Radiologic Techolongy at Santa Fe Community College
Santa Fe, New Mexico
Olive Peart, MS, RT(R)(M)
Radiologic Technology Program Chair
Fortis College
Landover, Maryland
Contents
Preface
Acknowledgments
Master Bibliography
I. PATIENT CARE
1. Ethical and Legal Aspects
Chapter Review Questions
2. Interpersonal Communication
Chapter Review Questions
3. Physical Assistance, Monitoring, and Medical Emergencies
Chapter Review Questions
4. Infection Prevention and Control
Chapter Review Questions
5. Pharmacology
Chapter Review Questions
II. PROCEDURES
6. General Procedural Considerations
Chapter Review Questions
7. Anatomy, Positioning, and Pathology
Chapter Review Questions
III. SAFETY
8. Radiation Physics and Radiobiology
Chapter Review Questions
9. Patient Protection
Chapter Review Questions
10. Personnel Protection
Chapter Review Questions
11. Radiation Exposure and Monitoring
Chapter Review Questions
IV. IMAGE PRODUCTION
12. Image Acquisition and Technical Evaluation
Chapter Review Questions
Chapter Review Questions
13. Equipment Operation and Quality Assurance
Chapter Review Questions
Chapter Review Questions
Chapter Review Questions
Chapter Review Questions
Chapter Review Questions
Chapter Review Questions
Chapter Review Questions
Chapter Review Questions
14. Practice Test Index
Preface
This ninth edition of Radiography PREP (Program Review and Examination Preparation), is intended to be useful throughout all phases of radiography education. This text is designed to be useful for regular coursework, helping the student to extract fundamental key concepts from reading assignments and class notes, and for making study and test preparation easier and more productive.
PREP is also useful for students preparing for their American Registry of Radiologic Technologists (ARRT) certification examination. It helps students direct their study efforts toward examination-related material and includes registry-type multiple-choice questions designed to help students practice test taking and critical thinking skills they will need for the ARRT radiography examination and for their professional careers.
The ARRT’s Content Specifications for the Examination in Radiography lists the examination’s four content categories and provides a detailed list of the topics addressed in each category. Radiography PREP is divided into four parts reflecting each of the four content categories. Part content reflects changes to the ARRT Content Specifications published in January 2016 and implemented in January 2017. The Safety and Image Production sections have each been divided into two separate sections for more focused study. Some basic introductory CT material is also included an area becoming increasingly important for the entry-level radiographer. As this field continues to grow, there is increasing need to include its fundamentals in the radiography curriculum. Particularly important is updated and expanded content in digital imaging. Obsolete content on film and intensifying screens have been deleted. SI units are used exclusively, with occasional equivalent traditional unit of measure provided for reference. Thus, study becomes even more directed and focused on examination-related material.
A series of tools are available for effective coursework study followed by preparation for the certification test. PREP and Radiography Review Flashcards are recommended for use with regular coursework. Used with
their companion book, Lange Q&A Radiography Examination, PREP and Radiography Review Flashcards provide a thorough preparation for the certification examination administered by the ARRT. Finally, certification examination preparation can be extended to include the computerized testing offered at the web site www.RadReviewEasy.com.
KEY FEATURES AND USE
• More than 400 illustrations and images appeal to the visual learner as well as the verbal learner. The essence of radiography is visual and PREP’s graphics and radiographic images visually express the written words.
• The numerous summary boxes serve to call the student’s attention to the most important facts in a particular section. Students can use summary boxes as an overview of key information.
• Inside covers list a number of formulae, radiation protection facts, conversion factors, body surface landmarks, digital imaging facts, acronyms, and abbreviations, radiation quality factors, and minimum filtration requirements. A “last-minute cheat sheet” is provided for some things that students often forget because they may not use them on a regular basis.
• The final review sections allow students to assess chapter material in two ways. The first review section, Comprehension Check, requires short essay answers; exact page references follow each question, providing answers in chapter material. The second section, Chapter Review Questions, consists of registry-type multiple-choice questions followed by detailed explanations. To make the most of their study efforts, students are encouraged to review in that order: Comprehension Check first, followed by the multiple-choice questions.
• Chapter 13 (Equipment) includes a section on Computed Tomography. As this field continues to grow, there is increasing emphasis on its inclusion in the radiography curriculum.
• Chapter 14 is a practice test; a simulation of the actual certification examination with questions designed to test your problem-solving skills and your ability to integrate facts that fit the situation. The questions are designed to provide focus and direction for your review, thus helping you do your very best on your certification examination.
