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Pearson's Comprehensive Medical Assisting Administrative and Clinical Competencies Second Edition CHAPTER 48 CHAPTER Radiology Lesson 2: Diagnostic Imaging Procedures Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Lesson Objectives Upon completion of this lesson, students should be able to … • Define and spell the terms to learn for this chapter. • Describe the process and medical use of fluoroscopy. • Discuss computerized tomography, positron emission tomography, magnetic resonance imaging, and ultrasound. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Lesson Objectives • Define and discuss the uses for radiology, radiation therapy, and nuclear medicine. • List four side effects of radiation therapy. • Describe the safety precautions to take for health care workers and patients relating to X-ray procedures. • Discuss the proper methods for storage of X-ray materials. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. General Categories of Diagnostic Imaging • • • • Invasive Noninvasive Procedures requiring contrast material Procedures not requiring contrast material Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Methods of Administering Contrast Media • • • • Orally Rectally IV Catheter Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Radiologic Imaging Procedures Requiring Contrast Media • Fluoroscopy procedures • Angiography • Arthrography Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Fluoroscopy Procedures • Visually examines a portion of the body or the function of an organ using a fluoroscope • Allows the radiologist to have immediate images • Moving image that is seen on the fluoroscope can be filmed using a radiograph (X-ray) to obtain a permanent record Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Fluoroscopy Procedures • Contrast media are often used to better visualize organ function and abnormalities • Fluoroscopic procedures include the gastrointestinal series, IVP+, cholecystogram, and myelogram Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gastrointestinal Series • Fluoroscopic study • Studies the digestive tract • Uses contrast media • Can involve an upper GI or lower GI • Patient instructions are important Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Instructions for Upper GI Series • • • • • • NPO after midnight No smoking Undress prior to procedure Drink barium sulfate during procedure Procedure can last several hours Normal eating can be resumed after procedure • Drinking water after procedure important • Stool may be chalky for a few days Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Instructions for Lower GI Series • Low-residue diet a few days before • All-liquid diet the morning before • Cathartic may need to be taken the day before • Undress for the procedure • Enema or barium sulfate given and patient retains during procedure • Prior to end of procedure enema is expelled and X-ray of empty bowel is taken Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Instructions for Lower GI Series • Regular diet can be resumed with lots of water • Whitish stools for 1 or 2 days Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Intravenous Pyelogram (IVP) • Examination of the kidneys, ureters, and bladder • Procedure takes 60 to 90 minutes • Iodine is used • Low-residue diet and lots of water the day before • Patient on NPO after midnight • Cathartic with enema the night before may be ordered Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Intravenous Pyelogram (IVP) • Patient undresses and IV of contrast medium is given • Urination and then one final X-ray may be required • Normal diet after exam with water Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Cholecystogram • Examination of the gallbladder • Requires contrast medium • Utilized when ultrasound has not provided a definitive diagnosis • Fat-free meal the night before with contrast medium pills • NPO after midnight • Patient undresses and X-ray is taken Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Cholecystogram • Patient is then asked to eat a fatty meal one hour later another X-ray is taken • Diarrhea may occur after procedure Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Myelography • Fluoroscopic procedure of the spinal cord • Involves a lumbar puncture • Used to detect compression of the spinal cord or herniated disks • Typically done if CT or MRI has not provided enough detail • Visualization of the cavities of the brain is done through a pneumoencephalograph Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pneumoencephalograph • Performed by injecting air instead of contrast media after some cerebral spinal fluid has been removed • Allows visualization of the cavities of the brain Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Angiography • Provides visualization of the internal anatomy of blood vessels after a radiopaque material has been injected into the blood vessels • Contrast medium is injected into an artery or vein by way of a catheter and threaded through the vessel until it reaches the correct site Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Angiography • Since iodine is used as the contrast medium, the patient should be tested for allergy to iodine before the procedure begins • The patient is monitored for a few hours after the procedure for any signs of bleeding from the puncture site Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Cardiac Catheterization • Form of angiocardiography • Frequently performed to assess the status of the coronary arteries • Catheter is inserted into the femoral artery and fed through the arteries until it reaches the heart Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Cardiac Catheterization • If obstructions are discovered, therapeutic interventions can take place, such as balloon angioplasty or stent insertion, to relieve blockage of coronary arteries • These procedures are costly, carry risks, and are not usually performed unless other procedures have failed to provide enough information Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Arthrography • Used to produce an arthrogram or image inside a joint • Helps diagnose abnormalities of the joints, tendons, ligaments, and cartilage of the knee, hip, or shoulder • Procedure involves injecting a local anesthetic followed by contrast medium or