View Full Version : How to take X-Rays
someone wrote asking about sites that told you how to take X-Rays, here is my reply - posted as it may be of general interest.
in what sort of circumstances? What are you trying to do?
x-rays need to be taken, and this is largely driven by the equipment available.
as I recall the HV (High Voltage) BBS talks about making this sort of equip and scientific America had plans years ago in their amateur scientist column, but taking X-Rays of yourself w/ homemade equip is generally considered foolhardy.
then they need to be developed
then they need to be interpreted.
there is a WHO book on developing them in the field and the "ridiculously simple" book on radiology is good for interpreting. also an article or two in the journal tropical doctor.
there are some threads under ortho that talk about these things and maybe under gear and equip. usual x-ray equip is built into a room and costs buccu bucks! portable x-ray equipment can be gotten for less, but still pretty pricy. there are the Polaroid systems to get around developing. there is also - spacing on the name - but shining a really bright light through the effected area to illuminate it if it's not to thick and ultrasound as a low cost, portable technology - however this takes skill to interpret.
some manufacturers may have their manual for a specific piece of x-ray equipment available online and I think the WHO library has a book on taking them, but it's probably not one of the online ones.
just not quite sure what you are looking for here. people normally go to a community college for 2 years to learn to take all sorts of X-Rays with various equipment.
-t
FlightERDoc
02-19-05, 21:48
In an austere or disaster situation, the most modern portable digital x-ray equipment is probably the best: no film, no developing, etc (and you have to have electricity anyway). These are quite expensive (and not on ebay), and as you say, not simple to use.
Very cool though: My dentist has them, so when I get an x-ray the office doesn't smell like developer and the image pops up on a 15" LCD monitor right in front of me, about 10x life size. Just the thing to get geeks into the dentists office!
Hi Folks:
In my area a lot of rural xray dept.s are going to this system, too. The small-town doc on duty can look at it, and if they need to send it across the state to whichever contract radiologist is on duty, it's just the touch of a button to do so.
Plus it eliminates the need for hard-copy storage. They are linked to the patients EMR, so most docs like it pretty well.
Stay Safe,
AGreyMan
FlightERDoc
02-28-05, 16:49
Hi Folks:
In my area a lot of rural xray dept.s are going to this system, too. The small-town doc on duty can look at it, and if they need to send it across the state to whichever contract radiologist is on duty, it's just the touch of a button to do so.
Plus it eliminates the need for hard-copy storage. They are linked to the patients EMR, so most docs like it pretty well.
Stay Safe,
AGreyMan
Yeah, they can email the images to a board certified state licensed doc in India who gets paid $0.14 per hour to read them too. Saves a lot of money.
Man, am I glad I didn't go into diagnostic rads.....
Yeah, they can email the images to a board certified state licensed doc in India who gets paid $0.14 per hour to read them too. Saves a lot of money.
Man, am I glad I didn't go into diagnostic rads.....
Yeah - "outsourcing" is even hitting docs :(
You do have to slightly temper that by considering that cost of living in India is REALLY CHEAP! and if you got into this field (medicine) for the money, you are in the WRONG business!
Still, the real outrage is that the HMO or hospital will have no problem charging the patient $150-$200 for "diagnostic interpertation" and not pass the savings onto the patient.
I used to work in radiology when I was a candystriper. One day, one of the techs was bored and said: "Hay - lets teach the vollunteer how to take X-Rays!" - was REALLY bummed that the dept head veto'd that idea... should have pushed it... Got to transport, develop and file um as well as sometimes stand in, doned in lead vest, and help support patients when they got zapped...
But I remember that docs sometimes took the things, so the basics of using a unit can't be that hard. I've never seen a tutorial on doing it, aimed at this sort of "crash course" for docs, though - anyone know of one?
While you've got me waining on memory lane, my worst day had to be when a tech walked in on me while I was reloading film cartrages - ignoring the "in use" light and I slammed the film safe closed on my hand... OUCH! That was before we got the circular, light safe door. And X-Ray film is EXPENSIVE!!!!!
Well, maybe it was the day I was working ICU and unloading drugs from the dumbwaiter - scooped and pulled the load onto the main counter, but there was one bottle with a diameter less then the slight gap between dumbwaiter and counter... Of cource it was a narcotic... and a pharm tech had to crawl into the shaft to recove the remains... and do the considerable DEA paperwork... Got blacklisted from ICU and Pharmacy that day :(
At least they let me dress in a lab coat or scrubs instead of the usual red and white stripes and taught me isolation procedures and some other stuff - like how to deliver babies in stuck elevators... (yeah - it happened sometimes).
Eventually, they hired me.
-t
FlightERDoc
02-28-05, 19:20
What really bugs me about it is that I have to pay a LOT for malpractice insurance. Doc Bombay there, if he screws the pooch, just laughs it off.
