Radiology room. Rules for equipping the X-ray room. General organizational measures

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted on http:// www. allbest. en/

Brief description of previous work activity

I, Liliya Yagfarovna Musina, born in 1980, graduated from Nizhnekamsk Medical College in 2006 with a degree in Nursing.

In 2001, I got a job at the Municipal Unitary Enterprise "NGMB No. 3" as a medical registrar at the Mammological Center.

At the end of the NMC, she was transferred to the position of a nurse in the same department.

From January 22, 2008 to April 22, 2008, she specialized in KMC in the cycle "Laboratory work in radiology", was transferred to the position of X-ray laboratory assistant and to polyclinic No. 2. In 2009 temporarily worked (for the period of study) in the fluorography room in the prevention department.

From October 1, 2009, to the present, I have been working as an X-ray laboratory assistant in the X-ray room of the Radiation Diagnostics Department of the Consultative and Diagnostic Polyclinic of the State Autonomous Institution "NTsRMB".

General medical experience - 12 years.

Special experience - 5 years

Brief description of the medical institution

In 2009, the health care of Nizhnekamsk has undergone major changes. Since October 1, all adult medical institutions in Nizhnekamsk have merged into a new entity- GAUZ "Nizhnekamsk Central District Multidisciplinary Hospital". The rural part of the Central District Hospital was connected with the district hospital of the river. n. Kamskiye Polyany.

The population of the city is served by two official medical institutions: the Children's City Hospital with a perinatal center (combining the Women's Consultation, the maternity hospital, the children's city hospital) and the Nizhnekamsk Central District Multidisciplinary Hospital, which now includes the former MBUZ "Dental Polyclinic No. 1 and No. 2", MBUZ "City Hospital No. 2", MBUZ "Nizhnekamsk Ambulance Station medical care”, the urban part of the Central District Hospital, MUE “NGMB No. 3”.

The structure of the GAUZ "Nizhnekamsk Central District Multidisciplinary Hospital":

1) The outpatient part includes:

Polyclinic No. 1 (attached population 101467 people)

Polyclinic No. 2 (attached population 86246 people)

Dental clinic (350 visits per shift)

· Consultative and diagnostic polyclinic (500 visits per shift).

In polyclinics No. 1 and No. 2, general practitioners conduct appointments.

Doctors of narrow specialties conduct appointments at the KDP. The Department of Radiation Diagnostics is part of the consultative and diagnostic polyclinic, has firmly taken an authoritative place in the hospital and plays a very important role in the treatment, diagnostic and preventive process.

The structure of the consultative and diagnostic polyclinic includes:

department of narrow specialists No. 1 (therapeutic profile),

department of narrow specialists No. 2 (surgical profile),

department of narrow specialists No. 3

department of radiation diagnostics

Department of functional diagnostics (FGDS, ultrasound, neurophysiology and other functional studies),

clinical diagnostic laboratory,

bacteriological laboratory,

department of medical examinations,

Uro-andrology department

Medical genetic consultation

breast center,

department of prevention

trauma center

2) The stationary part includes 30 divisions. The hospital consists of several buildings, interconnected by elevated passages, which allow transporting patients.

3) The administrative and economic part includes 20 divisions.

The regular number of beds in the hospital is 1110.

Today, 2572 employees work in the hospital. Including: doctors - 432; paramedical workers - 1344; junior medical staff - 480; other personnel - 316.

Department of Radiation Diagnostics

The quality of medical care to the population is determined not only by the adequacy of the forms of its organization, the state of the material and technical base of the healthcare institution, but, first of all, by the availability of qualified specialists. This can have a positive significance only if their work is well organized, materially equipped, and they are economically interested in the results of their work.

Table No. 1. States of health workers in the department of radiation diagnostics

no./p.	Position	By state
	Head of department
	Senior X-ray Technician
	Medical Registrar
	Sister is the owner
*X-ray room*
	Radiologist
	X-ray laboratory assistant
	Nurse
*X-ray computed tomography room*
	Radiologist
	X-ray laboratory assistant
	Nurse
*Cabinet of nuclear magnetic resonance imaging*
	Radiologist
	X-ray laboratory assistant
	Nurse

	*TOTAL for the Department of Radiation Diagnostics:*
	*w.h. medical staff:*
	*average staff*
	*junior staff*
	*other personnel*

Table No. 2. List of X-ray diagnostic devices of the Department of Radiation Diagnostics

№ p/n	Name of equipment	Type, brand	Factory number	Year of issue

	X-ray machine with a remotely controlled stand-table "Baccara"
	X-ray apparatus with digital radiological FLASH 2000 system with subtraction
	Device for fluorography	Renex-Fluoro
	Mobile x-ray machine	"Mobi-Ren-MT"
	X-ray mammograph
	Computerized X-ray mammograph	Mammo-4-MT
	X-ray diagnostic complex. stationary
	X-ray complex diagnostic teleoperated	"KRT-electron"
	X-ray CT scanner	Aguilion 16,
	X-ray diagnostic complex	"KRD 50/7-Reneks"
	X-ray unit diagnostic mobile
	Mobile x-ray diagnostic machine	Mediroll
	X-ray diagnostic portable
	Film fluorograph
	Film fluorograph
	Wall-mounted dental x-ray machine
	X-ray machine dental apparatus
	X-ray machine dental orthopantomograph	"Odontorama RS 100"
		"Electron"
	X-ray fluorographic digital apparatus	Renex-Fluoro
	X-ray diagnostic complex
	Mammography x-ray machine with stereotaxy	Mammo-MT
	Tomograph medical magnetic resonance	"Image-1"

Mobile ward x-ray machines Medirol and Mobi Ren-MT are located in the departments of anesthesiology and resuscitation No. 1 and No. 2. In the trauma department there is an X-ray mobile device "10 L-6". These mobile devices allow seriously ill patients to be X-rayed directly on the spot.

