If you forget your markers this stamp must be used!
An image of the Developer and Fixer Tank leading onto the Rollers and Dryer Unit.
Filling up the fixer tank, all done by hand
Here there are five types of cassette
35/43-
30/40 - Lumbar Spine and Thoracic Spine
35/35 - Female Chest and Paediatric and the Hamptons View in a Barium Sequence
24/30 -
18/24
Curved Cassette - more on this to come - amazing!
Hamptons View is now refferred to as the PRONE 30 in a Barium sequence.
As with the standard CR the main cassettes used are those with no descriptions of use next to them, as reference I have listed the uses for those cassettes not used with CR imaging.
Warning!! There are different types of cassette too a T2 is an extremity cassette which is a faster speed and a T8 is an all other parts cassette this is a slower speed. As I have learnt look at the T number, if you use a T8 for an extremity the resultant image is darker, and you may risk having to repeat.
The cassette has a patient details window at the top of it, I soon learnt to always place this at the top as you can cut off vital parts off an image if you dont, an example being the bases of a PA Chest, therefore having to repeat all because of my not thinking. I now understand why we taught about traditional development methods.
With this window being on the left side of the cassette you are not able to use a Left PA marker, as it will be placed over the patients details, therefore a Right PA marker has to be used which is contrary to that taught in our training. This takes some time to get the hang of but has its advantages.
The patient details are labelled to the image plate by using a machine called an "Identification Camera" this device uses a camera (inbuilt) and photographs the barcode on the request slip and then transfers it to the unexposed area on the cassette (the window)
Like CR the image plate is within the cassette holder and is read by a reader within the processor, above the imput slot are the five trays which hold the five types of film, the reader autmatically slects the size of film and transfers the image onto the film.
Once the image plate is read the cassette is pushed back out of the processor and ready for the next patainet, unlike CR this process is time consuming and at this stage the film is still being processed.
Once the cassette is returned the processor produces a hissing noise and produces a lot of noise and heat, another thing I ahve noticed whilst here is the amount you perspire, traditional processors produce an unusual amount of heat, which is very dry and produces an uncomfortable environment in which to work.
After about three minutes wait there is a cracka nd the image appears from the dryer and rests in the tray, the initail feel of the film is warm and sticky as though someone has spilt lemonade over it, compared to CR the images appear try and as though they have been printed on paper.
Thats the end of the developing side of the image, now the dignostic quality is assessed, unlike CR which has the afcility to change the contrast and density, rotate the image, annotate, and label an image with Plain Film what appears is what you get, there is no computer software taht can alter the image.
Once the image is developed it is placed on the light box where the exposure is assessed first Are the contrast and density enough to provide a diagnostic image? with CR they can to a degree by altered in this setting they can not an over exposed or dark image is not diagnostic so there must be a repeat using a lower kV, how lower is something i ahve been told comes with experience but something I think im grasping as the day moves along.
Magnification of an image involves a Magnifying Glass! Yep a Magnifying Glass no image zoom function it relys on traditional methods and to a degree is interesting to see. What happens if you forget your marker? You stamp it on, there is a stamping machine which stamps L or R onto your film, no fancy legends which can be enlarged. And annotations? you write them on with a black pen. It truly is amazing there is so much to think about before, during and after taht after one patient you dont want the next one.
Once the image is complete and finished your still not finished, the films have to be taken to the correct area and only by checking the request slip do you know where to send them next;
GP Patients; Conatct your GP within 5-7 days to arrange an appointment for your results
Orthopeadic Clinics; Pataint returns back to clinic with their films
Outpataints; Contact your GP within 5-7 days to arrange an appointment for your results
Inpataints; Mobile X_rays or walking patiants have their films delivered to the ward after processing
M.I.U/ Casualty; Patients films are placed on the Lightbox in M.I.U for Nurse Practitioners to assess the next course of action.
Developer and Fixer Tanks
The first thing I noticed was the use of plain film using a traditional processor using Fixer, Developer etc.
The large City hopsital uses CR equipment and is basically easy to use, very quick and not noisy.
The large City hopsital uses CR equipment and is basically easy to use, very quick and not noisy.
Here there are five types of cassette
35/43-
30/40 - Lumbar Spine and Thoracic Spine
35/35 - Female Chest and Paediatric and the Hamptons View in a Barium Sequence
24/30 -
18/24
Curved Cassette - more on this to come - amazing!
Hamptons View is now refferred to as the PRONE 30 in a Barium sequence.