Chapter review questions can be supplemented using Radiography Review Flashcards of the same content. Following completion of the chapter review questions, radiography flashcards, and the practice test, the student is ready for final self-evaluation by answering more “registry- type” questions in the companion text, Lange Q&A the Radiography Examination, Eleventh Edition, and supplemental study at its web site www.RadReviewEasy.com.
Acknowledgments
I appreciate having the opportunity to thank those who have most generously contributed their insights, talents, and concerns to this project. Foremost among those are my teachers and colleagues who have contributed to my knowledge over the years and the many students on whom I have had the privilege of sharpening my knowledge and skills. I am grateful to the professional staff of McGraw-Hill for their guidance through this project, with special notes of appreciation to Susan Barnes, Christina Thomas, Jeffrey Herzich, Nadine Elebrashy, and Graphic World, Inc. project manager Sunil Kumar for their creativity, support, and patience in bringing this text to publication. An additional note of appreciation goes to Jennifer Pollock for her development and maintenance of the books’ companion web site, www.RadReviewEasy.com. Her foresight and expertise have brought successful added dimensions to both texts PREP and the Q&A. Everyone at McGraw-Hill has been helpful in the development of these projects; it is always a pleasure to work with their creative and skilled staff.
An outstanding group of reviewers was recruited for this edition of PREP. Gloria Albrecht, Deanna Butcher, Gail Faig, Merryl Fulmer, Brenda Grant, Cheryl Peachey and Olive Peart are all invaluable resources to the health care and the radiologic imaging communities. They reviewed the manuscript and offered suggestions to improve style and remove ambiguities and inaccuracies. Their participation on this project is deeply appreciated.
I also extend my appreciation to Conrad P. Ehrlich, MD, for granting permission to use several radiologic images; Dr. Ehrlich and his staff at Housatonic Valley Radiological Associates have been most helpful.
The CT section in Chapter 13 could not have been accomplished without the help of several individuals; I am grateful to Sarah Bull, MS, DABR, Angie Dohan, RT(R), Conrad Ehrlich, MD, Paula Hill, RT(R)(CT)(CV)(M), Doug Schueler, RT(R)(CT), and Teresa Whiteside, BA, RT(R)(BD)(CT) (CBDT).
The preparation of this text would have been a far more difficult task without the help and encouragement of my husband, Tony. His enduring understanding, support, assistance, and advice are lovingly appreciated.
Master Bibliography
Adler AM, Carlton RR. Introduction to Radiologic and Imaging Sciences and Patient Care. 6th ed. St. Louis, MO: Saunders Elsevier; 2016.
ARRT Standards of Ethics. https://www.arrt.org/docs/defaultsource/Governing-Documents/arrt-standards-of-ethics.pdf?sfvrsn=10 Accessed March 27, 2017
ASRT Practise Standards. https://www.asrt.org/docs/default-source/practicestandards-published/ps rad.pdf?sfvrsn=2 Accessed March 27, 2017
Bushong SC. Radiologic Science for Technologists. 10th ed. St. Louis, MO: Mosby; 2013.
Bushong SC. Radiologic Science for Technologists. 11th ed. St. Louis, MO: Mosby; 2017.
Lampignano JP, Kendrick LE. Bontrager’s Textbook of Radiographic Positioning and Related Anatomy. 9th ed. St. Louis, MO: Mosby Elsevier; 2018.
Long BW, Rollins JH, Smith BJ. Merrill’s Atlas of Radiographic Positioning and Procedures. Vols 1-3. 13th ed. St. Louis, MO: Mosby; 2016.
Mills WR. e relation of bodily habitus to visceral form, tonus, and motility. Am J Roentgenol. 1917;4:155–169.
NCRP Report No. 102. Medical x-ray, Electron Beam and Gamma-Ray Protection for Energies up to 50 MeV (Equipment Design, Performance and Use). NCRP; 1989.
NCRP Report No. 116. Recommendations on Limits for Exposure to Ionizing Radiation. NCRP; 1987.
NCRP Report No. 160. Ionizing Radiation Exposure of the Population of the United States. NCRP; 2009.
Peart O. Lange Radiographic Positioning Flashcards. New York, NY: McGraw-Hill; 2014.
Peart O. Mammography and Breast Imaging PREP. New York, NY: McGraw-Hill; 2012.
Saia DA. Radiography PREP. 7th ed. New York, NY: McGraw-Hill; 2012.
