IntroductionThe role of the radiologist is to select the appropriate imaging methods for each radiographic examination and to determine whether the radiographs taken answer the clinical question indicated on the request form. For a radiologist to fulfill their role, they must be able to evaluate patients' clinical information, reason clinically, solve problems and reflect on their practice. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an Original Essay For this assessment, a radiographer's actions during an observed examination will be described, explained, and justified. The examination requested was that of a 50-year-old man, whose elbows were being x-rayed, in the emergency x-ray department. DiscussionRationale for why the examination was requestedRationale for a radiographic examination according to Vom et al (2017), is the process by which a practitioner evaluates the requested examination of clinical notes to verify whether it is appropriate. The Ionizing Radiation (Medical Exposures) Regulations (IR(ME)R 2000) state that patient exposure to ionizing radiation must not take place without prior justification. Therefore, before proceeding with the examination, the radiologist checked the request form to ensure that it was correctly completed (i.e. the correct name was written on the form) and that the indications The clinical and requested tests noted were appropriate and justified. The radiologist also verified that the request was authorized (signed by a licensed healthcare professional who has the right to act as a referent, e.g. physician, radiologist). Under the IR(ME)R Regulations (2000), hospitals are required to provide a list of medical and non-medical referents in all areas of the department so that the radiologist can verify that the request is authorized. In this scenario, clinical notes as the patient stated that he fell on outstretched hands (FOOSH) and had tender bilateral radial head, therefore radiographs of both elbows in anteroposterior and lateral projections were taken. requested. The radiologist felt the exam was warranted, in line with the International Commission on Radiological Protection (ICRP), because the exposure would be more beneficial than harmful because it allows doctors to see if there is a fracture. Knowledge of a fracture would modify and improve the patient's treatment, thus overcoming the risk. For practitioners to effectively assess whether the benefits of an exposure outweigh the risk, the referral form must contain sufficient information. This is why the IR(ME)R (2000) requires that referrers provide sufficient information about the clinical indication in the referral form so that the practitioner can correctly determine whether radiation exposure is or will be beneficial or will influence the patient's treatment. Positive verification of patient identification The patient's name was called from the waiting room and the patient was greeted upon entering the x-ray room. The operator introduced himself and others in the room to the patient in order to establish a friendly relationship with the patient (Whitley et al 2016). The radiographer proceeded to establish the patient's identity by asking him to provide his full name, address and date of birth in accordance with Trust protocols Ionizing Radiation (Medical Exposures) (IR(ME)R 2000) . This provision states that the operator (the person performing the exposure) is responsible for the correct identification of the patient subject to the medical exposure. The patient's response is then cross-referenced with theapplication form to ensure it is a match and that the correct person has been identified for review. The patient was also asked to confirm that they needed an exam, to indicate which area or body part needed to be examined and also when they last had an x-ray exam. This was done as another way to ensure the correct identification of the patient and a way to verify that the reference or clinical indications given by the referrer match what the patient says. The patient may have already undergone the same exam but the images could not be loaded onto the PACS and the practitioner was able to re-examine the patient without knowing that the exam was already performed. Therefore, asking the patient to confirm which part of the body needs to be examined and when they last had an x-ray is a good practice as it reduces the risk of the patient receiving an excessive radiation dose by ensuring that the correct area anatomical is examined and avoids unnecessary additional risks. examinations carried out due to a lack of communication. The Care Quality Commission (CQC) revealed in its 2013 annual reports that incorrect examinations due to failed identification processes were reduced through such additional checks of clinical information and previous imaging checks. The Society of Radiographer (SOR, 2016) also advises that in addition to confirming the patient's name, address and date of birth, practitioners should also confirm clinical information and previous images with patients, to minimize thus exam errors. reduce the patient's dose and ensure patient safety. The entire patient identification check process was carried out inside the x-ray room in others to