I'm confused about something, when the orthopedic doctor tells you an outlet, should the intensifier be placed cephalically pointed at the head, or the other way around?
Assuming your patient is supine, your receptor will lean toward the feet for an outlet (caudal beam path). Then for inlet, your receptor will then lean toward the head (a cephalic beam) remember the tube is under the table and you are technically shooting in PA. If your patient is positioned supine with their head on your right hand side, imagine staring straight ahead then an outlet would assume the receptor would be approximately in the 10p position on a clock face and your inlet would be in 2p. Hopefully that visual makes sense?
Thanks for the great question. I am not thinking about it in inches. I am finding the fulcrum where all three central rays intersect at the same point in space. In this example, the AP/PA height is irrelevant because the height is determined by the intersect of the inlet/outlet projections.
Great observation and per exposure yes, however the reduced number of exposures would result in a net overall dose reduction to the patient. One of the challenges of surgical imaging metrics is that each case is different and hard to measure and compare. Anecdotally, a surgeon once told me that a highly skilled technologist would reduce the average case dose by 60% to 75%. Their logic being that a highly skilled radiographer would get the image first time every time rather than a tech that may need three exposures to show what was needed. You also have to consider that each image would be a consistent reproduction to the previous which adds greater accuracy for the surgeon.
I'm confused about something, when the orthopedic doctor tells you an outlet, should the intensifier be placed cephalically pointed at the head, or the other way around?
Assuming your patient is supine, your receptor will lean toward the feet for an outlet (caudal beam path). Then for inlet, your receptor will then lean toward the head (a cephalic beam) remember the tube is under the table and you are technically shooting in PA.
If your patient is positioned supine with their head on your right hand side, imagine staring straight ahead then an outlet would assume the receptor would be approximately in the 10p position on a clock face and your inlet would be in 2p. Hopefully that visual makes sense?
How many inches or degrees did you raise to keep the AP level with the inlet/outlet? Or, what is a good rule of thumb for height to start out with?
Thanks for the great question. I am not thinking about it in inches. I am finding the fulcrum where all three central rays intersect at the same point in space. In this example, the AP/PA height is irrelevant because the height is determined by the intersect of the inlet/outlet projections.
@@jcastell1 you may also find this video helpful for getting a good start height.
ua-cam.com/video/o6WF_XAZ5xI/v-deo.htmlsi=SOYb_mZp3wyc-ie9
are you from Scotland?
I am indeed. I am originally from Glasgow but I now live in Nashville, TN
Interesting. But wouldn't the patient dose increase because the II is now farther away from the patient?
Great observation and per exposure yes, however the reduced number of exposures would result in a net overall dose reduction to the patient. One of the challenges of surgical imaging metrics is that each case is different and hard to measure and compare. Anecdotally, a surgeon once told me that a highly skilled technologist would reduce the average case dose by 60% to 75%. Their logic being that a highly skilled radiographer would get the image first time every time rather than a tech that may need three exposures to show what was needed.
You also have to consider that each image would be a consistent reproduction to the previous which adds greater accuracy for the surgeon.