Saia DA. Radiography PREP. 8th ed. New York, NY: McGraw-Hill; 2015.
Saladin KS. Anatomy and Physiology: e Unity of Form and Function. 7th ed. New York, NY: McGraw-Hill; 2015.
Seeram E, Brennan PC. Radiation Protection in Diagnostic X-ray Imaging. Burlington, MA: Jones and Bartlett Learning; 2017.
Seeram E. Digital Radiography: An Introduction. Clifton Park, NY: Delmar Cengage Learning; 2011.
Selman J. e Fundamentals of Imaging Physics and Radiobiology. 9th ed. Springfield, IL: Charles C Thomas; 2000.
Shephard CT. Radiographic Image Production and Manipulation. New York, NY: McGraw-Hill; 2003.
Statkiewicz-Sherer MA, Visconti PJ, Ritenour ER, Haynes KW. Radiation Protection in Medical Radiography. 7th ed. St. Louis, MO: Mosby; 2014.
Statkiewicz-Sherer MA, Visconti PJ, Ritenour ER. Radiation Protection in Medical Radiography. 6th ed. St. Louis, MO: Mosby; 2011.
Takahiro KAWAMURA*, Satoshi NAITO*, Kayo OKANO* and Masahiko YAMADA*. Improvement in Image Quality and Workflow of X-ray Examinations Using a New Image Processing Method, Virtual Grid Technology.
Wolbarst AB. Physics of Radiology. 2nd ed. Madison, WI: Medical Physics Publishing; 2005.
Wolbarst AB. Physics of Radiology. Stamford, CT: Appleton & Lange; 2003.
*Imaging Technology Center, Research & Development Management Headquarters, FUJIFILM Corporation
PART I Patient Care
CHAPTER 1
Ethical and Legal Aspects
Patient’s Rights
Patient Confidentiality
Informed Consent
Bill of Rights/Patient Care Partnership
Legal Issues
X-ray Examination Requests
Law/Medicolegal Issues
Standards of Ethics
ARRT Standards of Ethics
Honor Code
CHAPTER 2
Interpersonal Communication
Communication Skills
Types of Communication
Communication with Patients
Patient Identification
Verbal/Written and Nonverbal Communication
Patient Education
Examination Instructions
Communication Challenges Impediments
Medical Terminology
Strategies to Improve Communication
CHAPTER 3
Physical Assistance, Monitoring, and Medical
Emergencies
Physical Assistance and Transfer
Body Mechanics
Transfer Techniques
Patient Safety and Transfer Considerations
Patient Support Equipment
Oxygen
Suction
Tubes
Routine Monitoring
Assessment
Physical Signs
Vital Signs
Documentation
Medical Emergencies
Allergic Reactions
Side Effect Versus Toxic Effect
Latex
Anaphylactic Responses
Renal Function
Other Medical Emergencies
Vomiting
Fractures
Spinal Injuries
Epistaxis
Postural Hypotension
Vertigo
Syncope
Convulsion
Seizure
Unconsciousness
Acute Abdomen
Shock
Respiratory Failure
Cardiopulmonary Arrest
Stroke
CHAPTER 4
Infection Prevention and Control
Terminology and Basic Concepts
Microorganisms
Medical and Surgical Asepsis
Hand Hygiene
Personal Care
Cycle of Infection
Pathogens
Reservoir of Infection
Portal of Exit
Susceptible Host
Portal of Entry
Modes of Transmission
Standard Precautions
Infection Prevention and Control Basic Guidelines
Health Care–Associated Infections
Transmission-Based Precautions
Airborne
Droplet
Contact
Patients Whose Immune Systems are Compromised
Contaminated Material Disposal
CHAPTER 5
Pharmacology
Patient History
Administration
Routes of Administration
Intravenous Equipment
Venipuncture
Contrast Media
Patient History
Purpose
Types and Properties of Agents
Scheduling and Preparation Considerations
Contraindications and Patient Education
Reactions and Complications
Extravasation
Side Effect Versus Toxic Effect
Laboratory Values and Medications
Documentation
1
Ethical and Legal Aspects
Ethics refers to a set of principles of right and wrong behavior, a system of values that guides conduct in relationships among people in accordance with particular expected patterns of behavior. Ethical conduct is particularly important in the health care professions. The effects of our actions and/or behavior can harm others, put them at risk for harm, or violate their rights.
OBJECTIVES
At the conclusion of this section, the student will be able to:
• Discuss ethics relative to behavior and values, and their relationship to the health care professions.
