2. USEFUL TIPS FOR
NEWCOMERS
GET TO KNOW YOUR OPERATING ROOM
STAFF
KNOW THEIR ROLES, TITLES, AND LEARN
THE RULES
AT FIRST ASSUME EVERYONE AND
EVERYTHING IS STERILE
HELP WITH PATIENT TRANSFERS IF YOU
AND THE TECH YOU ARE WITH FEEL
COMFORTABLE DOING SO.
3. TIPS FOR NEWCOMERS CNT’D
KNOW HOW TO
DRAPE THE C ARM
KNOW HOW TO
IDENTIFY THE
PATIENT
KNOW WHICH
PLUGS TO USE
FOR THE C ARM
MONITOR
USE THE
RESTROOM
BEFORE AN OR
CASE
BEFORE GOING
INTO ANY OR ROOM,
DOUBLE CHECK
WHICH BODY PART,
WHICH SIDE YOU
ARE ON, AND WHICH
SIDE THE SURGEON
WILL BE ON.
ALWAYS MOVE
CAREFULLY/GRACE-
FULLY WHEN
MANIPULATING THE
C ARM
4. WATCH THE SURGEONS EYES WHEN MAKING AN
EXPOSURE!
LEARN THE LINGO (X-RAY, SHOT, PICTURE, A
SIMPLE NOD) ALL MEAN THEY WANT AN IMAGE. IF
YOU WATCH FOR THEIR EYES TO LOOK AT THE
MONITOR WITH A REMARK FOR AN IMAGE WILL
REDUCE THE AMOUNT OF REPEATS AND
MISCOMMUNICATIONS GREATLY.
5. IF YOU FEEL LIKE
YOU ARE GOING TO
FAINT, BACK UP TO A
WALL AND SLIDE
DOWN IT. YOU ARE
NOT THE FIRST
PERSON TO FAINT IN
AN OPERATING
THEATRE AND YOU
WILL NOT BE THE
LAST. EVEN A
HARDENED
RADIOGRAPHER
CAN FEEL FAINT IN
CERTAIN
CIRCUMSTANCES.
6. ORTHOPEDIC EXTREMITIES
WITH C-ARM
UPPER EXTREMITIES
C ARM IS USUALLY ON THE AFFECTED SIDE
OF:
- HAND
- FOREARM
- WRIST
- ELBOW
- DISTAL HUMERUS
FOR THESE EXAMS YOU MAY OFFER THE
SURGEON TO USE THE IMAGE INTENSIFIER
TO REST THE AFFECTED LIMB.
7.
8. UPPER EXTREMITIES
CONTINUED
UPPER EXTREMITY EXAMS THAT USUALLY
INVOLVE C ARM OPPOSITE TO AFFECTED
SIDE:
- HUMERUS
- CLAVICLE
- SHOULDER
ANGLE THE C-ARM TO MATCH THE ANGLE OF
THE PATIENT AS SUCH IN THE NEXT SLIDE.
ALSO WHEN DRIVING IN AT THIS ANGLE HAVE
THE ANESTHESIOLOGIST HELP GUIDE YOU
BEHIND THE PATIENT SO YOU DO NOT PULL
ANY OF THEIR LINES GOING BEHIND THE
PATIENT TOWARDS THE ANESTHESIOLOGIST
WORK AREA.
9.
10. INSTRUMENT CHECK FOR
ABDOMENS
ANY ABDOMINAL SURGERY THAT GOES OPEN WILL
NEED A PLAIN FILM XR TO EVAL FOR INSTRUMENTS
(AND SPONGES/NEEDLES IF COUNTS ARE NOT
CORRECT)
ORDER ABDOMEN PRIOR TO GOING INTO ROOM
IMAGE LOWER ABDOMEN IF THAT IS WHERE THE
SURGEON WAS WORKING
AND IMAGE HIGHER ABDOMEN IF THAT IS WHERE
THE SURGEON WAS WORKING
RUN THE IMAGE PLATE, TRACK THE EXAM, CALL THE
PIT RADIOLOGIST, CALL BACK THE OR ROOM WITH
EXACTLY WHAT THE RAD SAID.
11.
