{
"id": "radiography-patient-care",
"modality": "Radiography",
"category": "Patient Care",
"title": "Radiography Patient Care: Ethics, Assessment and Contrast",
"minutes": 9,
"slides": [
{
"id": 1,
"diagram": "title",
"heading": "Radiography Patient Care",
"bullets": [
"33 of 200 scored questions (16.5%)",
"Ethics, legal, vitals, infection, emergencies, contrast"
],
"narration": "Welcome to Radiography Patient Care. This section is 33 of the 200 scored questions on the radiography boards, about 16.5 percent. We'll cover ethics and the law, vital signs and patient equipment, infection control, medical emergencies, and the contrast media questions that show up every time. These are points you can bank, because most of them are straight recall, and a lot of it is what you already do on every shift. Grab a coffee and let's get started.",
"svg": ""
},
{
"id": 2,
"diagram": "consent",
"heading": "Ethics and consent",
"bullets": [
"Informed consent: risks, benefits, alternatives",
"Competent adult; may withdraw anytime, even mid-exam",
"Implied consent: unconscious or emergency patient",
"ARRT Code is aspirational; Rules are enforceable"
],
"narration": "Informed consent means the patient is told the risks, the benefits and the alternatives. It has to come from a competent adult, and that patient can withdraw consent at any time, even halfway through the exam. A family member cannot consent for a competent adult. Implied consent covers the unconscious or emergency patient. And for the ARRT Standards of Ethics, remember this: the Code of Ethics is aspirational, while the Rules of Ethics are mandatory and enforceable.",
"svg": ""
},
{
"id": 3,
"diagram": "legal-terms",
"heading": "Legal terms",
"bullets": [
"Battery: touching or imaging without consent",
"Assault: threat or fear of being touched",
"False imprisonment: unjustified restraint",
"Respondeat superior: employer is liable",
"Res ipsa loquitur: the thing speaks for itself"
],
"narration": "Legal terms are easy points if you keep them straight. Battery is touching or imaging a patient without consent. Assault is only the threat, or the fear, of being touched. False imprisonment is unjustified restraint, and restraints need a physician order, though sponges and sandbags are positioning aids, not restraints. Respondeat superior means let the master answer, so the employer is liable for your work. Res ipsa loquitur means the thing speaks for itself, which shifts the burden of proof to the defendant.",
"svg": ""
},
{
"id": 4,
"diagram": "vitals",
"heading": "Vital signs",
"bullets": [
"Adult pulse 60-100 beats/min",
"Respirations 12-20 breaths/min",
"Normal blood pressure below 120/80 mm Hg",
"Oral temp 37 C (98.6 F); SpO2 95-100%"
],
"narration": "Memorize the normal adult vital signs. Pulse runs 60 to 100 beats per minute. Below 60 is bradycardia, above 100 is tachycardia. Respirations are 12 to 20 breaths per minute, and kids run faster. Normal blood pressure is below 120 over 80 millimeters of mercury, where the top number, systolic, is the heart contracting. Oral temperature is about 37 degrees Celsius, or 98.6 Fahrenheit, and pulse oximetry, called S P O 2, is normally 95 to 100 percent.",
"svg": ""
},
{
"id": 5,
"diagram": "patient-equipment",
"heading": "Transfers and equipment",
"bullets": [
"Lock wheels; move toward the stronger side",
"IV bag 18-24 in above the vein",
"Drainage bags below the bladder or chest",
"Oxygen is a drug: never change flow without order"
],
"narration": "For transfers, lock the wheels and move the patient toward their stronger side, using good body mechanics: wide base, load close, bend your knees. Keep an IV bag 18 to 24 inches above the vein. Urinary drainage bags and chest tube units stay below the bladder or chest so nothing flows back. And oxygen is a drug. A nasal cannula runs about 1 to 6 liters per minute, and you never change the flow without an order.",