• Identify the acronym HIPAA and discuss that legislation’s impact on patient information.
• Identify the purpose of an Advance Health Care Directive and its impact on patient autonomy and decision-making.
• Discuss the radiographer’s responsibilities regarding patient examination requests.
• Describe examples of potential professional negligence.
• List the parts of the ARRT® Standards of Ethics.
• Identify where guidelines for the radiographer’s professional conduct can be found.
• Identify the types of communication and cite examples of each.
• List various challenges to effective communication and discuss tools and strategies available to meet these challenges.
• Discuss techniques to reduce patient anxiety in various age-specific groups.
• Discuss the radiographer’s responsibility related to patient education.
• List rules of body mechanics appropriate for the radiographer.
• Compare transfer methods for wheelchair/stretcher patient transport.
• Provide examples of objective and subjective patient information.
• Identify the use of various tubes and central lines.
• Identify the vital signs and their norms.
• Discuss the factors and conditions that can affect vital sign norms.
• Explain the use of various oxygen delivery systems.
• Define the terms related to allergic reactions.
• Discuss the importance of being alert to any change in patient condition.
• List various potential medical emergencies and identify the radiographer’s role in each.
• Define the infection prevention and control terminologies.
• Discuss the role of personal hygiene in preventing the spread of infection.
• Explain the cycle involved in transmitting infectious disease.
• Identify the three main modes of infection transmission and their transmission-based precautions.
• Discuss the radiographers’ approach to dealing with neutropenic isolation/precautions.
• Discuss the value of complete and accurate patient assessment.
• Identify component parts of patient history.
• List the various routes of medication administration.
• Describe anatomy and procedural technique pertaining to venipuncture.
• Identify the types of contrast media; cite examples of their use and identify potential complications/contraindications.
• Discuss the difference between side effect and toxic effect.
• Describe the levels of contrast media untoward responses.
PATIENT’S RIGHTS
Patient Confidentiality
Most institutions now have computerized, paperless systems (known as hospital information systems or HIS) to accomplish information transmittal; these systems must ensure confidentiality in compliance with Health Insurance Portability and Accountability Act (HIPAA) of 1996 regulations. A health care professional generally has access to a computerized system only
via a personal password, thus helping ensure confidentiality of patient information. All medical records and other individually identifiable health information whether electronic, on paper, or oral are covered by HIPAA legislation and by subsequent Department of Health and Human Services (HHS) rules that took effect in April 2001.
Ethical Behavior
• The effects of our actions and/or behavior can harm others, put them at risk for harm, or violate their rights.
All health care practitioners must recognize that their patients comprise a community of people belonging to all religions, races, and economic backgrounds, and that each patient must be afforded their best efforts. Every patient should be treated with consideration of his or her worth and dignity. Patients must be provided confidentiality and privacy. They have the right to be informed, to make informed consent, and to refuse treatment.
Informed Consent
Patient consent could be verbal, written, or implied. For example, if a patient arrives for emergency treatment alone and is unconscious, implied consent is assumed. A patient’s previously granted or implied consent can be withdrawn at any time. Written patient consent is required before any examination that involves greater than the usual risk, for example, invasive vascular examinations requiring the use of injected iodinated contrast agents. For lower risk procedures, the consent given on admission to the hospital is generally sufficient.
Conditions for Valid Patient Consent
• The patient must be of legal age.
• The patient must be of sound mind.
• The patient must give consent freely.
• The patient must be adequately informed about the procedure about to take place.
It is imperative that the radiographer takes adequate time to thoroughly explain the procedure or examination to the patient. An informed patient is a more cooperative patient, and a better examination is more likely to result. Patients should be clear about what is expected of them and what to expect from the radiographer. This must be considered the standard of care for each patient, to fulfill not only legal mandates but also professional and humanistic obligations.
Bill of Rights/Patient Care Partnership
The American Hospital Association’s (AHA’s) Management Advisory presented a Patient’s Bill of Rights that was first adopted by the AHA in 1973, then revised and approved by the AHA Board of Trustees in October of 1992. The 1992 Patient’s Bill of Rights detailed 12 specific areas of patients’ rights and the health care professional’s ethical (and often, legal) responsibility to adhere to these rights. The Patient’s Bill of Rights is summarized as the right to
1. considerate and respectful care;
2. be informed completely and understandably;
3. make decisions about plan of care/refuse treatment;
4. have an advance directive (e.g., a living will, health care proxy) describing the extent of care desired;
5. privacy;
6. confidentiality;
7. review his or her records (access to his or her health care information);
8. request appropriate and medically indicated care and services;
9. know about institutional business relationships that could influence treatment and care;
10. be informed about, consent to, or decline participation in proposed research studies;
11. continuity of care;
12. be informed about hospital policies and procedures relating to patient care, treatment, and responsibilities.