In the operating unit there is a mobile OKO RTS-612 unit (“C-arm”) used for R-examination in any projections without moving the patient. Designed for clinical use in vascular surgery, endoscopy, urology, traumatology, orthopedics, general surgery.

In its activities, the Department of Radiation Diagnostics is guided by the regulatory legal acts of the Ministry of Health and Social Development of the Russian Federation, the Republic of Tatarstan, the requirements of the Federal Law "On Radiation Safety Standards" (NRB-99) and the "Basic Sanitary Rules for Ensuring Radiation Safety" (OSPORB-2000).

The list of basic documentation that is available in the department:

Sanitary rules and regulations SanPiN 2.6.1.1192-03.

· Basic Sanitary Rules for Ensuring Radiation Safety (OSPORB-2000).

Sanitary rules SP 2.6.1.799-99.

Hygienic requirements for the design and operation of X-ray rooms, apparatus and X-ray examinations

・Alert scheme when various types disasters

Intra-hospital orders

· Journal of familiarization with orders

・Safety Log

Folders with instructions on labor protection

Folders with safety instructions

· Folder with exposure dose cards for group A personnel

· Folder with job descriptions

· Folders with technical documentation for operating X-ray diagnostic rooms and X-ray diagnostic equipment.

· Journal of maintenance of medical equipment.

Goals and objectives of the radiology department

The main goal of the radiology department is:

Providing the population of the city of Nizhnekamsk and the Nizhnekamsk region with emergency and planned qualified, the most affordable and guaranteed X-ray diagnostic care for patients in a hospital and polyclinic;

Provision of timely preventive fluorographic and mammographic assistance to the population;

Carrying out medical examination of working citizens and timely detection of probable diseases of the chest and mammary glands in the early stages, to prevent an increase in the number of complications and disability;

Conducting constant monitoring of radiation exposure of patients.

Interaction with other medical and preventiveinstitutions and medical schools

The Department of Radiation Diagnostics interacts with polyclinics No. 1, No. 2, the Department of Laboratory Diagnostics, Functional Diagnostics, departments of the hospital, the epidemiological service, and the territorial center for sanitary and epidemiological surveillance. Provides consultative assistance to doctors of other departments of the hospital on X-ray diagnostics of patients with various diseases. MUP "NTsRMB" cooperates with other hospitals of our republic, transfers information about identified patients with suspected oncopathology to the cancer center in Kazan. After a complete examination, patients with an unclear diagnosis or with difficulty in choosing a treatment are sent to the Republican Clinical Hospital for further in-depth examination and treatment.

Radiologists and X-ray laboratory assistants of the department undergo specialization and advanced training at the Kazan State medical academy and Kazan Medical College.

General organizational measures

All rooms of the department of radiation diagnostics comply with the "Hygienic requirements for the design and operation of x-ray rooms, apparatus and x-ray examinations". (SanPin 2.1.6.1192-03). All rooms have technical passports and sanitary and epidemiological conclusions for the operation of X-ray machines. There are orders: on the assignment of working persons to the personnel of group "A"; on the admission of personnel to work with sources of ionizing radiation (IRS); on the appointment of a person responsible for radiation safety. For all rooms there are acts of checking the grounding of X-ray machines and ventilation of rooms. All X-ray machines are equipped with X-ray clinical dosimeters DRK-1 to measure the radiation doses of patients during research. The measured radiation doses of patients are recorded in the patient register, in the medical history and in outpatient cards.

The department conducts individual quarterly dosimetric monitoring of group A personnel with registration of the results in the "Charts of Accounting for Individual Exposure Doses of Personnel". All offices have departments individual means protection for medical staff and patients: protective screens, aprons, skirts, aprons, collars, hats, gloves, glasses, lead rubber plates, in accordance with the requirements of SanPiN 2.6.1.1192-03, which are tested for lead equivalent once every 2 years.

The department collects and delivers silver-containing waste: x-ray film and used fixer. After the merger of all adult medical institutions of the city into MUP "NTsRMB", a centralized X-ray archive was created in the radiology department for x-rays in a separate isolated room, taking into account all the requirements of SanPiN and countermeasures. fire safety. X-rays archived for 5 years

The X-ray room where I work is located in Polyclinic No. 1 on the ground floor and is equipped with a RADREX device. X-ray diagnostic complex, designed to work on a table with a grating with a floating upper section FBT-10A and radiography on a stand with the patient in a standing position. The table of the FBT-10A series is intended for performance of all types of radiographic researches. For ease of patient positioning, it is facilitated by a floating top section mechanism. The horizontal movement of the table top is controlled by a foot pedal.

In combination with the X-ray table, a floor-to-ceiling X-ray tube stand is used. Movement or control of all its components is carried out manually, all components are fixed by means of electromagnetic brakes. Click-stops in the end position of moving the X-ray tube closer/further and turning the X-ray tube in the vertical direction facilitates positioning for tabletop exposures, for exposures with grating/rack, for exposures with gratings and ensures reproducible positioning.

Movement or control of each section can be done using a control box with control handles.

Also in the X-ray room there is a mammography device MAMMOGRAPH. With the help of this device, we perform mammography of the mammary glands in women over 40 years old. It is an X-ray system with exposure control by protective devices, with high frequency generator, with x-ray tube dual focus, detachable carbon fiber mesh grille, efficient magnification device.