12. INSTRUMENT CHECK FOR
CHESTS
THE VAST MAJORITY OF THESE ARE DONE
FOR POST OPEN HEART SURGERIES
(USUALLY A CABG)
PRE-ORDER SINGLE VIEW CHEST
TAKE TWO IMAGES, ONE OF THE LEFT AND
ONE OF THE RIGHT SIDE OF THE PATIENT (TO
ENSURE THAT YOU GET SKIN TO SKIN, AND
ENTIRE CHEST FOR SURGICAL INSTRUMENT
CHECK)
MAKE SURE COUNTS ARE GOOD
RUN THE IMAGE PLATES, TRACK THE EXAM,
CALL THE PIT RADIOLOGIST, CALL BACK THE
OR ROOM WITH EXACTLY WHAT THE RAD
SAID.
13.
14. LCE WITH CHOLANGIOGRAM
LAPAROSCOPIC SURGERY DONE TO
REMOVE GALLBLADDER
THE MAJORITY OF SURGEONS WILL
WANT THE C ARM TO COME IN FROM THE
PATIENTS RIGHT SIDE (PATIENT SUPINE)
THE IMAGE INTENSIFIER WILL BE
CENTERED BETWEEN THEIR RIGHT
ELBOW, AND MIDSAGGITAL PLANE, JUST
ABOVE THE SURGEONS LAPAROSCOPIC
CAMERA
15.
16. LINE PLACEMENTS
C ARM USED TO VERIFY TIP OF THE CENTRAL
LINE IN THE RIGHT ATRIUM OF THE HEART
DEPENDING ON WHETHER OR NOT THE
SURGEON IS PLACING THE CENTRAL LINE IN THE
LEFT OR RIGHT SUBCLAVIAN VEIN, WILL
DETERMINE WHICH SIDE YOU WILL BE ON
YOU WILL ALWAYS BE ON THE OPPOSITE SIDE OF
THE SURGEON.
SINGLE VIEW CHEST X RAY DONE POST-OP TO
EVALUATE FOR ATELECTASIS AND/OR
PNEUMOTHORAX.
SAVE FINAL IMAGE
TRACK THE EXAM
WAIT FOR CALL FROM PACU TO PERFORM
SINGLE VIEW CXR
17.
18.
19. THE CYSTO-ROOM
THIS ROOM DEALS WITH THE KIDNEYS,
URETERS, AND BLADDER.
USUALLY FOR KIDNEY STONE REMOVAL,
URETERAL STENT PLACEMENT, AND
URINARY NEOPLASM MANAGEMENT.
THIS ROOM HAS ITS OWN MOUNTED X
RAY EQUIMENT INTO THE SURGICAL BED.
THIS ROOM IS PARTIALLY STERILE, SO
YOU DO NOT NEED A MASK, BUT YOU DO
NEED A SURGICAL CAP AND BOOTIES.
(OR SCRUBS ARE ALSO OPTIONAL)
20.
21. PERCUTANEOUS
NEPHROLITHOTOMY
STERILE PROCEDURE DONE IN OR INSTEAD
OF CYSTO ROOM.
C ARM WILL BE USED AND PLACED ON THE
OPPOSITE SIDE OF THE SURGEON (ASK THE
SURGEON WHICH SIDE THEY WOULD THE C
ARM TO BE ON).
USUALLY PERFORMED DUE TO THE
SEVERITY OF A STRICTURE IN URETER.
THEREFORE THE SURGEON WILL PLACE A
NEEDLE ANTEGRADE INTO THE AFFECTED
KIDNEY, WITH FLUORO GUIDANCE, AND
PLACE THE STENT ANTEGRADE AS OPPOSED
TO RETROGRADE.
22.
23. ORIF HIPS
C ARM ALWAYS OPPOSITE TO AFFECTED SIDE
You will be moving from AP to LAT multiple times, so
when taking initial images (orthopedic surgeon will
reduce the femoral FX with the fracture table)
remember your C Arm placement, height of the C Arm,
angle of the C Arm, boom/piston distance, and oblique
angle of C Arm by writing them down before moving C
Arm away from the patient to be draped. (Be sure to
ask the surgeon if he likes the lateral angle you are
using).
ORDER OR FLUORO RVU
TRACK
24.
25.
26. SPINAL SURGERY WITH C
ARM
C ARM ALWAYS OPPOSITE TO WHERE THE
SURGEON IS WORKING
BE AWARE OF LINES, CATHETERS, WIRES
AND OTHER OBSTACLES (THERE ARE A LOT
OF THEM DURING NEUROLOGICAL SURGERY
CASES).