air or both into the joint Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Arthrography • Fluoroscope is used to evaluate the function of the joint • Procedure usually takes about 1 hour and the patient should be advised to expect some slight discomfort and swelling for a day or two • Patient should be advised to rest the joint during that time Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Procedures Not Requiring Contrast Media • Films of the: – Abdomen – Bones – Chest – Kidneys – Ureters – Bladder (KUB) – Paranasal sinuses Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Mammography • Radiology examination of the soft tissue of the breast to provide identification of benign and malignant neoplasms (tumors) Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Instructions for a Mammography • Due to the effects these products can have on the clarity of the test, prior to the procedure patients should be instructed not to use – Underarm deodorant – Talcum powder – Body lotion – Perfume Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Mammography Procedure • Patient stands in front of the X-ray equipment Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Mammography Procedure • Technician positions the patient carefully to have all breast tissue examined under X-ray • Patient should be instructed to follow the technician’s direction regarding placement of hands, arms, and body position • Patients of childbearing age are given a lead apron to wear during the procedure • Each breast is alternately compressed by the equipment to spread the tissue for better viewing • X-rays are directed at angles into the breast tissue Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Mammography Procedure • Procedure takes a few seconds for each view with the entire procedure lasting about 30 minutes • Patients may feel discomfort due to pressure during the breast compression Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Addressing Breast Lumps • Women over the age of 40 are advised by the American Cancer Society to have a yearly mammogram for early detection of breast cancer • Many abnormalities detected on mammograms are benign and present no danger to the patient Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Addressing Breast Lumps • If a lump is detected, the patient should follow up immediately with further testing and not wait to see if the lump disappears over time • Once a mammogram reveals suspicious tissue, a breast biopsy should be done to confirm the type of mass detected Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Stereotactic Breast Biopsy • Less invasive and less painful than previous types of biopsies • Procedure is done with the patient lying face down with the breast compressed between two paddles with the suspicious mass centered in the window of the paddle • A computer determines the precise positioning of the biopsy needle Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Stereotactic Breast Biopsy • A small sample of cells is taken and sent for review by a pathologist • After the examination is complete, the physician informs the patient of the pathologist’s findings Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Tomography • Allows for the penetration of dense areas • Tomography produces tomograms • Computed tomography produces CT scans Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Computed Tomography (CT) • Combines radiography with computer analysis of tissue density • X-ray camera rotates completely around the patient and the computer accumulates cross-sectional slices from each rotation of the camera Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Computed Tomography (CT) • CT scanner consists of a moveable table with a remote control, the circular structure or gantry that houses the X-ray equipment, and an operator console with monitor and computer equipment • Ancillary software and hardware sort, manage, retrieve, and store images Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Computed Tomography (CT) • Procedure is painless, noninvasive, and requires no special preparation • Patient lies on a narrow table that slides into the scanner • Computer then calculates various factors to detect tissue masses, such as tumors, bone displacement, and fluid accumulation Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Positron Emission Tomography • Examines the metabolic activity of the body • Patient injects or inhales a radioactive substance • Used to assist in treating conditions such as: – – – – – – Epilepsy Brain tumors Stroke Alzheimer’s disease Blood flow Metabolism of the heart and blood vessels Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Magnetic Resonance Imaging (MRI) • Provides a visual of internal tissues, organs, and structures • Image is threedimensional Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Magnetic Resonance Imaging • No ionizing radiation is used • Hard portion of bone matter cannot be viewed • Cannot be used on patients who have pacemakers or metallic clips on blood vessels • Functional MRIs allow for the observation of organ functions Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. MRI Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Instructions for Magnetic Resonance Imaging • Remove all jewelry, eye shadow, and metallic objects, such as watches, belts, hearing aids, and hairpins • Identify which devices, if any, have been inserted within the patient’s body such as: – Pacemakers – Dental implants – Surgical staples – Intrauterine devices Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Instructions for Magnetic Resonance Imaging • Leave credit cards or devices, which contain metallic or magnetic code strips outside the MRI chamber • Use patient gown if the patient’s clothing has zippers or metal snaps Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Digital Radiology and Ultrasound • Digital radiology – Uses standard fluoroscopy – Image is projected on a TV or video monitor screen – Digital angiography used for cardiac and pulmonary arteries and head and neck angiograms Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Digital Radiology and Ultrasound • Ultrasound/sonography – Uses high frequency waves to view internal structures – Applied in fetal monitoring and detecting abnormalities of the heart, liver, kidneys, thyroid, gonads, and blood