The X-ray room consists of the following rooms:

Treatment area 46.3 m 2 ;

Console 15 m 2;

Photo lab 12.5 m 2;

Ordinatorskaya 18 m 2;

Nursing 18 m 2;

The walls, floors and ceilings of each treatment room are covered with a protective layer of barite (plaster), the doors are made of leaded rubber. There are protective shutters on the windows of the treatment room. In the wall between the X-ray treatment room and the control room, a viewing window with leaded glass was installed to monitor the patient during X-rays. Near the entrance door to the treatment room, at a height of 1.6 meters from the floor, a light board was installed: “Do not enter”, automatically turns on during R-graphy. The walls of the rooms in the R-office are covered with light-colored oil paint. The floors are covered with linoleum. In the photo lab, the floor is covered with ordinary tiles, and the walls up to 2 meters high are covered with glazed tiles.

The lighting of the R-cabinet is artificial. The photo lab additionally has non-active flashlights with a green light filter.

All cabinets are equipped with: supply and exhaust ventilation providing 3-fold air exchange; central heating. There is sewerage, hot and cold water supply.

Organization of work of the X-ray room

The tasks of X-ray diagnostics are performed by an X-ray team consisting of a radiologist, an X-ray laboratory assistant and a nurse.

In his activities, the laboratory assistant reports to the head of the department, and during work - to the radiologist, and is responsible to him for the technical and economic condition of the R-office.

The X-ray laboratory assistant simultaneously manages the work of the nurse in the R-office and the middle junior medical staff of the medical departments.

At the workplace, the X-ray laboratory assistant acts as three specialists: an average medical worker, an X-ray technician and a photo laboratory assistant, performing alternately the duties of each of them. Workplace x-ray laboratory assistant during labor day constantly changing.

The working day of the X-ray laboratory assistant begins with planning, taking into account the volume and content of the upcoming studies. The time is specified for participation in medical manipulations during R-scopy and complex special studies, as well as for independent work. An approximate order of patients referred for conventional radiography is drawn up. During the working day, it is implemented by contacting the sisters on duty by telephone. All studies are carried out strictly according to the indications and directions of the attending physicians.

The decision on the need for an x-ray examination is made by the radiologist and puts his signature on the referral.

The X-ray laboratory assistant maintains medical accounting and reporting documentation in accordance with approved standards and within the established time limits;

1. Journal of diagnostic work of R-graphy (full name, age, diagnosis, address, place of work, film size and quantity, radiation dose and conclusion - the result of the image description).

2. Diary of R-research (preparation for the annual report).

3. Maintenance log of the R-device.

4. Journal of health education.

5. Safety magazine.

Records of the doses received by patients are recorded in the journal of R-graphy and R-scopy, as well as the medical history with the signature of the radiologist.

A daily record of work on surveys and departments is maintained.

I draw up a monthly report, where, in addition to all this, a record is kept of patients who are on a day hospital, referred from the military registration and enlistment office, and non-resident. From 8 o'clock I accept patients prepared for examination: for survey urography, radiography of the lumbosacral spine, irrigography. From 10:00 to 13:00 the rest of the examinations: images of the chest, skull, PPN, spine, limbs.

Before starting work, I conduct a visual inspection of the X-ray room and the X-ray machine. I check the integrity of cables, grounding. I do a trial run and then work according to the plan.

radiation radiological complication patient

Stages of radiography

1. I get acquainted with the patient's medical history, I conduct a brief briefing with the patient. I check the referral with the signature of the radiologist. Above the front door I turn on the "Do Not Enter" sign.

2. I include the necessary workplace. I set the X-ray mode appropriate for this patient. I insert the cassette into the cassette holder.

3. I put the patient on the table deck, center the central beam on the center of the cassette through the area under study and diaphragm the working beam in strict accordance with the size of the area under study.

4. I protect open areas of the body from unused rays, especially critical organs: gonads, mammary glands, thyroid gland, which are not the object of study.

5. I check the correct laying and centering x-rays on the monitor.

6. I give a command to the patient and turn on the high voltage.

7. I release the patient from protective equipment, take the cassette.

8. Photochemical processing of X-ray film through the AGFA processing machine.

9. Marking.

Photochemical processing of exposed X-ray films

Photo processing includes several successive stages:

Preparation of photo solutions;

Manifestation;

Intermediate flush;

fixing;

final flush;

Photo solutions are prepared strictly according to the manufacturer's instructions.

I dilute the developer and fixer in enameled jars. The developer must stand for at least 12 hours. Then I filter and pour into tanks-tanks.

I start processing the film with development. I lower the film, tucked into the frame of of stainless steel, into the developer and hold for 6 minutes, then rinse with water and dip into the fixer. I continue fixing until the milky white coating disappears. Next, I wash clean water. Then I label the x-ray. I stick a strip of paper on the raw picture, where I indicate the date, full name, age, case history and department number. As the depletion of the solutions change. I collect the used fixer solution in canisters. Further, the medical technician delivers silver-containing waste to a centralized collection point in Kazan. At present, I am processing films in a Kodak processing machine.

When performing radiography, I strive to limit the radiation exposure to the examined patients and the staff of the R-room:

1. I control the technical condition of X-ray diagnostic equipment.

2. I constantly improve the methodology and technique of research.

3. I apply the optimal physical and technical conditions of the study, contributing to the reduction of radiation exposure to the subjects without loss of diagnostic information:

a) I carefully block the working beam of R-radiation.

b) I use additional filters to optimize the output exposure dose;

c) try to use optimal modes appropriate for a particular object being examined.

4. I use a highly sensitive X-ray film with intensifying screens.

5. I use protective equipment that limits the area of irradiation of the area under study.

I cover the most vulnerable parts of the body with leaded rubber plates: gonads, mammary glands, thyroid gland, etc.