EASIER SPINAL CASES INCLUDE:
- MICRODISCECTOMY
- LAMINECTOMY
- SPINAL STIMULATOR
GENERALLY LATERAL VIEW WITH C ARM
USED
27.
28. TOTAL HIP ARTHROPLASTY
WITH PORTABLE X RAY
THE PATIENT IS USUALLY UP ON THEIR UNAFFECTED SIDE
ORDER SINGLE VIEW PELVIS TO EVAL THA PLACEMENT
PLACE THE IMAGE PLATE LENGTHWISE IN THE TECHMATE
(IMAGE PLATE HOLDER)
AFTER THE SURGEON, PA, SURGICAL TECH COVERS THE
TECHMATE WITH IMAGE PLATE WITH A STERILE DRAPE PLACE
THE IMAGE PLATE AGAINST THE PATIENT.
WITH THE BOTTOM OF THE PLATE LEVEL WITH THE SURGICAL
TABLE
AND ONE END EVEN WITH THE PATIENTS ASIS (THIS VIEW IS
CONSIDERED AN ORTHOPEDIC PELVIS SHOT, WHICH ENABLES
THE SURGEON TO SEE THE ENTIRE PROSTHESIS, AND
COMPARE IT TO THE UNAFFECTED LEG)
29. AFTER THE IMAGE IS TAKEN MOVE THE
PORTABLE OUT OF EVERYONES WAY
TAKE THE IP OUT OF THE TECHMATE
RUN THE IP
TRACK THE EXAM
GO BACK TO THE OR ROOM AND BRING
UP THE IMAGE
REPEAT AS NECESSARY
30.
31. CROSS-TABLE SPINE X RAY
FOR PROBE PLACEMENT
NOT VERY COMMON, BUT STILL UTILIZED
WITH SURGEONS THAT USE OLDER
TECHNIQUES.
JUST AS WITH THE THA PORTABLE, USE A
TECHMATE, BUT PUT THE FILM IN CROSS-
WISE; WAIT FOR SOMEONE TO DRAPE THE
TECHMATE.
PLACE THE IP DIRECTLY AGAINST THE
PATIENT.
THERE WILL BE A PROBE STICKING OUTSIDE
THE PATIENTS BACK (PATIENT WILL BE
PRONE)
CENTER YOUR FILM AND PRIMARY BEAM ON
THIS SPOT.
32.
33. RUN THE IMAGE PLATE
TRACK THE PROCEDURE UNDER A
SINGLE VIEW (LUMBAR, THORACIC,
CERVICAL) LATERAL SPINE
CALL THE PIT RADIOLOGIST FOR LEVEL
VERIFICATION
GO BACK TO THE OR ROOM AND BRING
UP THE IMAGE
LET THE NEURO SURGEON KNOW WHAT
THE RADIOLOGIST SAID
REPEAT AS NECESSARY
34. ABDOMINAL AORTIC
ANEURYSM
AS A STUDENT YOU WILL NOT BE DOING
MUCH, BUT IT IS VERY IMPORTANT TO
UNDERSTAND WHAT IS GOING ON
AS A TECHNOLOGIST ORGANIZATION IS
KEY IN THIS PROCEDURE.
ENSURE THAT THE POWER INJECTOR IS
CLEAN AND READY FOR ACTION
PSI IS SET TO 900 (VERIFIED WITH
VASCULAR SURGEON)
36. THE POWER INJECTOR: A
QUICK GUIDE
STEP ONE: BEFORE EACH AND EVERY CASE MAKE SURE
THAT THE POWER INJECTOR IS CLEAN, POWERED ON,
AND PSI IS SET TO 900. AND LEAVE A LITTLE PIECCE OF
PAPER ON TH EPOWER INJECTOR TO DOCUMENT EACH
INJECTION YOU DO.
STEP TWO: ONCE THE POWER INJECTOR HAS BEEN
BROUGHT INTO THE ROOM, AND IF THE OR STAFF IS
NEW/DOES NOT KNOW HOW TO LOAD THE POWER
INJECTOR INSTRUCT THEM HOW TO DO SO.
