Produce images using fluoroscopy
Overview
SFHCI.F SFHCI.F This standard is concerned with the examination of anatomical structures using fluoroscopy. This will be undertaken as part of a diagnostic and/or treatment process. The outcomes will be of sufficient quality to assist diagnosis and or treatment. This standard should be undertaken within the scope of your own role. Key people are those involved in the individual's care and others involved in provision of services. Users of this standard will need to ensure that practice reflects
Performance criteria
You must be able to:
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apply standard precautions for infection control and other appropriate
health and safety measures
ensure all necessary preparations have been made by the individual
and staff before starting the procedure
check and prepare the equipment required for the examination
ensure the environment is conducive to maintaining the privacy and
dignity of the individual
check the identification details before commencing the procedure in
accordance with local policies and procedures
communicate with the individual / key people to facilitate their
understanding of and co-operation with the examination
establish the individuals capacity to understand the procedure with
the help of key people if necessary
obtain valid consent for the procedure in accordance with national
and local guidelines
respect the individuals privacy, dignity, beliefs and decisions
clearly explain the procedure and possible outcomes, including risk,
benefits and limitations
check individuals of child-bearing potential for pregnancy or
possible pregnancy, if appropriate to the examination, and take action
in accordance with local protocols
confirm the status of key people before the examination and, where
their presence is required, adhering to local guidelines
examine previous relevant images and clinical information, where
available, to ensure that the correct procedure and techniques are
employed
assess the individuals clinical and physical condition prior to the
start of the examination with a view to proceeding
give the individual clear information on the possible after effects of
the use of contrast media and medicines
position the individual and adjust their clothing according to the
protocols for the examination to be performed in a manner which allows
an optimal outcome to be achieved while:
16.1 recognising the individuals need to retain their dignity and self
respect
16.2 ensuring his/her comfort as far as possible
16.3 preventing the appearance of artefacts
position the imaging equipment appropriate to the examination
technique with anatomical legends or electronic annotation correctly
placed
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apply, check and adjust appropriate exposure factors, collimation
and radiation protection devices to minimise exposure to the individual
whilst optimising diagnostic image quality
ensure the details of the individual are accurately recorded in the
fluoroscopic equipment or if previously entered, check for accuracy
check the room prior to making the exposure to ensure that only
essential, protected persons remain with the individual and that all local
protocols have been adhered to
administer appropriate contrast media and medicines in accordance
with the local protocols for the examination
seek confirmation that the individual is ready before the exposure is
made and maintain communication with the individual/key people to
facilitate their understanding and ensure their co-operation throughout
the examination
observe the individuals condition and well-being at all times and
take appropriate action
ensure that all dose reduction/protection processes have been
employed
adjust the equipment to optimise the images for the purpose of the
examination
monitor and accurately record the individuals exposure to ionising
radiation throughout the procedure according to local protocols and
local rules
capture permanent images where required and according to local
guidelines for the examination
recognise where equipment malfunctions during the procedure and
take appropriate action
check the identification of the images against associated documents
examine the images to ensure that the anatomical coverage is
consistent with the examination request, the clinical information
provided and local protocols
ensure the images are:
31.1 correctly labelled with the individuals orientation and identification
details
31.2 are processed and inspected for satisfactory technical and
diagnostic quality according to local guidelines and criteria
make a decision with the regard to the need to repeat any images
or to take additional images to enhance the examination
following the preliminary imaging examination, inform to the
appropriate person if an abnormality is observed on the image which is
likely to require further investigation or treatment, following
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departmental protocols
provide the individual with information relating to the procedure and
aftercare where necessary
explain the process for obtaining results
record, collate and prepare appropriate information, documentation
and images for transfer or storage according to local protocols
verify that the images have arrived/been stored according to local
protocols
recognise where help or advice is required and obtain this from
appropriate sources
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Knowledge and Understanding
You need to know and understand:
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legal, organisational and policy requirements relevant to your role,
the role of others in your organisation and the activities being
carried out
the relevant national and local standards, guidelines, policies and
procedures that are available and how and when they should be
accessed
the importance of respecting individuals culture, privacy, dignity,
wishes, beliefs and decisions
the limitations of your own knowledge and experience and the
importance of operating within your scope of practice
the roles and responsibilities of other team members
the importance of obtaining valid consent in line with national and
local guidelines
clinical appropriateness of the examination request and the action
to take when the request is not appropriate
gross anatomy of the area being examined
physiological and pathological processes relevant to the area
being examined
the medical terminology relevant to the examination including
abbreviations
when standard and additional views are required to aid diagnosis
and to enhance the examination
the range and safe use of contrast media and medicines in
fluoroscopic examinations
the behaviour of contrast media and medicines and how this may
affect images obtained and their interpretation
the clinical conditions appropriate for fluoroscopic examination
the clinical implications of any allergies relevant to the
examination
the recognition of the variations of normal anatomy demonstrable
by fluoroscopy and contrast media within your scope of practice
the recognition of abnormal anatomy demonstrable by fluoroscopy
and x-ray contrast media and the significance of such abnormality
within your scope of practice
manifestations of individuals physical and emotional status
production, interactions and properties of x-rays
the harmful effects of radiation to the human body and use of
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radiation protection equipment
ways in which images can be captured, processed and
permanently stored
how to adapt communication styles, ask questions, and listen
carefully in ways which are appropriate for the needs of the
individual
methods of communicating difficult and complex information to
individuals and key people
the importance of providing individuals and key people with
opportunities to ask questions and increase their understanding
the information that should be given to individuals before, during
and on completion of the examination
the inter-relationship between Kilo Volt Peak (kVp) and
Milliamperage (mA) and Time (seconds)
variables affecting exposure factors and how to manipulate
exposure factors for the examination and the individual as
appropriate
the technical and diagnostic quality requirements of the image
recognition of artefacts and their impact
factors which influence the decision to repeat images
equipment capabilities, limitations and routine maintenance
including the quality control processes required by the operator
image manipulation and post processing
the importance of timely equipment fault recognition and local
procedures for reporting these
contra-indicators to the procedure
the preparation of the individual, equipment and environment for
fluoroscopic examinations
orientation and appropriate use of anatomical legends and
electronic annotation
the range of techniques that may be used to optimise image
quality and dose for the individual, including selection and
provision of suitable projections, appropriate use of collimation
and strategies to reduce dose to individuals and staff
the role of other imaging modalities and diagnostic investigations
relevant emergency procedures and the types and use of
emergency equipment available
procedures relating to recording, collating and preparing
appropriate information, documentation and images for transfer or
storage according to local protocols
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how to keep full, accurate and clear records in line with
organisational procedures
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Scope/range
Scope Performance
Scope Knowledge
Values
Behaviours
Skills
Glossary
Links To Other NOS
External Links
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This standard links with the following dimension within the NHS
Knowledge and Skills Framework (October 2004):
Dimension: HWB6 Assessment and treatment planning
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