And, if I rely on his interpretation (and it's wrong), I'm the one in court, and my malpractice carrier paying. Not some guy they can't find in a country with 1.1 billion people.
As far as teaching docs how to run the equipment, happens all the time - 2 days or so. Most private offices that have their own x-ray have one of the docs as the designated operator (with the site license, responsible for everything). As long as I work in a hospital I don't have to worry about it, if I go work as a doc in the box (urgent care) I might.
Yes - def problem on the liability end... but so is the whole liability system. As EMT's we never worried that much about it, but I know a lot of MD's and Pmeds that simply will not stop at accidents on the highway because they might get sued, unless it's obvious that it's REALLY bad...
> As long as I work in a hospital I don't have to worry about it, if I go work as a doc in the box (urgent care) I might.
We mostly saw it on graveyard shifts in the ER, but sometimes at rush times in other units.
On the Doc in the Box senario - out here, it's outsourced - which is a drag for the pt. You have to go to some Rad clinic to get zapped and come back (and get charged for a second visit). What's REALLY annoying, is that most times your having to do this as a CYA move on the docs part because of that very liability (just like most lab tests). And people wonder why medical care in this country is the most expensive in the world - frickin lawyers! In the middle east they manage to provide excellent medical care at 1-2 cents on the dollar of what we pay... Go figure...
I also don't know about "Doc in the box" being about "urgent care". Most arround here do the standard clinic things and can't handle emergency care. I love um! - Was paying out the nose for med insurence through my uni and getting basically incompetent care (met tests were extra and VERY expensive!) - lucky to see a REAL MD (they had ONE) vs a $35-$70 per visit w/ the Doc in a box and the latter usually set me up w/ samples for needed drugs, if they had them. (the ones I needed - it wasn't a junky nervana). Oddly, the Doc in a box MD's were usually Indian... Diff value system, I guess.
I don't know about this country - it's so messed up. I wanted to go into medicine when I was a kid, but the whole "get rich quick" by sueing someone, regulations to the assinine extent and legal liability thing tempered that REAL QUICK! I mean you are trying to help these people. You would think they would be gratefull. They are in the third world, but here they look at you as a quick path to a free lunch. It DISGUSTS ME!
Sorry, I'm ranting....
-t
FlightERDoc
02-28-05, 20:46
Yes - def problem on the liability end... but so is the whole liability system. As EMT's we never worried that much about it, but I know a lot of MD's and Pmeds that simply will not stop at accidents on the highway because they might get sued, unless it's obvious that it's REALLY bad...
> As long as I work in a hospital I don't have to worry about it, if I go work as a doc in the box (urgent care) I might.
We mostly saw it on graveyard shifts in the ER, but sometimes at rush times in other units.
On the Doc in the Box senario - out here, it's outsourced - which is a drag for the pt. You have to go to some Rad clinic to get zapped and come back (and get charged for a second visit). What's REALLY annoying, is that most times your having to do this as a CYA move on the docs part because of that very liability (just like most lab tests). And people wonder why medical care in this country is the most expensive in the world - frickin lawyers! In the middle east they manage to provide excellent medical care at 1-2 cents on the dollar of what we pay... Go figure...
I also don't know about "Doc in the box" being about "urgent care". Most arround here do the standard clinic things and can't handle emergency care. I love um! - Was paying out the nose for med insurence through my uni and getting basically incompetent care (met tests were extra and VERY expensive!) - lucky to see a REAL MD (they had ONE) vs a $35-$70 per visit w/ the Doc in a box and the latter usually set me up w/ samples for needed drugs, if they had them. (the ones I needed - it wasn't a junky nervana). Oddly, the Doc in a box MD's were usually Indian... Diff value system, I guess.
I don't know about this country - it's so messed up. I wanted to go into medicine when I was a kid, but the whole "get rich quick" by sueing someone, regulations to the assinine extent and legal liability thing tempered that REAL QUICK! I mean you are trying to help these people. You would think they would be gratefull. They are in the third world, but here they look at you as a quick path to a free lunch. It DISGUSTS ME!
Sorry, I'm ranting....
-t
Fortunately, the hospital I work at is a 600+ bed tertiary care Level I trauma center.... we have a full rads dept 24x7.
I have a friend who runs an urgent care center in one of the LA suburbs. EM board certified, etc. Adjacent to a community hospital with excellent ED but not trauma rated - the UCC gets a lot of business. He has 3 or 4 midlevels (PA/NP's) and 3 other docs. $80 a visit cash (for no insurance), labs the next day, rads next door, it's a nice setup. Especially since nobody works nights(past 8) and none of the docs work weekends (unless they want to).
Level 1 Trauma is FUN, FUN, FUN! - you get the interesting cases. Never worked anywhere that the docs went home at 8pm - you lucky dog! Personally, I liked graveyard. Allways more interesting than the daytime shifts. More "action", but also long lulls to goof off and have fun. Pretty laid back, intersperced w/ interesting cases showing up and pure chaos...