STEP THREE: ONCE THE VASCULAR SURGEON SIGNALS
FOR AN INJECTION FROM THE POWER INJECTOR GO TO
THE POWER INJECTOR AND ASSIST THE SURGEON BY
PURGING ALL THE AIR OUT OF THE LINE BY HAND
TURNING THE POWER INJECTOR.
ONCE ALL AIR HAS BEEN CONFIRMED TO BE PURGED OUT OF
THE LINE ASK THE SURGEON IF THE CURRENT RISE/FALL
SETTINGS ARE WHERE THEY WOULD LIKE IT (USUALLY
BETWEEN 1 AND 2 SECONDS)
37. POWER INJECTOR
CONTINUED
THE SURGEON WILL THEN CALL OUT NUMBERS AS SUCH: “15 PER
20”
THIS MEANS TWO THINGS: A. THE 15 IS THE RATE IN ml/sec AND B.
THE 20 IS THE VOLUME HE WANTS TO INJECT IN ml.
TO SET THIS PRESS THE BUTTON NEXT TO THE RATE BOX
LABELED “SET” ONCE
TYPE IN THE NUMBER
THEN PRESS THE SET BUTTON IN THE RATE BOX ONCE MORE.
THE RATE IS NOW LOCKED IN.
NEXT PRESS THE SET BUTTON WITHIN THE VOLUME BOX ONCE.
TYPE IN YOUR VOLUME.
THEN PRESS THE SET BUTTON IN THE VOLUME BOX ONCE MORE,
AND NOW YOUR VOLUME IS LOCKED IN.
NOW PRESS THE SINGLE BUTTON ON THE LOWER RIGHT HAND
SIDE OF THE POWER INJECTOR MONITOR.
ASK THE SURGEON IF ALL THE AIR IS OUT OF THE LINE.
IF THE ANSWER IS YES, PRESS THE YES BUTTON; IF THE ANSWER
IS NO, PRESS THE NO BUTTON (BOTH LOCATED ON THE
POWERINJECTOR MONITOR)
ONCE YOU SEE AN ORANGE LIGHT FLASHING FROM THE POWER
INJECTOR ITSELF, YOU ARE READY FOR INJECTION.
38. POWER INJECTOR
CONTINUED
TELL THE SURGEON THAT YOU ARE READY FOR INJECTION,
AND HOLD THE INJECTION TRIGGER IN YOUR DOMINANT
HAND.
THE SURGEON WILL START THEIR CINE-RUN, AND TELL YOU
TO INJECT.
PRESS THE INJECTOR TRIGGER AND AT THE SAME TIME SAY
“INJECTING”
WHEN THE INJECTION IS DONE, SAY “INJECTED”
WRITE DOWN THE VOLUME YOU INJECTED ON THE LITTLE
PIECE OF PAPER YOU LEFT ON THE POWER INJECTOR (ADD
ALL THE INJECTIONS AT THE END AND TELL THE NURSE THE
TOTAL)
GO BACK TO THE C ARM MONITOR TO START ROADMAPPING
AND MEASURING
BE SURE TO CLEAN THE POWER INJECTOR AT THE END OF
EVERY CASE, WATER SOLUBLE CONTRAST IS VERY STICKY
AND CAN RUIN THE CONTRAST HOLDER OF THE POWER
INJECTOR.
GREAT JOB!
40. FLUORO PEDAL
1: LEFT FLUORO PEDAL SHOULD BE SET
TO FLUORO
2: BLUE BUTTON SWITCHES THE LEFT
FLUORO PEDAL BETWEEN FLUORO AND
ROADMAP
3: RIGHT PEDAL SHOULD BE SET TO
SUBTRACTION
41. AAA IMAGING/PROCEDURE
AFTER THE C ARM IS DRAPED, AND
WHEN THE SURGEON SIGNALS YOU TO
COME IN, BRING THE C ARM TOWARDS
THE PATIENT AT A PERPINDICULAR
ANGLE
CENTER FOR A PELVIS SHOT FOR INITIAL
IMAGE
CENTER THE IMAGE WHERE THE
SURGEON WANTS.