The x-ray room also has protective equipment for personnel: aprons, skirts, gloves, glasses, collars and headgear made of lead rubber. When conducting R.-study using a portable ward apparatus (in the ARC department), radiation protection is carried out by distance.

All employees are equipped with individual dosimeters, which are monitored quarterly. The control of protective equipment is carried out once every two years by specialists of the NEC "Proton". Carry out annual preventive medical examinations employees to identify contraindications to work with radiation sources.

Documents regulating the work of the X-ray room

Sanitary rules and regulations SanPiN 2.6.1.1192-03.

Hygienic requirements for the design and operation of X-ray rooms, apparatus and X-ray examinations.

Basic Sanitary Rules for Ensuring Radiation Safety (OSPORB-2000).

Sanitary rules SP 2.6.1.799-99.

Journal of Safety Engineering.

Hospital orders.

Alert scheme for various types of disasters.

Instructions for the actions of medical personnel in case of fire.

Number of X-ray examinations in 2012

R-graphy of the chest 2357/2707

R-examinations of bones 1032/3238

Irrigography 86/258

R-graphy of bones and joints 3097/5019

Skull R-graphy 85/159

R-graphy of the paranasal sinuses 1174/1174

Plain urography 14/15

Specialist. styling 23/49

Mammography 1428/5706

Total: 9296/18325

Description of more complex X-ray examinations

1. Excretory urography (excretory) - X-ray examination of the urinary tract after intravenous administration water-soluble contrast agent and its excretion by the kidneys.

This research technique allows you to study the morphological and functional state of the kidneys, ureters and bladder. This study is based on the ability of the kidneys to absorb, concentrate and excrete an intravenous iodine-containing substance.

The study is carried out on an empty stomach after cleaning the body enema. Preliminary test for sensitivity to contrast is performed. At least 40 ml of 60-76% solutions of triiodinated substances are used: urotrast, verografin, omnipaque, urografin and others. Indications - all organic diseases and kidney damage.

Radiography is carried out in the position of the patient on the back using R-film 30x40 cm. The laying is performed in such a way that the kidneys, ureters and bladder are displayed on the radiograph. If the bubble shadow is clipped due to tall of the patient, then it is filmed separately on a film of 18x24 cm. In urography, four radiographs are usually performed. The first picture is taken before the introduction of a contrast agent to review the shadow picture of the abdomen and identify possible radio-positive shadows in it (concrements, calcifications, foreign bodies). After the introduction of a contrast agent, as a rule, three pictures are taken - after 7, 15 and 45 minutes.

In some cases, with sufficient contrasting of the urinary tract on them, the doctor will cancel the 3rd image, or, conversely, prescribe additional urograms later in 1-3 hours if pathological changes are noticed.

X-ray stacking instony bone according to Stanvers

During this examination, the patient lies face down on the table top, the chin is pressed to the chest. The head is turned so that the sagittal plane makes an angle of 45 degrees with the plane of the cassette. Under these conditions, the long axis of the investigated pyramid is located in a plane parallel to the deck of the imaging table. The plane of the physiological horizontal is perpendicular to the cassette. The central beam is directed cranially at an angle of 10 degrees to the center of the cassette. Stenvers stacking X-ray is used to assess the structure of the pyramid of the temporal bone and determine the condition of the internal auditory canal, as well as the inner ear.

Mammography in two projections

The purpose of the image is to study the structure of the mammary gland in cases where any induration is found in it during palpation, as well as during a screening examination of women over 40 years old. During the exposure, the patient is facing the x-ray machine. The height of the cassette holder must be adjusted so that the mammary gland is comfortably located on its surface in the center and the nipple is brought to the contour. The mammary gland should be tightly compressed and we take a picture.

Correctness criteria: nipple on the breast contour, medial or lateral region, skin in the inframammary zone.

Irrigography (colonography).

X-ray examination of the colon after filling its lumen with a contrast medium. The patient comes to the study on an empty stomach with the colon thoroughly cleaned of the contents (for this purpose, cleansing enemas are made the night before and in the morning before the study). To introduce a contrast mass into the large intestine through the anus, the Bobrov apparatus is used. This device, consisting of a cylinder for suspensions of barium sulfate, rubber tube with an enema tip and a rubber bulb for blowing air into the balloon.

The patient is placed on the table. Insert the tip into the anus behind the sphincter of the rectum. Then the large intestine is gradually filled with a contrasting mass under pressure. When it passes into the descending intestine, the patient turns to the left side. Following the introduced contrast suspension, the volume of which is 400-450 ml, air is injected into the intestine. A suspension of barium sulfate envelops the mucous membrane of the colon, and the air inflates its lumen. The resulting double opacification of the colon creates optimal conditions to detect organic changes in it. After radiography of all parts of the colon, the patient is sent to the toilet for maximum bowel emptying from the injected contrast media. A repeated x-ray examination of a partially collapsed intestine supplements information about its condition.

The described simultaneous double contrasting of the colon allows you to better study its position, contours, displacement and expanded mucosa over a large area. It creates the best opportunities for the detection of neoplasms of the intestine.

The main clinical symptoms of complications and the tactics of medical personnel when they occur are as follows:

In R-studies with intravenous administration of iodine-containing R-contrast agents, due to their individual intolerance during the study, dangerous complications are possible that require urgent medical care. For this purpose, the R-office has a first aid kit, which includes:

Adrenaline 0.1% - 1.0.

Norepinephrine 0.2 - 1.0.

Mezaton 1% - 1.0.

Suprastin 2% - 1.0.

Tavegil 0.1 - 2.0.

Prednisolone 30 mg.

Dexamethasone 4 mg.

Ephedrine 5% - 1.0.

Atropine 0.1% - 1.0.

Eufelin 2?4% - 10.0.