"svg": ""
},
{
"id": 6,
"diagram": "isolation",
"heading": "Infection control",
"bullets": [
"Hand hygiene breaks the chain of infection",
"Airborne (N95): TB, measles, varicella",
"Droplet (mask): influenza, pertussis, mumps",
"Contact (gown, gloves): MRSA, VRE, C. diff",
"C. diff: soap and water, not alcohol rub"
],
"narration": "Hand hygiene is the single best way to break the chain of infection. Then match the precaution to the bug. Airborne precautions, with an N95 respirator and a negative pressure room, are for TB, measles and varicella. Droplet precautions, a surgical mask, are for influenza, pertussis and mumps. Contact precautions, gown and gloves, are for MRSA, VRE and C. diff. And for C. diff, wash with soap and water, because alcohol rub does not kill the spores.",
"svg": ""
},
{
"id": 7,
"diagram": "emergencies",
"heading": "Medical emergencies",
"bullets": [
"Adult CPR: 100-120/min, 2 in deep, 30:2",
"Seizure: protect head, nothing in the mouth",
"Hypoglycemia: shaky, sweaty; sugar if alert",
"Stroke FAST: face, arms, speech, time"
],
"narration": "Adult CPR is 100 to 120 compressions per minute, at least 2 inches, or 5 centimeters, deep, at 30 compressions to 2 breaths, with an AED as soon as you have one. For a seizure, protect the head, move things away, and never put anything in the mouth. Hypoglycemia looks shaky, sweaty and confused, so give sugar if the patient is alert and can swallow. For stroke, think FAST: face, arms, speech, and time of onset.",
"svg": ""
},
{
"id": 8,
"diagram": "contrast-prep",
"heading": "Before contrast",
"bullets": [
"Check allergies, medications, creatinine, eGFR",
"Creatinine about 0.6-1.2 mg/dL, BUN 7-20",
"Metformin: hold 48 h only if eGFR <30 or AKI",
"Suspected perforation: water-soluble, not barium",
"Order: non-contrast, iodine, then barium"
],
"narration": "Before any contrast, check allergies, medications, and renal labs, including creatinine and e G F R, the estimated glomerular filtration rate. Normal creatinine is about 0.6 to 1.2 milligrams per deciliter, and BUN about 7 to 20. Per the A C R, hold metformin for 48 hours only if e G F R is below 30 or there is acute kidney injury. If perforation is suspected, use water-soluble iodine, not barium. Scheduling order is non-contrast exams, then iodine, then barium.",
"svg": ""
},
{
"id": 9,
"diagram": "contrast-reactions",
"heading": "Contrast reactions",
"bullets": [
"Mild: limited hives, itching, nausea",
"Moderate: diffuse hives, bronchospasm",
"Severe: laryngeal edema, anaphylactic shock",
"Vasovagal: slow pulse; anaphylaxis: fast pulse",
"Most severe reactions occur within 20 minutes"
],
"narration": "Know the A C R severity scale. Mild reactions are limited hives, itching and nausea. Moderate reactions are diffuse hives or bronchospasm. Severe reactions include laryngeal edema and anaphylactic shock. Here's the classic trap: both vasovagal and anaphylactic reactions drop the blood pressure, but vasovagal has a slow pulse, treated with atropine and raised legs, while anaphylaxis has a fast pulse, treated with epinephrine. Stay with your patient, because most severe reactions occur within 20 minutes.",
"svg": ""
},
{
"id": 10,
"diagram": "summary",
"heading": "Lock these in",
"bullets": [
"Patient can withdraw consent at any time",
"Pulse 60-100, respirations 12-20",
"CPR: 100-120/min, 2 in deep, 30:2",
"Metformin: hold 48 h if eGFR <30 or AKI",
"Vasovagal = slow pulse; anaphylaxis = fast"
],
"narration": "Let's lock it in. A competent patient can withdraw consent at any time. Normal pulse is 60 to 100, and respirations are 12 to 20. Adult CPR is 100 to 120 compressions per minute, 2 inches deep, 30 to 2. Metformin is held for 48 hours only when e G F R is below 30 or there is acute kidney injury. And vasovagal means a slow pulse, while anaphylaxis means a fast pulse. Now hit Practice this chapter and test yourself.",
"svg": ""
}
]
}