View source for Planning Imaging Areas X-Ray Units Part I

<br>In looking at how to best parse the various imaging modalities: MRI, Nuclear medicine, Ultrasound, etc. I have decided to simply lump all of the x-ray units into one long blog entry. I think doing it this way will accomplish two things: First, it will help make a clear differentiation between x-ray and non-x-ray imaging technologies, and second, it will help to show the variations in x-ray devices. While somewhat remedial for a clinician, a medical equipment planning project will often include team members who are not as well versed in these nuances.[https://Www.Discountmedicalsupplies.com/customer/account/login/ discountmedicalsupplies.com] The role of a medical equipment planner is to educate the entire design team to the technologies being used. This helps to elevate the overall level of medical planning knowledge.<br><br><br>An x-ray is an x-ray. But there are various types of x-ray units to address different needs. When the patient can come to the x-ray unit, the x-ray device and room can be specialized to the type of study or body part. Teeth, Jaw, breast, foot, chest, etc. If the unit comes to the patient, the x-ray unit is more universal: Portable X-ray unit or Mobile C-arm. There are in fact 2 sizes of C-arm, the smaller of the 2 (Mini C-arm) typically used to image limbs (hands, wrists, feet, etc). In addition, the ER usually has access to a portable X-ray and Mobile C-arm when the patient cannot be easily moved, or time is of the essence. X-rays are a form of radiation and therefore require the room to be shielded.<br><br><br>Lead is the most common form of shielding, due mostly to its density. Using concrete or other shielding substance will greatly increase the [http://Www.Discountmedicalsupplies.com/ambulation-mobility.html thickness] of the walls and complicate the design of surrounding rooms. The greater the throughput of the the x-ray device, the greater the cumulative amount of radiation produced. When a patient is having an x-ray, the amount of radiation given at at a single sitting is not dangerous. It is the cumulative exposure over time that is dangerous. Each of us can go in for dental x-rays, a routine chest x-ray, or a visit to the ER if we sprain or break something.<br><br><br>These infrequent exposures represent no health risk to us. The rooms are shielded for the protection of those who work in the vicinity of the room. The offices, exam rooms, conference rooms and staff work areas. A patient may receive a series x-rays (Usually 1 - 8, but can be more) in a single sitting. The x-ray tech may see 3 - 4 patients per hour over an 8 hour shift. So that would be over 200 exposures per day. Without the lead shielding, the clerk who sits at the desk on the adjacent wall or the family members sitting in the waiting room across the hall would be exposed to these very large cumulative doses. So we are shielding the people who are working, visiting or being cared for in the adjacent areas. Radiation scatters, so think not only about the 4 walls,  [https://towsonmedicalequipment.com/product-category/wheelchairs/ Planning Imaging Areas (X-Ray Units Part I)] but also the floor and ceiling.<br><br><br>A licensed physicist will calculate the amount of shielding required, but typically every x-ray room can be shielded with a simple 1/8 inch leaded sheet rock. The critical factor is the installation. Joints, corners, and punch outs need to be installed correctly to avoid any leakage. The source of all x-rays is an x-ray tube. The tube is housed in an articulating arm, (wall, table or ceiling mounted) or within the unit itself. The other components of an X-ray unit have a specific purpose related to: patient positioning, power generation, or image acquisition. Patient positioning. X-rays produce images because they pass through bone, tissue and fluid at different rates. Dense structures appear in white and less dense appears in black on the image.<br><br><br>The goal of patient positioning is to make the x-rays pass through the patient in a path that will have the least interference to the structure the radiologist wants to view. If you have ever shifted, moved, or repositioned yourself to get a better view of something, you have been "positioning". So standing, laying down, sitting, or otherwise being contorted into the "ideal" position to yield the best image of a bone, organ or structure the radiologist wants to read. The table is the most basic positioning device. These can tilt up, side to side and telescope to allow the technician to move a patient into the ideal position. This articulation requires ample room.<br><br><br>When a design team takes a "department tour" you typically see an imaging table in its flat position. Think of a swiss army knife in your pocket. Then think of it with every blade and tool extended. The x-ray room needs to accommodate the table in all of its various extensions. So when you do a walking tour of the department and see the table in its "closed" position, you may not get a sense of the space it needs to move around within. I find that 1 in 5 departments I have visited had at least 1 room with a conflict between the range of motion of the imaging table and 1 of the walls or cabinets.<br><br><br>Power Generation. X-ray tubes require a lot of energy. Most will require a dedicated 480v feed into the power cabinet. Image acquisition. Image acquisition is simply the process of capturing an x-ray image. Traditionally, a film cassette is placed behind the patient. The X-ray tube generates a burst of x-rays that pass through the patient and into the x-ray film cassette. The x-ray film [https://Www.Youtube.com/watch?v=SYDsYrbT_yg captures] the image. The film cassette is placed in a "bucky" or simply leaned up against the patient. A bucky is a device that holds the x-ray film cassette. Today, there are digital x-ray units that have almost eliminated the need for film.