Strofantin 0.025% - 1.0.

Cardiamin 2% - 2.0.

Glucose 40% - 20.0.

NaCl 0.9% - 20.

NaCl 0.9 - 400.

Glucose 5% - 400.

Penicillinase 1,000,000 units

Polyglukin 400.0.

Soda 4% - 200.0.

Air duct.

Kornzang.

Language holder.

Gag.

In cases of syncope, cardiovascular collapse, acute respiratory distress, Quincke's edema, anaphylactic shock, the R-room staff begins to provide medical care, followed by a call to the resuscitation team.

The main clinical symptoms of complications and the tactics of medical personnel when they occur are as follows:

Cardiovascularcollapse - acute vascular insufficiency.

It is caused by a drop in the tone of small vessels, and develops with massive blood loss, trauma, myocardial infarction, poisoning, and anaphylactic shock.

Symptoms: pallor of the skin, anxiety, feeling short of breath, cold clammy sweat, bluish extremities, loss of consciousness, weak thready pulse, rapid breathing, lowering blood pressure, the degree of which characterizes the severity of the collapse.

The patient is laid on a couch with an elevated foot end; loosen buckles and straps, create fresh air.

Call the resuscitation team;

Make injections of cordiamine or caffeine;

2. Acute respiratory distress.

May be due to: laryngospasm, bronchospasm, laryngeal edema, pulmonary edema.

Symptoms: shortness of breath, shortness of breath, agitation, tachycardia, cyanosis, foamy sputum.

Avoid retraction of the patient's tongue;

Call the ARC brigade;

In / injected 5-10 ml of a 2.4% solution of aminophylline per 20 ml of 40% glucose, 60 mg of prednisolone, 20 ml of a 30% solution of sodium thiosulfate, 4 ml of a 1% solution of diphenhydramine;

Breathe pure oxygen

Artificial ventilation of the lungs through a mask.

3. Quincke's edema.

Symptoms: the sudden appearance of extensive hyperemic blisters on the skin of the face and a plaque-like rash throughout the body, a rapidly growing swelling of the face and tongue, a feeling of fear, shortness of breath, runny nose, lacrimation, itching.

0.5 ml of a 0.1% solution of adrenaline per 20 ml of NaCl 0.9%, 2 ml of a 1% solution of diphenhydramine, 90 mg of prednisolone, 20 ml of a 30% solution of sodium thiosulfate, 5 ml of a 2.4% solution of eufillin per 20 ml of 40% glucose solution;

If the condition worsens, call the ARC brigade.

4. Anaphylactic shock is the most severe manifestation of an allergic reaction that occurs with the introduction of drugs, radiopaque substances.

Symptoms: rapidly developing pallor of the skin, a feeling of tightness in the chest, severe weakness, dizziness, headache, shortness of breath, nausea, vomiting, urticaria, Quincke's edema, cyanosis, cold sweat, loss of consciousness, convulsions, involuntary urination and defecation, rapid decrease in blood pressure.

Lay the patient on a couch with a raised leg end, create an influx of fresh air

Immediately call the ARC brigade;

Intramuscularly inject 10% -1.0 caffeine or cordiamine 2.0 ml;

In / inject 120 mg of prednisolone per 20 ml of saline, 0.5 ml of 0.1% adrenaline solution per 20 ml of 0.9% NaCl, 4 ml of 1% solution of diphenhydramine or suprastin 2% -2.0.10 ml 10% calcium chloride solution;

In case of respiratory disorders, inject 1.0 ml of 1% solution of lobeline;

To establish breathing with pure oxygen;

Artificial lung ventilation, closed heart massage according to indications.

When providing emergency care for anaphylactic shock, speed and accuracy of the appointments are required.

Prevention of these complications:

1. Preliminary testing for patient tolerance of a contrast agent;

2. Patients taking antihistamines (diphenhydramine, pipolfen, suprastin, tavegil) in the evening on the eve of the study and in the morning on the day of the study;

3. Prohibition of drinking liquids in the evening on the eve of the study and eating on the day of the study.

Work on professional development

During her work in the X-ray service, she learned how to operate a fluorograph, X-ray machines: Prestige, RUM 20, KRD-50/7-Reneks, KRT Electron, Medirol, RTS-612.

Worked out all the used styling and modes. I pass on my practical skills in radiology to beginner radiologists.

I work closely with radiologists. Discuss current topics on X-ray diagnostics. I keep accounting records. Every year I prepare a report of X-ray examinations, a report of R-examinations by departments. I work systematically to improve my skills. I attend conferences, nursing classes.

In my practical activities I use special literature: "Atlas of styling" (authors: Kishkovsky, Tyunin, Esinovskaya). "Medical X-ray technology" (author: Kishkovsky, Tyunin), "Guide for X-ray laboratory technician" (author: V. Yakovets), "Physico-technical foundations of radiology" (author: Monich).

I conduct health promotion and disease prevention work. I conduct explanatory work among patients about the need for this or that X-ray examination, about radiation protection. I conduct conversations with patients, medical staff about the expediency of a healthy lifestyle.

Conducted lectures and discussions on the following topics:

"The role and importance of fluorography in the early diagnosis of tuberculosis and oncological diseases"

"The need for an X-ray examination"

"Movement is life"

"Smoking is injurious to health"

"Alcoholism is a disease"

"Prevention of AIDS infections"

"Prevention of venereological diseases"

“Influenza Prevention. The Importance of Influenza Vaccination

"Healthy lifestyle".

San. dez. mode in x-ray room e

In the X-ray room, disinfection is carried out in a timely manner and sanitization. Ventilation for 10 minutes every 1-2 hours, especially after fluoroscopy. Sanitary day - once a month. Treatment of the entire R-cabinet - 2 times a month, with a solution of vinegar (for lead dust). Wet cleaning R-cabinet - 2 times a day.