ALL CINE RUNS ARE AUTOMATICALLY
SAVED
42. ROADMAPS
DURING THE AAA PROCEDURE, YOU WILL DO MANY
ROAD MAPS
STEP 1: THE SURGEON WILL DO A CINE RUN
STEP 2: WHEN THE SURGEON ASKS FOR A
ROADMAP, START BY PEAK OPACIFYING THE IMAGE
BY PRESSING THE PEAK BUTTON ON THE MONITOR.
STEP 3: PRESS THE PAUSE BUTTON AFTER THE
IMAGE HAS PEAK OPACIFIED ALL THE WAY
THROUGH.
STEP 4: PRESS THE ROADMAP MASK BUTTON ON
THE MONITOR
STEP 5: PRESS THE SAVE MASK BUTTON (WAIT FOR
IMAGE TO SHOW UP) ON THE MONITOR
STEP 6: PRESS THE USE MASK BUTTON (WAIT FOR
IMAGE TO SHOW UP) ON THE MONITOR AND PRESS
THE EXIT BUTTON ON THE MONITOR AFTER.
STEP 7: TELL THE SURGEON THAT THE ROADMAP IS
UP.
43.
44. MEASURING
AFTER A ROADMAP IS MADE, A SURGEON MAY ASK TO DO
SOME MEASURING.
STEP 1: PRESS THE ANNOTATIONS BUTTON ON THE
KEYBOARD
STEP 2: PRESS THE MEASURING BUTTON ON THE
MONITOR
STEP 3: PRESS THE CALIBRATION BUTTON ON THE
MONITOR
STEP 4: ASK THE SURGEON WHAT THE CALIBRATION
DISTANCE IS BETWEEN THE DOTS (YOU WILL SEE DOTS
ON THE X RAY, USUALLY 5 MM IN DISTANCE)
STEP 5: ONCE THE CALIBRATION IS FINISHED ASK THE
SURGEON WHERE THEY WOULD LIKE TO MEASURE
(PRESS THE MEASURE BUTTON FOR EACH
MEASUREMENT THAT IS NEEDED)
STEP 6: ONCE YOU HAVE COMPLETED ALL
MEASUREMENTS BE SURE TO SAVE THAT IMAGE WITH ALL
THE MEASUREMENTS!
45.
46. AAA: WHICH IMAGES TO
SAVE?
SAVE WHENEVER A NEW SURGICAL
APPARATUS IS BEING INTRODUCED (IE:
CATHETER).
SAVE WHENEVER ANY BALLOONING IS
TAKING PLACE (THE MOST IMPORTANT
IMAGE IS THE ONE WHERE THE BALLOON
IS MOST FULL)
SAVE WHEN ANY PART OF THE AORTIC
GRAFT IS DEPLOYED
47.
48. UPPER AND LOWER
EXTREMITY ANGIOGRAPHY
FOR ORDERING REFER TO THE OR PROCEDURE BOOK
LOCATED IN THE DARK ROOM
THE SET UP FOR THE C ARM IS EXACTLY LIKE THE SET UP
FOR THE AAA, EXCEPT YOU DO NOT USE THE POWER
INJECTOR (UNLESS IT IS A PSEUDO ANEURYSM IN THE ILIACS
THEN IT IS EXACTLY THE SAME)
YOU WILL ALWAYS BE ON THE OPPOSITE SIDE OF THE
SURGEON, FOR UPPER EXTREMITIES PLACE C ARM ON THE
AFFECTED SIDE, SINCE THE OR ROOM WILL ROTATE THE
PATIENT ONCE PREPPED AND READY.
FOR LOWER EXTREMITIES PLACE THE C ARM ON THE
AFFECTED SID AS WELL BECAUSE THE SURGEON WILL GAIN
ACCESS TO THAT BLOOD VESSEL FROM THE OPPOSITE SIDE.
INCORPORATION OF MEASURING AND ROADMAPPING IS
HIGHLY LIKELY IN THESE CASES.
SAVE THE SAME IMAGES AS YOU WOULD IN THE AAA.
49. ORIF PELVIC SURGERIES
AS A TRAUMA HOSPITAL YOU WILL SEE
MANY FX PELVISES IN THE OR
THESE INCLUDE: ORIF PELVIC RAMI,
ORIF ACETABULUM, ORIF SI SCREWS,
AND MANY OTHER VARIATIONS.