The AHA recently replaced the Patient’s Bill of Rights with The Patient Care Partnership Understanding Expectations, Rights, and Responsibilities. Their plain-language brochure includes the essentials of the Bill of Rights and reviews what patients can/should expect during a hospital stay.
The Patient Care Partnership
What to expect during your hospital stay:
• High-quality hospital care.
• A clean and safe environment.
• Involvement in your care.
• Protection of your privacy.
• Help when leaving the hospital.
• Help with your billing claims.
Source: The American Hospital Association.
The Patient Care Partnership statement addresses high-quality hospital care combining skill, compassion, and respect and the right to know the identity of caregivers, whether they are students, residents, or other trainees. It includes a clean and safe environment, free from neglect and abuse, and information about anything unexpected that occurred during the hospital stay. The Patient Care Partnership identifies involvement in your care; it elaborates on patient discussion/understanding of their condition and treatment choices with their physician, the patient’s responsibility to provide complete and correct information to the caregiver, and understanding who should make decisions for the patient if the patient cannot make those decisions (including “living will” or “advance directive”).
The Patient Care Partnership statement also identifies protection of your
privacy—describing the ways in which patient information is safeguarded. It also describes help when leaving the hospital availability of and/or instruction regarding follow-up care. Finally, the Patient Care Partnership statement addresses help with your billing claims including filing claims with insurance companies, providing patient physicians with required documentation, answering patient questions, and assisting those without health coverage.
The above-mentioned patient rights can be exercised on the patient’s behalf by a designated surrogate or proxy decision maker if the patient lacks the decision-making capacity, is legally incompetent, or is a minor. Many people believe that potential legal and ethical issues can be avoided by creating an Advance Health Care Directive or Living Will. Because all individuals have the right to make decisions regarding their own health care, this legal document preserves that right in the event an individual is unable to make those decisions. An Advance Health Care Directive, or Living Will, names the individual authorized to make all health care decisions and can include specifics regarding DNR (do not resuscitate), DNI (do not intubate), and/or other end-of-life decisions.
LEGAL ISSUES
It is essential that radiographers, like other health care professionals, should be familiar with their Practice Standards published by the American Society of Radiologic Technologists (ASRT). The Standards provide a legal role definition and identify Clinical, Quality, and Professional Standards of practice each Standard has its own rationale and identifies general and specific criteria related to that Standard. The student radiographer can access the individual Standards, their rationale, and criteria on the ASRT website.
Advance Health Care Directive/Living Will
• Preserves a person’s right to make decisions regarding his or her own health care.
• Names the individual authorized to make all health care decisions for
them.
• Can include specifics regarding DNR, DNI, and other end-of-life decisions.
X-ray Examination Requests
X-ray examinations must be requested by authorized individuals, typically by a physician or a physician’s assistant, or nurse practitioner. Request forms for radiologic examinations must be carefully reviewed by the radiographer prior to commencement of the examination. Many hospitals and radiology departments have specific rules about exactly what kind(s) of information must appear on the requisition.
An all-important first step is careful and accurate patient identification and verification. Patient identification, and correctly matching the patient with the intended examination, is a routine activity in the health care environment. The health care worker has primary responsibility for checking/verifying patient identity. Most facilities require verification using at least two patient identifiers. Rigorous observance of “timeout” processes prior to procedures can avoid costly events, including those involving patient identification. It is important that the radiographer obtains a short but adequate, pertinent patient history or reason the examination has been requested. Because patients are rarely examined or interviewed by the radiologist, observations and information obtained by the radiographer can be a significant help in making an accurate diagnosis. The radiographer must be certain to obtain all clinical information in a manner and environment that ensures patient privacy.
The requisition is usually printed with the patient’s personal information (name, address, age, admitting physician’s name, and the patient’s hospital identification number). When examining a patient who is admitted to the hospital, the requisition should also include the patient’s mode of travel to the radiology department or other imaging facility (e.g., wheelchair vs. stretcher), the type of examination to be performed, pertinent diagnostic information, and any infection control or isolation information. The radiographer, having access to confidential patient information, must be mindful of compliance with HIPAA regulations.