We allways had lab and X-Ray 24/7 - but for some, didn't wait for techs... depended on the case. There were few techs on those shifts, and if it got busy...
Don't let the "lush" services make you lazy or forgetfull - never know when you might need to use long forgotten skills. "Use it or loose it!" - stay in practice - even if you don't have to! The day may come when it's important.
noticed the 2 step arround the lability issue - basic philisophic difference or... Just querious...
take care,
-t
ps: where are you thinking of relocating? Remember you said you wanted to move.
Come on, the UCC would bore you to death.
No evenings or nights would be nice - but it wouldnt be that stimulating.
I know 80% of Emergency Medicine is just UCC stuff anyway - but at least some of our patients are sick - I can take or leave trauma - but without a few really sick meds or peds every now and again I would go insane.
Gentlemens hours perhaps - but pretty boring!
Craig
> Come on, the UCC would bore you to death.
> No evenings or nights would be nice - but it wouldnt be that stimulating.
Nights are where it's at - the GSW's, the guy freaking out on PCP that wants to attack ANYTHING - medics, O2 tank, gurney... It doesn't matter... nailed the MD in the face comming to sedate him w/ thorazine with a kick... Took 8 of us to hold him down! The MD had to take some out time... or the REALLY suprised and overweight teen comming in w/ stomach cramps that kicked out a healthy baby and didn't know she was pregnant... (that must have been an interesting and uncomfortable converstaion afterwords w/ the parental units...) Fun times!
I'll never forget the REALLY cute girl that came in w/ a STD complaint and was hitting on me - tempting, but... (part profesionalism - you just don't do that - nurse - sure, pt - NOT!, and part common sence).
2 of the hospitals I worked at hosted chopper services - so we got really interesting cases, sometimes.
-t
FlightERDoc
02-28-05, 22:56
We work 12 hour staggered shifts (new docs starting q 2 hr) which is nice, but makes shift work suck.
That said, I do prefer working weekend nights. I'd rather be tired than bored.
> We work 12 hour staggered shifts (new docs starting q 2 hr) which is nice, but makes shift work suck.
Don't quite understand... why? We didn't do that, though were teaching hospitals.
> That said, I do prefer working weekend nights. I'd rather be tired than bored.
Absolutely! - Weekends are fun! Still, full moons sometimes make them pretty lame...
Kind of feel like that a pre-teen doing that "well I've shown you mine, how about showing me yours?" thang! - Not mentioning any names or personally identifying items - what are your (or Craigs, Keiths, RR's or whoevers...) most memorable ER expeiences??? Common guys! - there have got to be some good stories out here... Maybe we should start a diff thread - think we have drifted pretty far from radiology...
-t
FlightERDoc
03-01-05, 09:59
> We work 12 hour staggered shifts (new docs starting q 2 hr) which is nice, but makes shift work suck.
Don't quite understand... why? We didn't do that, though were teaching hospitals.
> That said, I do prefer working weekend nights. I'd rather be tired than bored.
Absolutely! - Weekends are fun! Still, full moons sometimes make them pretty lame...
Kind of feel like that a pre-teen doing that "well I've shown you mine, how about showing me yours?" thang! - Not mentioning any names or personally identifying items - what are your (or Craigs, Keiths, RR's or whoevers...) most memorable ER expeiences??? Common guys! - there have got to be some good stories out here... Maybe we should start a diff thread - think we have drifted pretty far from radiology...
-t
We have residents and attendings scheduled to start q 2 hours. The idea is that there will always be someone "fresh" on, and if a particularly difficult patient comes in at 11:45 into a shift, the outgoing doc won't have to try and stabilize him, do sign-outs to the next shift, etc.
Staff works on a similar staggered shift but I think it's q3 or 4 for the nurses. Clerks work 8 hour shifts as do the lab/rad techs, transporters, housekeeping, etc.
This is the part I didn't get:
> which is nice, but makes shift work suck.
Think I get what's nice about it, but why does that make "shift work suck"?
-t
FlightERDoc
03-01-05, 13:23
Because you're frequently starting consecutive shifts at different times. And, a shift that starts at (say) 10 PM (which is the latest we have shifts start, they don't run around the clock, thankfully) is a bear to adjust for, at least for me. I might get a 2-3 hour nap the afternoon before but thats about it. Then, off at 10 AM (which isn't too bad) but then what? Sleep during the noisiest and busiest part of the day? And perhaps get a shift starting at 6 PM (which isn't supposed to happen but.....).
Its still better than fixed shifts, and the rotation allows everyone (except the attendings and for some reason, the chief resident) to be equally annoyed.
The attendings work whenever their group schedules them. The chief resident works days only, the damned slacker.
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