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Transcript

  • 1. HSC 3409-30
    Treatment Procedures
  • 2. Treatment Tasks
    Review of the chart (signature??)
    Preparation of room
    Identify and greet
    Assist onto table into position
    Locate marks
    Raise couch
    Move patient into position
    Rotate gantry & collimator
    Position beam modifiers and shapers
    Leave room
    Monitor the patient
    Set controls
    Beam on
    Record treatment
    Assist patient out of room
  • 3. RadOnc record
    Separate from hospital chart
    Contains:
    Diagnosis to include pathology etc.
    Consultation
    Consent
    Response to treatment
    Monitoring of treatment
  • 4. RadOnc chart cont.
    EMR
    Record & Verify
    Quality Assurance
  • 5. Treatment Preparation
    Patient Identification (photo)
    Signed prescription
    Detailed positioning and immobilization information
    Dosimetry plans
    Calculations
    Treatment record
    Documents delivery
    Records fractional and cumulative doses
    Machine settings
    Verification imaging
    Any rx. change
  • 6. Radiation Prescription
    Anatomic site
    Total radiation dose
    Fractionation
    Protraction
    Treatment technique
    May have:
    Energy
    Port size and angles
    Beam modifiers
  • 7. Radiation Prescription cont.
    Be aware of changes:
    Signature must accompany changes
    Fractionation
    Total dose
    Addition/deletion of blocks/bolus
  • 8. Treatment Plan Description and Reference
    Treatment field syn. With field portal or port
    Each field has a different name
    Changes are denoted with a subscript, numbers or prime marks
    Specifies field size (w X l), orientation and beam modifiers
    Images
  • 9. Treatment Record
    Documents implementation of treatment
    Should be able to tell:
    Last treatment
    How far along
    Films needed
    Changes to rx.
    Treatment date, number, elapsed days, fractional and total dose delivered, notations, initials
  • 10. Verification Images
    Hard film
    Electronic Image
    Usually weekly
    Graticule (BB tray)
  • 11. Treatment Room
    Isocenter (3 axes of rotation)
    Lasers
    Lighting
    Treatment couch
    Cleaning supplies
    Treatment accessories/devices
  • 12. Patient Transfers
    Wheelchair transfer
    Gurney transfer
  • 13. Patient position, isocenter, and field placement
    Patient positioning
    Localization
    Isocenter positioning
    Verification Imaging
  • 14. Beam Positioning and Shape
    MLC
    Blocks
  • 15. MLC
  • 16. Blocks
  • 17. Beam Modifying Devices
    Bolus
    Compensators
    Wedge
    Transmission Filters
  • 18. Bolus
  • 19. Compensators
  • 20. Wedges
    YouTube - Wedge It
  • 21. Electron beam modifiers
    Collimation
    Internal Shielding
    Bolus
    Shaping
  • 22. Assessment and acceptance of treatment parameters
    Patient monitoring systems
    Console
  • 23. Treatment Delivery
    Beam on/off
    Interruptions
  • 24. Common treatment techniques
    Multiple fields
    Adjacent fields
    IMRT
    IGRT