maintain patient confidentiality, thus complying with Health and Social Care Council guidelines on Confidentiality (2017) which state that patient confidentiality must be respected and protected at all times.Required radiation protection considerationsAfter checking the application form and correctly identifying the patient in accordance with Trust IR(ME)R 2000 procedures, the radiologist checked PACS and RIS for any previous images the patient may have from previous exams according to local rules (2017). This allows the radiologist to determine in which projections the exam should be performed and if it is necessary, as the patient may have already had the exam but still be sitting in the waiting room. This avoids unnecessary examinations, thereby reducing the patient's exposure to radiation. According to Whitley et al (2016) and local rules (2017), x-ray doors should be knocked down and the radiologist should position the x-ray beam away from the door to reduce the likelihood of someone entering the hood during the exhibition, thus guaranteeing public safety. The patient's companion was asked to wait outside as the only people allowed in the room during an examination are those whose presence is necessary for the examination according to the rules of the A&E department (Local Rules 2017). Before the exposure, the radiologist ensured that all people in the room were behind the glass screen, as indicated by local rules (2017). Practitioners are asked to ensure they remain behind a glass shield during exposure as it is made of lead (a material that can inhibit radiation particles). Therefore, the radiation emitted from the x-ray tube cannot pass through it, ensuring that all people are safe from scattered radiation. The examination was finished, the radiologist made surethat the radiation dose received by the patient was accurately recorded as required by the IRR (IRR, 1999) to enable dose monitoring for patients and dose assessment to ensure patient safety. According to the International Atomic Energy Agency (IAEA, 2016), medical practices regarding irradiation can be improved and radiation doses can be reduced without losing diagnostic quality by constantly and accurately recording administered doses. to patients, reporting dose-related incidents and analyzing all patient dose data. They also state that the doses tracked for each patient can help prevent unnecessary exposures and that the information obtained can also be used in establishing diagnostic dose reference levels at the national or regional level. Methods used to reduce the amount of scattered radiation and radiation dose received by the patientScattered radiation can be defined as photons scattered into the patient's body or into the detector, as stated by Holmes et al (2013). It can also be defined as radiation deflected by an object (e.g. detector, table, wall), from the main beam of radiation exiting the x-ray tube. Scattered photons reduce the contrast and definition of the 'resulting image or x-ray. The quantity of dispersed products depends on the size of the field or area of ​​the irradiated patient and the source-image-receptor distance (SID). The increase in scattered radiation produced reduces image quality. To minimize the amount of scatter produced and avoid unnecessary tissue irradiation, the radiographer reduced the field size by collimating the x-ray beam to include only the elbow area of ​​interest. According to Holme (et al 2013), collimation improves image quality and reduces the radiation dose received by the patient as well as staff, by minimizing scattering. The patient was correctly positioned so that the resulting image showed the area of ​​interest and no repetition was necessary (Whitley et al 2016). The radiologist also verified that the patient's lower limbs and torso were not under the imaging table and therefore not in the primary beam and that gonadal protection was also provided. All this has been done to protect the lower limbs and gonads from scattered radiation, and to certify that the dose to the patient is kept as low as reasonably possible (IR(ME)R 2000). Other measures were taken by the radiologist to reduce the radiation. dose to the patient, this included preparing the room and setting the main exposure before inviting the patient into the room to minimize motion blur (distortion of the image caused by the movement of the patient, equipment or film during exposure). This reduces the risk of repetitions, thereby reducing the dose to the patient. Explanation of the choice of exposure factors made and any manipulation of them that was undertaken. The radiologist used exposure factors of 60 kvp (kilovoltage) and 2 mAs (milliampere seconds) for the two anteroposterior routes. and the lateral projection of the elbow. According to Whitley et al (2016). KVp is the penetrating power of the X-ray beam and mAs is the amount of radiation used. Low, high kVp and low mAs were used because the patient was very thin and the area of ​​interest was small, meaning the radiation was not going well. through many soft tissues. Therefore, a large amount of high-energy radiation is not necessary as this would unnecessarily increase the dose delivered to the patient. That would work.