Processing of the shooting table is carried out by wiping with a 1% solution of chloramine after each patient.

Rag treatment - soaking in 1% chloramine solution for 1 hour, then rinsing under running water, dry, store in a closed container for clean rags.

Treatment of enema tips. Soaking in a 3% solution of chloramine, then immersed in a 0.5% washing solution heated to 50C, washed with a brush, then with running water, dried and sent for sterilization to a centralized sterilization department. Currently, disposable enema tips are used.

After use, the Bobrov apparatus is soaked in a 1% solution of chloramine in an appropriate container for 1 hour, then washed, dried, and stored in a clean container.

All utensils for storage, processing are marked and used strictly for their intended purpose. In addition to chloramine, other disinfectants are also used. means: purzhavel, deochlor, calcium hypochlorite.

In the event of a disaster, fire, there are schemes for notifying employees during working and non-working hours, indicating the responsible persons, their addresses and telephone numbers.

San. dez. we carry out the mode on the basis of these orders:

Order No. 720 dated July 31, 1978 "On improving medical care for purulent surgical diseases and strengthening measures to combat nosocomial infections."

Order No. 408 of July 12, 1989 "On measures to reduce the incidence of viral hepatitis in the country."

Order No. 806 dated October 7, 1992 "On strengthening the organization of measures to combat HIV infection."

Order No. 770 dated 06/10/95 "Sterilization and disinfection of medical devices".

SanPiN 2.1.7.728-99 "Rules for the collection and disposal of waste from healthcare facilities."

M.U. No. 287-113 of the Ministry of Health of the Russian Federation 12/30/98. “On disinfection, pre-sterilization cleaning and sterilization of medical devices”.

conclusions

During the period of work she mastered the basic and special methods of X-ray examination. I made my own table technical parameters studies of various organs and systems to the apparatus "RADREX", I know photolaboratory processing of exposed films. I know the safety rules (anti-radiation protection of patients and staff, fire and electrical safety). I can take pictures in standard and atypical projections in a gentle mode, avoiding additional trauma to patients during the examination. I have good clinical training, I know how to provide emergency first aid, including the simplest methods of resuscitation.

It is important to know the basics of dosimetry of ionizing radiation and radiation biology, knowledge of the physical foundations, means of protection and features of the interaction of X-rays with body tissues.

Offers.

Improve the material and technical bases of X-ray rooms.

Improve the quality of maintenance of X-ray equipment and conduct repair work in a shorter time frame.

Achieve a reduction in radiation exposure by: choosing the optimal technical parameters taking into account the characteristics of the patient, using a highly sensitive film and intensifying screens, preventing defects in the process of photo processing of the removed materials, monitoring the preparation of the patient for the study, etc.

To improve the qualifications of the staff of the X-ray room in order to reduce the duration of examinations and defects in work.

X-ray laboratory assistant: __________________ Musina L.Ya.

Hosted on Allbest.ru

Opening an X-ray room - the initial stage

We at the Eco-Safety Group of Companies always recommend: to organize your own X-ray room, it is more profitable for a clinic to work with one qualified contractor than with several - this is both a question of price and a question of saving time. But situations are different, so in each case, the medical organization proceeds from the totality of the circumstances.

Like any project, opening an X-ray room begins with an understanding of why the clinic needs it. If it is highly specialized, then it makes no sense to purchase a device with a wide range of capabilities. So, based on the development prospects, it is necessary to at least approximately estimate the basic parameters:

enterprise capacity
facility throughput
price
manufacturer reliability
factors that will affect the service life, profitability, etc.

At the first stage of opening an X-ray room, it is necessary to find out the needs of the clinic and the future director. It often turns out that the manager does not clearly understand what he really needs and what financial costs he will ultimately incur. Here is just one aspect of the problem: the more functional the device, the more expensive it is not only in itself, but also in terms of the costs of installed protection from ionizing radiation, installation and maintenance.

IMPORTANT!
When choosing medical x-ray equipment you need to keep in mind one important detail, which experts are well aware of. Each such X-ray complex must have a registration certificate valid on the territory of the Russian Federation. Incidents still occur when medical X-ray equipment is purchased, but it does not have a registration certificate, or it has ended, or it ends at the time of commissioning. This does not mean that it cannot be operated in principle, just that its work is illegal in our country. It is unreasonable to expect that a manufacturer will issue or renew a registration certificate for the sake of one client. Therefore, the availability of this document must be checked both on the manufacturer's website and on the website of Roszdravnadzor in the section on medical devices.

X-ray room project

When the choice of medical x-ray equipment is made, and maybe even an order is placed for it, you should start developing the project of the x-ray room itself. This is done on the condition that the clinic has sufficient space for this. The requirements for the X-ray room are described in great detail in the Sanitary Rules and Norms "Hygienic requirements for the design and operation of X-ray machines and X-ray examinations. SanPiN 2.6.1.1192-03".

It is necessary to pay special attention to the fact that X-ray rooms must not be placed in residential buildings, with the exception of dental devices with radiovisiographs. This is one of the reasons why small clinics prefer to enter into contracts with specialized medical institutions, rather than install their own equipment.

When developing a project for an X-ray room, one must also remember that for the functioning of an X-ray room, not only the room itself for placing the apparatus, but also additional rooms for laboratory assistants and changing clothes for patients may be needed.

You may be interested

Verification of medical equipment as a guarantee of the quality of services provided
Rules for the operation of medical equipment: legal framework, technical support, licensing of service centers

As a rule, stationary x-ray machines require a 3-phase power supply. With this, a modern clinic should not have a problem. But there is another nuance.