As with the standard CR the main cassettes used are those with no descriptions of use next to them, as reference I have listed the uses for those cassettes not used with CR imaging.
Warning!! There are different types of cassette too a T2 is an extremity cassette which is a faster speed and a T8 is an all other parts cassette this is a slower speed. As I have learnt look at the T number, if you use a T8 for an extremity the resultant image is darker, and you may risk having to repeat.
The cassette has a patient details window at the top of it, I soon learnt to always place this at the top as you can cut off vital parts off an image if you dont, an example being the bases of a PA Chest, therefore having to repeat all because of my not thinking. I now understand why we taught about traditional development methods.
With this window being on the left side of the cassette you are not able to use a Left PA marker, as it will be placed over the patients details, therefore a Right PA marker has to be used which is contrary to that taught in our training. This takes some time to get the hang of but has its advantages.
The patient details are labelled to the image plate by using a machine called an "Identification Camera" this device uses a camera (inbuilt) and photographs the barcode on the request slip and then transfers it to the unexposed area on the cassette (the window)
Like CR the image plate is within the cassette holder and is read by a reader within the processor, above the imput slot are the five trays which hold the five types of film, the reader autmatically slects the size of film and transfers the image onto the film.
Once the image plate is read the cassette is pushed back out of the processor and ready for the next patainet, unlike CR this process is time consuming and at this stage the film is still being processed.
Once the cassette is returned the processor produces a hissing noise and produces a lot of noise and heat, another thing I ahve noticed whilst here is the amount you perspire, traditional processors produce an unusual amount of heat, which is very dry and produces an uncomfortable environment in which to work.
After about three minutes wait there is a cracka nd the image appears from the dryer and rests in the tray, the initail feel of the film is warm and sticky as though someone has spilt lemonade over it, compared to CR the images appear try and as though they have been printed on paper.
Thats the end of the developing side of the image, now the dignostic quality is assessed, unlike CR which has the afcility to change the contrast and density, rotate the image, annotate, and label an image with Plain Film what appears is what you get, there is no computer software taht can alter the image.
Once the image is developed it is placed on the light box where the exposure is assessed first Are the contrast and density enough to provide a diagnostic image? with CR they can to a degree by altered in this setting they can not an over exposed or dark image is not diagnostic so there must be a repeat using a lower kV, how lower is something i ahve been told comes with experience but something I think im grasping as the day moves along.
Magnification of an image involves a Magnifying Glass! Yep a Magnifying Glass no image zoom function it relys on traditional methods and to a degree is interesting to see. What happens if you forget your marker? You stamp it on, there is a stamping machine which stamps L or R onto your film, no fancy legends which can be enlarged. And annotations? you write them on with a black pen. It truly is amazing there is so much to think about before, during and after taht after one patient you dont want the next one.
Once the image is complete and finished your still not finished, the films have to be taken to the correct area and only by checking the request slip do you know where to send them next;
GP Patients; Conatct your GP within 5-7 days to arrange an appointment for your results
Orthopeadic Clinics; Pataint returns back to clinic with their films
Outpataints; Contact your GP within 5-7 days to arrange an appointment for your results
Inpataints; Mobile X_rays or walking patiants have their films delivered to the ward after processing
M.I.U/ Casualty; Patients films are placed on the Lightbox in M.I.U for Nurse Practitioners to assess the next course of action.
If a fracture is seen then a red dot (actual red dot) is placed on the film and sent across. Its not uncommon to be asked to explian the fracture to them as they have to ring the details through to a large City Hopsital fracture clinic before reffering the patinets on. the films must always be booked out if this is the case.
This has been a lurning curve and a real eye opener into a realm of radiography without the technology which most of us myself included have taken for granted for the previous two years.
This in my view places a greater emphasis on the need to get it right first time and to strive for a perfect image with correct annotations and exposures and that using this traditional method can only help to improve my acquisition and disgnostic skills.
This has been a lurning curve and a real eye opener into a realm of radiography without the technology which most of us myself included have taken for granted for the previous two years.
This in my view places a greater emphasis on the need to get it right first time and to strive for a perfect image with correct annotations and exposures and that using this traditional method can only help to improve my acquisition and disgnostic skills.
The Video below demonstrates the procedure from labelling the cassette in the identofication camera, the cassette being placed into the processor and the resultant image appearing to be being placed on a light box.
1 comment:
Well done, really good reflection on how different it can be working with conventional film rather than CR!
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