50. ORIF PELVIC RAMI
MOST COMMON VIEWS INCLUDE THE
INLET AND OUTLET VIEWS (GREAT
STARTING POINT IS 30 DEGREES BOTH
WAYS, REGARDLESS OF SEX)
SOMETIMES BOTH JUDET VIEWS WILL BE
INCORPORATED, DEPENDING ON THE
SEVERITY OF THE PELVIC RAMI
FRACTURE.
51.
52.
53. ORIF ACETABULUM
THIS WILL INCORPORATE ALL VIEWS OF
THE PELVIS (INLET, OUTLET, AND BOTH
JUDETS)
A NEW VIEW WILL ALSO BE USED HERE,
CALLED THE TEAR-DROP VIEW
55. TEAR-DROP VIEW CONTINUED
TRUE FLOOR OF THE ACETABULUM
CORRESPONDS TO THE RADIOGRAPHIC
TEARDROP OF THE PELVIS.
THE TEAR DROP LIES IN THE
INFEROMEDIAL PORTION OF THE
ACETABULUM, JUST ABOVE OBTURATOR
FORAMEN.
THE LATERAL AND MEDIAL LIPS
CORRESPONDS TO THE EXTERNAL AND
INTERNAL ACETABULAR WALLS,
REPESCTIVELY.
56. SI SCREWS
SACROILIAC SCREW FIXATION FOR
SACRAL AND ALA PELVIC FRACTURES
INLET/OUTLET, AND JUDET VIEWS ARE
USUALLY USED
57.
58. PELVIC ORIF MISCELLANEOUS
OR FLUORO RVU
OCCASIONALLY AN O-ARM SPIN WILL BE
USED DURING THESE CASES.
ORDER OR O-ARM FOR THESE
INSTANCES
59. THE O-ARM: QUICK GUIDE
WHEN MOVING THE O ARM, FIRST MAKE
SURE THAT THE MONITOR AND THE O-ARM
ITSELF IS UNPLUGGED
YOU WILL HEAR THE MONITOR START TO
BEEP (THAT MEANS IT IS RUNNING OUT OF
BATTERY POWER)
THAT IS WHY YOU MUST FIRST BRING IN THE
O-ARM MONITOR FIRST, THEN PLUG IT INTO A
RED OUTLET
THEN BRING THE O ARM IN, AND PLUG IN THE
MONITOR TO THE O ARM.
MAKE SURE THAT THE BLUE CORD BEHIND
THE O ARM MONITOR IS PLUGGED INTO THE
STEALTH MACHINE THAT IS MARKED “O-ARM”
60. THE O ARM: A QUICK
GUIDE
BE SURE TO ENTER IN THE PATIENT
INFORMATION BEFORE IMAGING.
BEFORE DRIVING THE O ARM OVER THE
PATIENT* RAISE THE O ARM UP AND
OUT, A GOOD DISTANCE SO THAT YOU
HAVE WIGGLE ROOM WHEN THE O ARM
IS CLOSED OVER THE PATIENT
ONCE THE PATIENT HAS BEEN COVERED
WITH A SECOND STERILE DRAPE THE
SURGEON WILL SIGNAL FOR YOU TO
COME IN WITH THE O ARM
61. THE O ARM: A QUICK
GUIDE
BEFORE DIRIVING THE O ARM TOWARDS THE PATIENT, MAKE
SURE THAT THE CIRCULATOR IS ON THE OTHER SIDE OF THE
PATIENT TO HELP GUIDE YOU IN.
WHEN DRIVING IN MAKE SURE YOU GO IN PERPINDICULAR TO
THE PATIENT.
LET THE CIRCULATOR KNOW YOU ARE DRIVING FORWARD.
ADJUST AS NECESSARY (IE: THE NURSE SAYS YOU ARE TOO
HIGH, LOWER THE O ARM, OR IF YOU ARE TOO LOW, RAISE
THE O ARM)
DRIVE VERY CAREFULLY AND GRACEFULLY.
ONCE YOU ARE CLEAR THE CIRCULATOR WILL LET YOU KNOW
YOU ARE GOOD.
THEN ANNOUNCE TO THE ROOM THAT YOU ARE CLOSING.