The radiographer must be certain to understand and, if necessary, clarify
the information provided, for example, any abbreviations used and any vague terms such as leg or arm (femur vs. tibia, humerus vs. forearm). The radiographer must also be alert to note and clarify conflicting information, for example, a request for a left ankle examination when the patient complains of, or has obvious injury to the right ankle. The radiographer should also ascertain that clinical indicators match the requested examination. Computerized systems or department policy may require that there should be appropriate and accurate diagnostic information accompanying every request for diagnostic procedure.
Law/Medicolegal Issues
The four primary sources of law are the Constitution of the United States, statutory law, regulations and judgments of administrative bureaus, and court decisions.
The Constitution expresses the categorical laws of the country. Its impact with respect to health care and health care professionals lies, in part, in its assurance of the right to privacy. The right to privacy indicates that the patient’s modesty and dignity will be respected. It also refers to the health care professional’s obligation to respect the confidentiality of privileged information. Communication of privileged information to anyone but the appropriate health care professionals is inexcusable.
Statutory law refers to laws enacted by congressional, state, or local legislative bodies. The enforcement of statutory laws is frequently delegated to administrative bureaus such as the Board of Health, the Food and Drug Administration, or the Internal Revenue Service. It is the responsibility of these agencies to enact rules and regulations that will serve to implement the statutory law.
Court decisions involve the interpretation of statutes and various regulations in decisions involving individuals. For example, the decision of an administrative bureau can be appealed and the court would decide if the agency acted appropriately and correctly. Court decisions are referred to as common law.
There are two basic kinds of law: public law and private (civil) law. Public laws are those that regulate the relationship between individuals and government. Private, or civil, law includes laws that regulate the relationships among people. Litigation involving a radiographer’s
professional practice is most likely to involve the latter.
Tort
• A private/civil injustice.
• Reparation can be sought.
• Is either intentional or unintentional.
A private (civil) injustice, injury, or misconduct is a tort, and the injured party may seek reparation for damage incurred. Torts are described as either intentional or negligent/unintentional.
Examples of intentional (misconduct) torts include false imprisonment, assault and battery, defamation, and invasion of privacy. False imprisonment is the illegal restriction of an individual’s freedom. Holding a person against his or her will or using unauthorized restraint can constitute false imprisonment. Various types of immobilization devices (e.g., carefully placed positioning sponge or sandbag) can be used, with consent, to effectively reduce motion from involuntary muscular tremors resulting from anxiety or pain.
Assault is to threaten harm; battery is the carrying out of the threat. A patient might feel sufficiently intimidated to claim assault by a radiographer who threatens to repeat a difficult examination if the patient does not try harder to cooperate. A radiographer who performs an examination on a patient without his or her consent, or after the patient has refused the examination, can be guilty of battery. A charge of battery may also be made against a radiographer who treats a patient roughly or who performs an examination on the wrong patient.
For Negligent Tort Liability, Four Elements Must Be Present
• Duty (what should have been done)
• Breach (deviation from duty)
• Injury sustained
• Cause (as a result of breach)
A radiographer who discloses confidential information to unauthorized individuals can be found guilty of invasion of privacy. A radiographer whose disclosure of confidential information is in some way detrimental to the patient (e.g., causing ridicule or loss of job) can be accused of defamation. Spoken defamation is slander; written defamation is libel.
The assessment of duty (what should have been done) is determined by the professional standard of care (that level of expertise generally possessed by reputable members of the profession). The determination of whether the standard of care was met is usually made by determining what another reputable practitioner would have done in the same situation. Medical malpractice lawsuits are principally initiated on the basis of the negligence theory of liability, that is, failure to use reasonably prudent care.
Examples of negligent/unintentional torts can include imaging the wrong patient, or injury to a patient as a result of a fall when left unattended on an xray table, in a radiographic room, or on a stretcher without side rails or safety belt. Radiographing the wrong patient or opposite limb are other examples of negligence.
The term malpractice is usually used with reference to negligence. Three areas of frequent litigation in radiology involve patient falls and positioning injuries, pregnancy, and errors or delays in diagnosis.
Negligence
• Medical malpractice lawsuits are principally initiated on the basis of the negligence theory of liability.
Patient falls and positioning injuries. Examples: A sedated patient left unattended in the radiographic room falls from the x-ray table; a patient with a spinal injury is moved from the stretcher to the x-ray table, resulting in irreversible damage to the spinal cord.
Pregnancy. Example: The radiographer fails to inquire about a possible
