdomen, severe abd. pain, N/V, extreme thirst, poss. hypovolemic shock.
Facial injuries usualy include? Blow-out fracture - Malar bone (cheekbone) and the maxillary sinus.
How should a facial trauma be treated? As a basal and spinal cord injury, because it is close to the base of the skull and spinal cord.
What are some results of a spinal cord injury? Cessation of motor function/partial or complete cess. of phys. function due to level of damage:loss of bladdwr control, bowel control, loss of feeling, paralysis.
Most spinal cord injuries occur where? Cervical or lumbar areas because these are the most mobile parts of the spine.
Two types of head injuries? 1.Open injury:to skull or meninges, brain is susceptible to damage or infection. 2.Closed (blunt injury); brain tissue may swell; resulting in pressure to brain.
Why must brain and spinal cord injuries require special care? These tissues have very little healing power.
Fractures at the base of the skull are called what and may result in what? Basal skull fracture may result in tear of the dura mater, that may cause leakage of the cerebral spinal fluid (CSF).
Layers beneath the skull? Skull, dura mater, arachnoid, subarachnoid(space w/CSF), Pia mater and brain.
What is a subdural hematoma? An accumulation of blood between the arachnoid and dura mater resulting from a contusion or laceration of the subdural blood vessels.
What does an isolette do for the infant patient in the NICU? They are environmentally and thermal controlled, and the practice of meticulous infection control measures.For infants w/ low birth weights or immature immune system which makes them more susceptible to infection.
Angulated Fractures: The bone fragments & fractures at an angle to each other. Caused be direct or lateral force.
Avulsion Fx Pulling away of bone and tissue from ordinary connections. Caused from direct energy and resisted extension of area affected.
Bucket handle Fx Common in spine and involve condensing of the bone on one side, Cases: axial force applied from above
Comminuted Fx Breaking of bones in many pieces. Crushing injuries usually produce them
Greenstick Fx A break on only one side of the cortex- usually in children. Causes: minor direct or indirect force.
Closed Fx Skin is unbroken. Causes: by lesser force than other type fx.
Impacted Fx Wedging of bones against each other. Causes: axial force distal to fracture site.
Oblique Fx Angled across the cortex of the entire bone. Causes: compression w/direct or indirect force.
Open or Compound FX Breaking of the skin above fracture site. Causes; Moderate or extreme force causes the tissue tolerance to be surpassed.
Pathologic Fx May be transverse, oblique or spiral. Caused be force imposed on weakened bone by tumor.
Spiral Fx Curve around the cortex of the bone. Causes: twisting when the distal end is unable to move.
Straddle Fx Involve the pubic rami and are bilateral. Causes; Falling w/ great force directly on an object.
Transverse Fx Crosswise breaks through the bone. Causes: direct or indirect force in the direction of the site.
Symptoms and complications of Fx. Swelling, edema, bleeding, bruising and shock. Complications: malunion, nonunion, thrombophlebitis, fat embolism, infection, laceration of an artery & nerve damage.
Types of Child retraining devices? Sheet, Mummy, Pigg-o-stat (chest, and abd. uprights, plastic mold (IVP, abdomens) not extremities.
Created by: sewwhat4