<br><br><br>The x-ray image is captured digitally in a receptor and processed directly into an image (DR or Direct Radiography) or the image is captured on a phosphorous plate that is read in a "Plate Reader". Think of a phosphor plate as a high-tech "Etch-a-sketch". The plate reader converts the image into [https://www.youtube.com/watch?v=UGG4Uk11UNI digital] format, then clears the phosphor plate. These plates are re-used many times before needing to be replaced. The plate readers and laser imagers are now an integral part of the image acquisition process. Fewer and fewer "wet processing" systems are in use. No less important in all of this is the image viewer. The image viewer is a high definition computer monitor. It displays the x-ray image and allows the operator to zoom, edit and make adjustments to make the image much easier to view. These have taken the place of x-ray view boxes (Illuminators), which were used to view hard copy x-rays.<br><br><br>This speed is represented in 2 ways, first in the acquisition of the image and second, in the sharing of the image. Step 1 is image acquisition. For this there are 3 possibilities. First, conventional film. Second, CR or computer radiography and third, DR or direct digital radiography. The analogy of a film camera versus a digital camera is easy for most of us to imagine. In the tradition process, film had to be developed before the image could be seen. In CR, the x-ray image is acquired on a plate and then processed in a "Plate Reader". There is only a slight speed advantage between traditional film processing and CR.<br><br><br>Here is a rather fun video that compares traditional film processing to the CR Plate reader method. You can see from the video that the CR is slightly faster. This method of digitizing the image still requires the plate (The digital imaging version of a memory card) to be inserted into a machine (Plate Reader) to be viewed on a computer screen. By contrast DR, or direct digital radiography, offers instantaneous access to the image. As the x-ray is taken, the image is captured and displayed directly from the x-ray device. In DR, there is no additional step of running a plate though a reader.<br><br><br>An x-ray tech must view the image before the patient can be excused (Usually). This allows them to confirm the x-ray quality was good (Patient position & exposure). With CR, the image is delivered to a monitor after it is passed through a reader. In DR, the image display is instantaneous. This allows the technician to know immediately if the x-ray taken was of sufficient quality to allow the film to be "read" by a radiologist. The patient can be excused and the room prepared for the next patient. A hard copy x-ray film can be passed though a scanner to become digitized.<br><br><br>Today this is common for retrieving old patient x-rays. Typically the x-rays are kept on file for 7 years if an adult and until the age of 21 if a minor. That means there are a lot of hard copy films in storage. Because many of these films (OK, most) are never going to be pulled, it would be a wasteful exercise to convert all of them to digital. What typically happens is a [https://Www.Vitalitymedical.com/ request] to retrieve an old x-ray film is made, the film is pulled and scanned into a digital file. This x-ray film is now a part of the PACs system and can be distributed accordingly. As old x-ray films are no longer required to be stored, they are destroyed and the storage space can be converted to other uses.<br><br><br>Traditional x-ray images were created in film, the film was developed, and the hard copy film was available to be hand delivered or duplicated as needed. CR, or computed radiography, allowed the x-ray image to be stored on a "Plate" and read into a digital file on the PACs network. The CR system still required the plate to be manually loaded into the device, creating a lag time between the time of the x-ray and when the plate was transported and loaded into the reader. DR, or direct digital radiography, allows the image to be captured into the PACs system and visible to the tech, radiologist or doctor at the moment the x-ray is taken.<br><br><br>This greatly streamlines the process. Both CR and DR allow the image to be sent via electronic means. The limiting factors are access to a computer and a monitor with sufficient resolution. The added benefit of PACs is the reduced need for storage of hard copy x-rays. The existing stores of x-ray film are being purged a little more each year as the required holding period for the films expires. The cost of the [https://Www.Youtube.com/watch?v=e7I904J8-bQ technology] to acquire, store and share digital x-rays is high as compared to the traditional methods. This meant that the technology was implemented only in the areas where it could be cost justified. The imaging department, ER and ICU were about the only place you might find a PACs viewing monitor or plate reader.<br><br><br>Today, the cost of the systems have come down and the original investment in the technology has allowed for a small incremental investment to move the technology into other departments and even off-site locations. The traditional x-ray viewbox (Illuminator) will eventually be phased out in much the same way as the darkroom has been. As a medical equipment planner, the important task is to understand the clients need at building occupancy, but also in the future. Making sure that there is a clear migration path for PACs stations to replace the x-ray viewboxes is just one example of where medical equipment planning makes a project more efficient. An architect has a tremendous volume of codes, regulations and client expectations for simply designing the 4 walls, floor and ceiling or each room. The medical equipment planners insight into how technology changes will impact the work flow and space requirements is of critical importance. When selecting your medical equipment planner, make certain they are involved early with the architectural design team.<br><br><br>Items on site may differ from in store stock, subject to change or may be substituted for a similar item. Some items are not carried but, are added online from when the manufacture catalog updates. 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