At the time of peak load, when applying high voltage per tube, it is necessary to provide for the possibility of consuming 10-15 kilowatts. Such capacities are not always available to the medical organization. This means that in the design of the X-ray room, it is necessary either to provide for an additional generator, or to contact the local power company with a request to connect additional capacities. As a result, the solution of this issue may take several months, and this must also be taken into account.

When creating an X-ray room project, a number of features must be taken into account. Among the two most significant are:

separate electrical panel, power and multiplicity supply and exhaust ventilation, the width of the passage between the installed apparatus and the walls of the room
grounding, which traditionally most construction organizations treat with insufficient attention. And, of course, take into account the human factor.

IMPORTANT!
There are cases when, during maintenance work in the X-ray room, the IT specialist forgets to connect the ground cable. As a result, the cathode-ray tube burned out while turning on the X-ray machine.

After the approval of the project of the X-ray room by the customer (medical organization), it must be submitted for examination to Rospotrebnadzor. Therefore, when choosing a designer, it is very important to understand whether they can meet all the requirements prescribed normative documents. Otherwise, the project will have to be redone until the specialists of Rospotrebnadzor have no comments left during the examination.

The implementation of the approved project of the X-ray room can be carried out in the usual way. construction organization who is able to perform work without deviating from the documentation. There is only one feature here, which should have been taken into account again at the design stage.

Since medical X-ray equipment is a source of ionizing radiation, appropriate radiation protection must be implemented. Today, there is a fairly wide range of special materials - from traditional lead sheets to X-ray protective sheets of gypsum boards. And here it is necessary to take into account the peculiarity of the region where the equipment is installed. Somewhere lead will be cheaper, and somewhere barite plaster. So there is no single solution here.

Commissioning and connection of the X-ray room

Installation of equipment, commissioning, connection to the medical information system (MIS) of the clinic and training of specialists, as a rule, take from five to ten days. The final assembly time depends on the initial preparation of the X-ray room for installation and the individual characteristics of the room.

Connecting to the MIS usually does not cause any particular problems for qualified employees. Most modern x-ray equipment is supplied with software operating in the DICOM format, which is suitable for integration with modern HIS. If the information system is installed old, then the specialists of the organization that undertook the installation of the equipment have to conjure a little.

After the X-ray equipment is ready for operation, it is time to train the personnel who will work on it. By this time, medical workers should not only have a diploma of secondary medical education as an X-ray laboratory technician and a certificate of a specialist in an X-ray laboratory technician, but also take radiation safety courses.

Traditionally, training takes one or two work shifts and is conducted by a medical equipment engineer. However, if the equipment is complex and has various additional functions, then the help of the applicator may be required. He will tell and show which modes are best to choose for obtaining high-quality images of various anatomical regions. However, with modern means of communication, advice on the operation of the equipment can always be obtained in real time.

After the installation and commissioning of X-ray equipment, the stage of obtaining permits for working with sources of ionizing radiation (IRS) begins. A number of required measurements and a passport of the X-ray room is issued. The package of documents is submitted to the Department of Radiation Hygiene of Rospotrebnadzor for conducting a sanitary and epidemiological examination and issuing a sanitary and epidemiological conclusion on the compliance of working conditions with sources of ionizing radiation.

Documentation can be undertaken by both the organization that installed the equipment and the clinic itself. There is no general rule here - everything depends on the characteristics of the region and the level of interaction between the medical organization and regulatory authorities.

Estimation of the cost and time of launching the X-ray room

Opening an X-ray room in a clinic is a costly process, not only in terms of money, but also in terms of time. On average, turnkey cabinet delivery time is 3-5 months. This includes:

supply of equipment
creation and coordination of the project with the customer
coordination of the project with Rospotrebnadzor
room preparation
equipment installation and staff training
obtaining permits from Rospotrebnadzor.

The price of opening an X-ray room consists of:

the cost of the equipment itself
project cost
preparation of the premises, taking into account the purchase of building materials
equipment installation and personnel training.

At the same time, it should always be taken into account that the cost of each item of expenditure can increase and decrease depending on many factors.

Each project is unique in its own way. Solutions that are good in St. Petersburg will not necessarily be ideal for the regions. Therefore, in order to implement such an expensive project as an X-ray room, a clinic must always have a clear concept of its development and a well-calculated economy.

IMPORTANT!
It is impossible to name even an approximate amount for opening an X-ray room. No one can say how much the device costs until a choice is made. First, the leader stops at one option, then he can choose another. A separate expense column is the price of delivery: from a warehouse in Russia or from abroad. The cost of the project is also unstable, depending on the readiness of the premises. The equipment of the premises depends on their readiness and the cost of materials in the region and their delivery to a specific place. All these issues are discussed before the conclusion of the contract and it is impossible to say for sure in advance.

Fast and high quality X-ray design office and any other room with a source of ionizing radiation. From small x-ray room with a visiograph in a dental clinic to the departments of radiation diagnostics.

The specialists of our organization have accumulated extensive experience in the implementation x-ray projects. Faced with different situations, we will be able to offer the optimal solution that ensures security and a reasonable budget, both on x-ray project, and on , dentistry project and other objects.
It must also be remembered that (), construction, manufacture of process equipment and radiation protection equipment cabinet x-ray or other industrial premises is carried out by organizations that have special permits (licenses) issued by authorized bodies.

If you need to develop dental office x-ray project, CT placement project, MRI or projects on placement of x-ray machines in other premises, contact us and our specialists will help you find a highly functional technical solution.