HOLD THE CLOSE BUTTON UNTIL THE O ARM IS CLOSED AND A
LIGHT APPEARS AT THE TOP OF THE O ARM
TAKE 2D SCOUT PICTURES TO ENSURE THAT THE SURGEON
IS HAPPY WITH WHERE THE O ARM SPIN WILL OCCUR. (PRESS
THE 2D IMAGE BUTTON FOR THESE SCOUT FILMS)
62. THE O ARM: A QUICK
GUIDE
ONCE THE IMAGE IS CENTERED
CORRECTLY PUSH THE 3D BUTTON.
ORIENTATE THE PATIENT CORRECTLY ON
THE O ARM MONITOR.
SELECT THE PROPER BODY PART
SELECT THE CORRECT THICKNESS.
ONCE EVERYONE IS CLEAR AND READY
DUCK BEHIND THE O ARM AND HOLD THE
3D IMAGING BUTTON UNTIL IMAGES
APPEAR ON THE O ARM SCREEN.
63.
64. GI LAB PROCEDURES
GI LAB IS LOCATED NEXT TO OUTPATIENT
SURGERY, JUST NORTH OF PACU AND
PEDS PACU
65. ERCP
ENDOSCOPIC RETROGRADE
CHOLANGIOPANCREATOGRAPHY
USUALLY FOR CHOLEDOCHOLITHIASIS
(GALLSTONES)
SOMETIMES FOR PANCREATITIS, STENT
REMOVAL, AND RENDEZVOUS WITH IR.
MAKE SURE THE NURSE HAS PUT IN AN
ORDER FOR XR ENDOSCOPY B/I
66.
67. ERCP
MOST GI DOCTORS WILL LAY THE PATIENT LAO
MORE COMMONLY AT MEMORIAL CENTRAL, THE
GI DOCTOR WILL LAY THE PATIENT SUPINE.
AS IN THE PREVIOUS SLIDE, THE SCOPE SHOULD
BE AT THE BOTTOM OF THE X RAY VIEW,
RESEMBLING A LEXUS SYMBOL.
THIS WILL ENABLE THE GI DOCTOR TO VISUALIZE
THE GALLBLADDER, CYSTIC DUCT, COMMON
BILIARY DUCT, THE DUCT OF WIRSUNG, COMMON
HEPATIC DUCT, THE LEFT AND RIGHT HEPATIC
DUCT, AND THE LIVER.
SAVE IMAGES WITH CONTRAST, BALLOONING,
STENTING, AND WIRE BRUSH FOR CYTOLOGY
ASK THE GI ASSISTANT HOW MUCH CONTRAST
THEY INJECTED, AND INCLUDE THIS NUMBER
WITH THEY TYPE OF CONTRAST USED IN YOUR
ORDER NOTES.
68. EGD WITH BALLOON
ESOHPAGEAL DILATION
USUALLY DONE ON PEDIATRIC PATIENTS
IN GI LAB, BUT CAN ALSO BE DONE IN
DIFFERENT AREAS OF THE HOSPITAL.
69.
70. BRONCHOSCOPY ROOM
LOCATED ON THE SECOND FLOOR IN
CONSCIOUS SEDATION
THE C ARM WILL ALWAYS COME IN FROM THE
PATIENTS LEFT.
THE FLUOROSCOPE IS USED TO VERIFY THE
POSITION OF THE DOCTORS CYTOLOGY
CLAMP.
OR FLUORO RVU MAY BE ORDERED
A SINGLE VIEW CHEST SHOULD BE
PERFORMED IMMEDIATELY AFTER THE
PROCEDURE IS DONE TO VERIFY THAT
THERE IS NOT A PRESENCE OF ATELECTASIS
OR PNEUMOTHORAX.
71.
72. BIRTH AND DELIVERY
ROOM
VERY RARELY THE BIRTH AND DELIVERY ROOM
WILL CALL THE OR RAD TECH FOR AN
INSTRUMENT CHECK.
THIS IS FOR AN EMERGENT C-SECTION, AND THE
DELIVERY ROOM WAS NOT ABLE TO DO A
SPONGE COUNT.
A LOW ABDOMINAL X RAY SHOULD BE IMAGED.
BE SURE TO GET THE DELIVERY ROOM NURSES
NUMBER FOR RESULTS.
RUN THE IMAGE PLATE.
TRACK THE PROCEDURE.
CALL THE PIT DOCTOR.
CALL BACK THE DELIVERY ROOM NURSE WITH
THE RESULTS FROM THE RADIOLOGIST.
