Summary of HOW TO X-RAY an UPPER EXTREMITY TRAUMA | radiology program | humerus | elbow | forearm | positioning

Summary of "HOW TO X-ray an Upper Extremity Trauma | radiology program | Humerus | Elbow | Forearm | positioning"

This instructional video by Ray focuses on how to effectively perform X-rays on an Upper Extremity Trauma patient, specifically involving the Humerus, Elbow, and Forearm, when the patient has limited mobility and pain. The video emphasizes critical thinking, adaptability, and patient empathy in trauma imaging, especially when ideal positioning is not possible.

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Main Ideas and Concepts

• Patient Assessment and History Taking
  • Begin by asking the patient about the injury, pain location, and range of motion.
  • Understanding pain distribution helps tailor positioning and imaging strategy.
  • Assess the patient’s ability to move the shoulder, Elbow, and wrist to determine feasible positions.
• Challenges with Trauma Patients
  • Patients may have limited or no ability to move the injured limb due to pain or injury.
  • Routine imaging positions may not be possible.
  • The radiographer must think critically and adapt positioning techniques accordingly.
• Critical Thinking in Imaging
  • Use knowledge of routine exams and anatomy to “solve the puzzle” of positioning.
  • Adjust the X-ray tube and image receptor (cassette) around the patient rather than forcing patient movement.
  • Employ alternative positioning methods like cross-table views and the “Coil Method” when standard positions are not achievable.
• Positioning Techniques Demonstrated
  • Upper Extremity Positioning with Limited Movement
    • Patient keeps arm extended or slightly rotated without bending the Elbow.
    • Arm positioned away from the body as much as possible.
    • Use of sponges, tape, and supports to maintain position.
  • Cross-Table Imaging
    • Useful when patient cannot move arm or extend it.
    • Image receptor placed next to the patient’s arm on the table.
    • Tube angled appropriately to compensate for object-to-image distance (OID).
  • Coil Method for Lateral Oblique Views
    • Angle the tube 45 degrees toward the humeral head along the long axis.
    • Used when patient cannot externally rotate the arm.
  • Air Gap Technique
    • Increase the distance between patient and image receptor to reduce magnification caused by OID.
    • Adjust tube distance accordingly (e.g., increasing from 40 inches to a greater distance).
• Patient Communication and Empathy
  • Demonstrate positioning to the patient before asking them to move.
  • Encourage deep breathing to help relax muscles and reduce pain.
  • Never force movement; work within the patient’s comfort.
  • Explain the importance of positioning for accurate diagnosis and eventual pain relief.
• Technical Tips
  • Use manual technique instead of automatic exposure control (AEC) when positioning is non-standard.
  • Tape and sponges are critical aids to stabilize the arm.
  • Collaboration with another technologist is recommended to support the patient’s arm during positioning changes.
  • Shielding is important but may be omitted for demonstration purposes.
• Professional and Emotional Preparedness
  • Expect to encounter difficult cases and emotional challenges.
  • Experience builds confidence and desensitization to trauma imaging.
  • Embrace challenges and continuous learning to improve skills.
  • Trauma imaging can be rewarding for those who enjoy problem-solving and variety.
• Additional Resources and Encouragement
  • The presenter encourages viewers to like, subscribe, and share the video.
  • Promotes his website (x-raybrady.com) for technique cards and merchandise.
  • Ends with motivational advice about overcoming fear, learning from mistakes, and discovering personal greatness.

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Detailed Methodology / Instructions for Imaging Upper Extremity Trauma with Limited Mobility

1. Initial Patient Interaction
   • Obtain injury history and pain localization.
   • Assess range of motion and ability to position the arm.
2. Explain and Demonstrate Positioning
   • Show the patient the position you want them to achieve.
   • Ask for cooperation and encourage breathing and relaxation.
3. Positioning for Humerus and Elbow
   • Position the arm away from the body without bending the Elbow.
   • Use a board or image receptor to support the arm.
   • For lateral views, position the condyles perpendicular to the image receptor.
   • Use the PA method for lateral Humerus when possible.
4. Cross-Table Imaging
   • Place image receptor next to the patient’s arm on the table.
   • Angle the tube to compensate for OID.
   • Use tape and sponges to stabilize the arm.
5. Coil Method for Lateral Oblique
   • Angle tube 45 degrees toward the humeral head.
   • Center beam at Elbow joint.
   • Useful when patient cannot externally rotate arm.
6. Adjust Technical Factors
   • Use manual exposure technique.
   • Increase tube distance (air gap technique) to reduce magnification from OID.
   • Adjust technique to compensate for added tissue or non-standard positioning.

Notable Quotes

— 26:21 — « Try not to go too hard in the paint next time. »

— 27:19 — « At first you may struggle but just like anything else you've learned, practice makes progress. Do not shy away from difficult exams or you'll never get better. You must conquer your fears and get over them. »

— 27:50 — « You will make mistakes but as long as you learn from them you will grow each and every time. Just like anything else in life, you must make mistakes to learn and grow. »

— 27:58 — « Eventually you'll get enough experience and confidence to where you look forward to traumas because all the other routine exams eventually just get boring and you enjoy a little challenge and adrenaline to slice up your day. »

— 29:14 — « Man and that's the juice that keeps me going. Hope you all are doing well out there and discovering your greatness within you because you have greatness within you. »

Category

Educational

Video