We will help you

- to develop the best planning and technological solutions for placement of x-ray machines;
- to formulate a medical-technical (technical) task. It is worth noting that any design of x-ray rooms should be carried out according to the technical or medical-technical assignment;
- select the necessary composition of X-ray protection equipment for personnel and patients (including stationary ones);
- develop or change (if necessary) architectural, technological, structural and engineering solutions in compliance with all standards regarding electrical, ventilation, X-ray radiation and other utilities.

Stages of designing X-ray rooms

- You send us a request for X-ray room design by email or phone;
- Provide a plan of the premises and the name of the equipment, or at least its type: dental x-ray machine, orthopantomograph, diagnostic x-ray for 2 workplaces, CT scanner, scanner, etc.;
- We send you a partially prepared MTZ or TK for x-ray room design and contract. Agree, sign;
- Our specialists go to survey the object and collect the initial documentation for the design (our specialist will tell you about this in more detail). The initial data can be transferred to us without the departure of our specialist, as part of the work with MTZ or TK. This is true for standard projects or projects with the replacement of equipment or renovation of the premises;
- We develop project documentation X-ray room design, we will coordinate it with the Scientific and Practical Center for Medical Radiology, Moscow (for customers from Moscow) or the MONIKI MONIKI (for customers from the Moscow Region) and transfer it to you. For other cities, you perform this action yourself, and we provide technical support.

What is included in the design of the X-ray room

To the specialized section of the Technological part of the project ( x-ray project) for any of the premises where placement of x-ray machines, whether dental office x-ray project, x-ray room design any other medical institution, x-ray equipment placement project in production and even X-ray design premises in transport communication hubs includes:

I. Medical technical task . Document - basis for design of x-ray rooms;

II. Explanatory note :
- 1. General data and compliance requirements x-ray equipment placement project regulatory framework;
- 2. Initial data for design;
- 3. Technological solutions:
- a. Process Equipment Requirements and Compliance design standards;
- b. Radiation safety calculation parameters;
- c. climate requirements x-ray room
- d. lighting requirements for x-ray room;
- e. Requirements for water supply and sewerage in x-ray room;
-f. Power Requirements x-ray rooms(composition of x-ray rooms);
-g. fire safety requirements;
- h. Waste disposal requirements;
- i. Requirements for the organization of X-ray studies;
- j. Measures to prevent radiation accidents;
- k. Requirements for the decommissioning of the X-ray machine;
- 4. Conclusions.

III. Cabinet plan with the arrangement of technological equipment as part of X-ray rooms (rooms);

IV. Table for calculating the required additional protection of enclosing structures;

v. Conditional Schema contour re-grounding

VI. Arrangement plan for cable channels and concrete foundations as needed, depending on the x-ray machine;

VII. List of interior decoration of x-ray rooms;

VIII. Hardware Specification.

Need to know

Carrying out X-ray examinations, as in medicine (for example, in x-ray in dentistry), and in production, industrial and transport institutions ( defectoscopy and screening of cargo and passengers using beam inspection installations) is carried out only if there is sanitary and epidemiological conclusion on the compliance of working conditions with sources of ionizing radiation with sanitary rules.
Therefore, project development placement of x-ray machines- this is only the beginning of the path to X-ray studies. This is followed by a huge amount of work associated with the preparation and execution of documents necessary to obtain sanitary and epidemiological conclusion for work with sources of ionizing radiation, sanitary and epidemiological conclusion for the implementation of a certain type of activity, and in some cases (for example, in veterinary medicine), also receiving licenses to carry out activities using a source of ionizing radiation.

Confidence

If you need to obtain a sanitary and epidemiological certificate for x-ray room, to work with sources of ionizing radiation or license for medical activities then we can help you.

If you need to carry out work on the organization additional protection based x-ray room project, you can entrust the performance of these works to us.

Qualitative X-ray room design This is the key to the comfortable work of your staff..

Radiography is prescribed for the diagnosis of various diseases and developmental pathologies. Depending on the area being examined, X-rays can show:

In the lungs - tuberculosis, pneumonia, any pathological processes, neoplasms and foreign bodies
In the bones - fractures, cracks, displacements, adhesions
In the intestine - obstruction and foreign objects
In the bones of the skull - cysts, osteoporosis, cerebral hernias, osteosclerosis, hematomas, congenital deformities
In the spinal column - osteochondrosis, arthritis, kyphosis, congenital pathologies and injuries

This diagnostic method is also widely used in gynecology, dentistry, urology and other areas of medicine. The study is also carried out to assess the severity of injuries, before and after surgery to evaluate the effectiveness of treatment.

X-ray benefits

Lower radiation dose. Compared to fluorography, x-rays have 10 times less dose of radiation received by the patient.
Painless and safe. Patients do not experience discomfort during the diagnosis.
The minimum number of contraindications. The only absolute contraindication is pregnancy.

Indications for x-ray

X-rays are often prescribed in the diagnosis of injuries - this method allows you to examine the musculoskeletal system in detail, see fractures and cracks in the bones, as well as their displacement. In addition, indications for the study are:

Evaluation of the correct installation of orthopedic structures
Preparation for surgery
Suspicion of benign and malignant neoplasms in bone tissue
Degenerative-dystrophic processes
Assessment of the quality of the treatment

Preparing for an x-ray

Special preparation before most types of x-rays is not needed. Immediately before the study, you need to take off your clothes, remove bandages and plasters, remove jewelry from the area under study - for this, in medical centers there is a special room. The rest of the body is covered with a protective apron - it is also issued in clinics. Organ research gastrointestinal tract need to be carried out on an empty stomach.

Book an x-ray in Moscow

To undergo diagnostics in Moscow, choose the appropriate medical center. We have collected as much information as possible about the centers – we have identified 24-hour institutions, marked addresses on the map, indicated the cost of x-rays, and collected reviews.

Categories

Popular