vessels Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Ultrasound Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Preparation for the Ultrasound Examination • The patient should wear loose-fitting garments or clothing that is easy to remove since the procedure is performed over bare skin • During a fetal ultrasound or pelvic ultrasound, the patient is instructed not to urinate right before the test since a full bladder displaces the intestines and allows for a better view of the uterus Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Preparation for the Ultrasound Examination • The patient may be asked to drink a quart or more of water just prior to either of these examinations • For an ultrasound of the gallbladder or liver, the patient may be asked not to eat for several hours before the procedure Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Patient Preparation for the Ultrasound Examination An ultrasound being performed on a patient. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Radiation Therapy • Uses radioactive substances to diagnosis and treat diseases • Uses a specific dose of radiation to kill diseased cells • Normal cells are altered but will naturally repair • Also known as: – Cobalt treatment – X-ray treatment – Radiotherapy Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Types of Rays in Radiation Therapy • Alpha rays – Least penetrating of the rays – Positively charged with helium particles • Beta rays – Able to penetrate body tissues – Negatively charged Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Types of Rays in Radiation Therapy • Gamma rays – Are electromagnetic waves emitted by atoms of radioactive elements as they undergo disintegration – Can penetrate most body tissue, but are absorbed by lead Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Conditions Treated with Radiation Therapy • • • • • • Various types of cancers Hodgkin’s disease Wilms’ tumor Retinoblastoma Keloids Malformed blood vessels in the brain Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Methods of Administering Radiation • External radiation therapy (ERT) – Administering calculated doses of radiation to a specific site • Internal radiation therapy (IRT) – Administering radiation through a sealed container that houses radioactive material – Administering radiation through a liquid form via the patient’s mouth, bloodstream, or instilling it into a body cavity Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Nuclear Medicine • Uses radioactive isotopes to treat and diagnosis diseases • Involves the use of radioactive isotopes of iodine, cobalt, and other elements • Also known as radionuclide imaging Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Units of Radiation Dose • Rad – Unit used to measure the amount of ionizing radiation absorbed • Rem – Unit used to measure occupational exposure • Units used to measure the effects of radiation: – Roentgen (R) – Gray (Gy) – Sievert (Sv) Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Effects of Overexposure to Radiation • • • • • • • Lowered red and white blood cell counts Bone marrow alteration Burns Damage to ovaries and testes Fetal damage Cancer Premature aging Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Primary and Secondary Radiation • Primary radiation – Strikes the patient for either therapeutic reasons or for an X-ray examination – Once the primary beam strikes the patient, it can then become secondary radiation as it bounces off the patient • Secondary radiation – Strongest closest to the patient Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Shields to Provide Protection from Radiation Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Guidelines for Maintaining Personnel Safety • Wear film badge on outer clothing when exposed to any form of X-rays • Ensure badge is never covered • Stay behind lead shield in a lead-lined room when X-ray equipment is being used • Note sign or lighted display regarding Xray in use • Check equipment on a routine basis Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Guidelines for Maintaining Personnel Safety • Wear protective devices if in the room when X-ray is being taken • Have periodic testing to ensure no presence of blood abnormalities from radiation exposure Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Guidelines for Maintaining Patient Safety • Inquire if patient has recently been exposed to X-rays • Ask patient if she is possibly pregnant • Advise patients, particularly females, regarding radiation risks • Place a lead shield over the abdominal and reproductive organs in patients who are of childbearing age or are pregnant, and children Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Guidelines for Maintaining Patient Safety • Position patients to accurately obtain image • Only perform procedure if you are trained and authorized Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Parts of Radiographic Equipment Generic parts of radiographic equipment: (A) X-ray tube; (B) collimeter; (C) radiographic table; (D) bucky tray for cassette and film; E) movable table. Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Processing X-Ray Film • Film development takes place in the darkroom • Darkroom contains red or orange safe lights • Darkroom should always be locked when film is processing • Film can be processed using either manual and automated methods • Automated processing can take 90 seconds to 10 minutes depending on equipment Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Storage of X-ray Films • Kept in containers that protect film from light, heat, chemical fumes, and moisture • Stored in a dry, cool place in a sealed package • Stored on end to prevent pressure damage and where expiration dates can be viewed • Films should only be touched with one hand • Processed films should be stored in custom envelopes and filed in film cabinets Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Ownership of Film • Property of the medical facility or hospital that performed the X-ray • Written reports can be sent to other physicians at patient’s request • Films can be loaned to referring physicians if necessary • Films are a permanent record of the patient • Copies can sometimes be purchased by the patient Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Questions? Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.
