Saturday, December 17, 2011

CXR Speech

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I. Topic Chest x-ray

II. General purpose To inform

III. Specific Purpose To inform the audience how patients are prepared before and during a chest x-ray.

IV. Central Thought I am going to explain the steps taken before and during a chest x-ray.

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V. Outline of Speech

Have you ever had a respiratory infection like bronchitis, or possibly pneumonia? Well if you have, then you probably had an exam that I’m going to talk about.

I am currently enrolled in the radiography program here at Southern Union, and in my clinical experiences I have learned how important it is to prepare a patient correctly the very first to prevent unnecessary radiation exposure to the patient.

Today I’m going to explain the steps taken before and during a chest x-ray. A chest x-ray is just a very common exam of the upper body used to diagnose various disease states, injuries, and in some cases---to ensure proper placement of medical devices in the upper body. I’m sure all of you have had at least one chest x-ray before. I know I’ve had several when I had pneumonia and many people get chest x-rays during a yearly checkup. They’re very common.

The very first step is to make sure that if the patient is a female in her reproductive years, to ask her if she has any chance of being pregnant, because radiation exposure could harm the fetus. If she does have a chance of being pregnant, she will have to stall the exam for that day, talk it over with her physician, and together they can decide if the exam is totally necessary.

If the patient has no chance of being pregnant, you should begin by explaining the procedure--- just kind of let them know what to expect and answer any questions he or she may have. Also let the patient know how important it is to remain very still during the exposure. If the patient moves, the radiograph will be blurred, which means to repeat the exam ---causing unnecessary radiation exposure.

After the patient is aware of the exam----check to make sure their top is free of metal or any objects that could interfere with the radiograph. If the patient does have metal objects or anything like that, you should have the patient step into a dressing room, remove their bra if they have one-----remove jewelry like necklaces, earrings, eyeglasses, and things like that, and slip on a hospital gown. Bellybutton rings

While the patient is changing, you go ahead and set up your x-ray tube like you’ll need it, place an unexposed cassette in the chest board, and set you technique. Your technique is just the amount of radiation you’ll need to expose the chest of your patient�since you are performing a chest x-ray. For a larger patient, you’ll use a higher technique, and for a smaller patient----a smaller technique. By them, your patient should be gowned and ready for the exam.

There are projections for a chest x-ray. The 1st projection is called a PA projection. PA stands for Posterioanterior, which means the x-ray beam will enter the patient from the back of the body (Posterior) to the front of the body (Anterior).

When the patient is ready, you need to shield the patient with a lead apron. This is another very important step------lead protects the body from radiation exposure.

Wrap the lead apron around the patient’ hips. This will protect the reproductive organs from radiation. Then you should have the patient step forward facing the chest board as close as possible.�Make sure they are centered to the board and then have them flex their arms like this with their arms behind their back. This just rolls the shoulder blades to the side so they will be out of the lung field on the radiograph. Then slightly roll their shoulders forward like this�it just lowers the collarbones a little and then have them lift their chin up slightly.

Now the patient is ready for the exposure. Have them take in a deep breath and hold it. This just lowers the diaphragm out of the way of some of the body parts. While they’re holding their breath-----press the exposure button. Then the patient can relax.

Go ahead and set your technique for the nd projection, which is called the Left Lateral Projection. The patient’s left side will be against the chest board and the x-ray will be entering the patient laterally( or thru the side of the body.) The side of the body is thicker than the front-back part of the body, so your technique will be higher for the lateral than it was for the PA projection.

Go ahead and remove the exposed cassette, set it aside, and place an unexposed cassette into the chest board. Have the patient place his or her left side to the chest board, making sure the body is centered. Have the patient lift the arms above the head so that the bones of the arms will not be in the way on the radiograph. Have the patient take in a deep breath and hold it. Press the exposure button and have the patient sit in a chair while you process the film, because If the radiograph shows signs of movement, or certain artifacts that weren’t removed,--------then one or possibly both of the projections will have to be repeated.

Chest x-rays are very common exams in radiology departments and they can be used to diagnose many diseases. Two very important steps in preparing the patient is making sure females cannot possibly be pregnant, and always remembering to shield your patient if possible----------- from radiation exposure. Now I hope you understand some of the things that go on before and during a chest x-ray.

VI. Outside Source Merril’s Atlas of Radiographic Positions and Radiologic Procedures Volume 1 th Edition

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