Can Students take an xray by themselves in the room with the animal

Re: Can Students take an xray by themselves in the room with the animal

Elerrina — Fri, 26 Sep 2014 23:59:25 GMT

what task is this for?

Re: Can Students take an xray by themselves in the room with the animal

Charley83 — Fri, 26 Sep 2014 18:01:04 GMT

In got signed off for PPE - mainly did it out with the horses as had all of it on gloves, aprons, thyroid guards, baddge etc. However when doing it in practice - I put on ppe but went behind lead screen to take x-ray. NPL they need to have much better descriptive guidance notes as a lot of it is open to interpretation.

Re: Can Students take an xray by themselves in the room with the animal

Alasdair Mathieson — Fri, 26 Sep 2014 09:51:16 GMT

[quote user="Sal the 1st"]

so how would you take an xray where the lungs needed to be inflated without being in the room? which is the example being used - there are instances (rare but necessary) where there needs to be somebody in the room. Dont forget that PPE consists of more than a lead apron or a dosemeter it can also include lead gloves, hand/sleeve shields, lead sheets, thyroid guards, glasses etc depending what is being done - and also that some practices do not have a separate room for radiography (not that common now but still possible) and people do have to stay in the room behind a screen when xrays are being taken. I think the 'NEVER' statement being made here needs to be qualified

[/quote]

Spot on. There will be times when the rules have to be bent, and you use maximum protection and common sense. Not sure how or why you can sign something like this off as a simulation.

Re: Can Students take an xray by themselves in the room with the animal

Nick Shackleton — Fri, 26 Sep 2014 00:00:44 GMT

We used to tally who had inflated chests or were present in the room during exposure and try and rotate so not just one person was inflating chests. Also for some contrast investigations vets like to have a dynamic image ie the radiograph is taken as the contrast is injected. Usually for these the vets would gown up. We used to have in theatre fluro unit which we had to stay in room during exposure. We ensured everyone involved wore lead gowns, thyroid shields and dosimeter. We all kept a record of staff present during all exposures. Where possible if people aren't required in the room then leave the room. But in some cases this isn't possible. As others have stated inflated chest radiographs are a lot better then a standard radiograph. Just remember your inverse square law. If you're a meter away from the primary beam then you quarter the dose you receive. Even more so if wearing the appropriate PPE. Personally think this could be simulated as part of NPL in my opinion. Also as others have said you can't inflate the chest and take exposure. There is probably something in your local rules about remaining in the room during exposure. As others have mentioned consult your RPS/RPA

Re: Can Students take an xray by themselves in the room with the animal

Steph Worsley — Thu, 25 Sep 2014 23:00:13 GMT

I agree with Sal, radiographs where the lungs are inflated can be a very important diagnostic tool (for example when looking for metastatic disease or subtle alveolar patterns - that might be missed on just inspired radiographs), so unless you have the luxury of a ventilator and the patient tolerates it then you will need to be in the room. so NEVER say NEVER

Re: Can Students take an xray by themselves in the room with the animal

Sal the 1st — Thu, 25 Sep 2014 19:09:29 GMT

Re: Can Students take an xray by themselves in the room with the animal

helen lloyd — Thu, 25 Sep 2014 10:54:08 GMT

To check you are not being exposed is the reason for dosemeters usually and ppe to prevent exposure from broken machines/leaks. I qualified years ago and was never allowed to be in the room and always wore a lead apron and dosemeter

Re: Can Students take an xray by themselves in the room with the animal

Sal the 1st — Thu, 25 Sep 2014 10:21:02 GMT

[quote user="Katie Mansfield"]

We are NEVER in the room for any reason.

[/quote]

well if this is what everybody is being taught now, why do practices even have dosemeters and PPE? because if this is the case surely neither would ever be required. There are a few cases (note only a few) where it will need somebody in the room (and inflating the lungs would be one of them). My previous advice stands check with your RPS/RPA

Re: Can Students take an xray by themselves in the room with the animal

Katie Mansfield — Thu, 25 Sep 2014 08:10:43 GMT

I just qualified in July. For my NPL I simulated wearing of PPE and also took exposures of the aprons and gloves to check for cracks etc. We are NEVER in the room for any reason.

Re: Can Students take an xray by themselves in the room with the animal

Sal the 1st — Wed, 24 Sep 2014 00:16:47 GMT

[quote user="Samantha Mason"]

Receiving conflicting information on this so any instruction or written guidance would be amazing. I was told I had to be in the room wearing PPE while the xray was taken while I was a student in order for my NPL skill to be signed off by Clinical Coach even though I objected quite ferociously about not wanting to. It was inflating the lungs during the xray. No other students at my UNI have done been exposed and when I brought it up to the head of the department they said as part of the NPL skill task that it could not be simulated and that it was a legit case so no unnecessary exposure occurred. They said in order to have wearing PPE signed off I had to wear it in the room during an xray and I should feel grateful they felt I was competent to do the xray. The clinical tutor had stated earlier before this meeting that we were not do be in the room when xrays were taken. When this was brought up during the current meeting they said she meant we weren't allowed to physically restrain the animal with us being exposed to primary beam but being outside of the main beam was fine. I am confused about this please help! The instructor who said not to do it is back working with the RCVS so no longer there to help.

Thank you!

[/quote]

what does your RPS/RPA say?

Re: Can Students take an xray by themselves in the room with the animal

Heather Bacon — Tue, 23 Sep 2014 20:02:29 GMT

I have been told by the QAS/NPL staff at college that under no circumstances should we be in the room unless we are behind a lead screen, and that we should not be needing to manually restrain the patient in small animal practice. I have got it all signed off just by showing my CC that I know where it is and can put it on.

Re: Can Students take an xray by themselves in the room with the animal

Samantha Mason — Tue, 23 Sep 2014 19:26:39 GMT

I spoke to the Head of the Vet Nursing Department because the clinical tutor had left. What I was told by her was that it was a skill that could not be simulated. We had to wear lead apron and gloves in the room during an actual xray and that I should be flattered they had the confidence in my abilities to allow me to do it in the first place. Almost all of my classmates simulated it to get it signed off so I don't know why she would tell me that unless all of my classmates are going to have to correct their NPLs??? This is why I am trying to find out more information. I have finished NPL and placement so it is just to find out what is correct. Thanks guys for the quick responses!

Re: Can Students take an xray by themselves in the room with the animal

lskm 23 — Tue, 23 Sep 2014 19:00:02 GMT

Hi, we have a no holding/ no one in the room policy when taking x-rays so our PPE for x-ray is never used (apart from dosimeter of course). To cover the NPL I get my student to wear the lead aprons to demo to me that they are able to put them on but we would never break practice policy just for NPL.

Can you not speak to a tutor at college?

Re: Can Students take an xray by themselves in the room with the animal

Steph Worsley — Tue, 23 Sep 2014 18:41:36 GMT

Hi I cannot really help you with the NPL side of things as I don't have any experience with this.

I am a little bit confused are you both inflating the lungs AND taking the radiograph or are you inflating and someone else is taking the radiograph?

As long as you are wearing suitable PPE and your dosimeter and ideally behind a lead screen as well then it will be fine for you to be in the room (as long as you are complying with local rules) as you will generally be a sensible distance away from the patient as well to help reduce the risk of scatter radiation.

Ideally you would have someone else exposing as it is difficult to both inflate and expose correctly and safely. (they prep, you inflate and tell them when you are at inflation and they expose)

You should never be in the room unnecessarily i.e. to restrain the patient/just to sign off an NPL.