Summer Wonder

Week of: 2007-08-13

Abstract: A flood in the MR room, Notes on techniques.

Mood: Upbeat

What went well: Gaining confidence and self-initiative.

What needs work: Reduce retakes.

Elucidation: As I increase my skills there's more opportunity to learn more about how to set techniques. For example, with a Lateral thoracic spine, you have the pt raise their arms above the head – this helps the radiologist gain a view of the upper T interverbral formaina. Also, a longer exposure time, up to five seconds. Exposure is divided into Milliamperage and time (Milliamperage seconds mAs.) As you increase the time the millamps go down to maintain the exposure.

As I gain experience I find increasing or reducing the kilovoltage peak (kvp) allows me to increase or reduce time. In the case of the Lateral T spine (5 seconds) it blurs the lungs – the pt must remain still, seated or supine is best. You need more technique than a CXR.

In a chest x-ray, CXR you deliberately increase KVP and reduce time to create a snap shot of the lungs. Of course I leaned this in the classroom last year. But there exists a separation between learning it and knowing it as applied to the clinical experience.

I did a larger amount of retakes last week. I'm not sure what to attribute this to but I will ensure to make this week different. This said, my confidence increased.

Things were incredibly busy on Tuesday, as usual. I did five AP pelvis exams and other exams. A bit more of a crazy day. What's neat is how I'm handling it and putting out good work.

Wednesday I talked to a pt who got run over by a land-mover. I looked at the comparison films, ER and OR to post OP and beyond. It was night and day, His maleoli were completely smashed in the ER films. He's able to walk now. Very gratifying to hear how our ortho department is improving quality of life. And nice to see how my contribution helps.

My clinical site is expanding into an additional MR room. On Friday, I was greeted by flashing light and a recording, “ALL NON-ESSENTIAL PERSONELL MUST LEAVE THIS LEVEL.” I assumed that meant me. But how to best achieve that objective. It turned out the my lateral path put me in the center of the “emergency.” An electrician in the MR construction site had inadvertently cause the sprinkler system to engage, thus signaling the fire response team. The emergency amounted to a fleet of shop vacs and push broom wielding hardhats attempting clear the site of 2-3 inches of standing water. The fire fighters were chuckling.

Goals for next week: Continue cleaning up on comps in Ortho.