Step by Step Guide to

A Typical Radiographic Examination

Request Form
Check form is fully completed and signed.
Check pregnancy question (ASP8) if required.
Check examination request correlates to clinical history.
Register on computer.
Take special care with details from, elderly, handicapped, deaf, blind, very young, individuals with poor English etc.
Review any previous reports and or films.

Request form + Patient.
Confirm details of patient and examination.
Check you understand any terminology and know full details of the projections required.
Identity, use a positive ID check, use D.O.B and or address.
Previous examinations,
Check and have patient sign for pregnancy risk if appropriate.

Escort patient to changing cubicles.
Give changing instruction relevant to examination.
Use starch free examination gown and dressing gown.
Ensure patient's modesty is protected and they are warm enough.
Instruct patients in the removal of artifacts relevant to the examination, i.e. jewellery and prostheses,

****** Whilst Patient is Changing ******

Pre examination Preparation
Ensure examination room is clean and tidy, linen pads cassettes etc.
Plan sequence of films for maximum speed and patient convenience.
Ensure all  emergency equipment is functional and ready.
Ensure any cassettes, grids, lead rubber protection, foam pads etc. you may require are clean and to hand.
Set appropriate exposure for first projection.
Place cassette and anatomical marker in position for first projection.

****** Collect Patient and escort to examination room ******

The Examination
Greet patient and make positive identity check. State your name and grade.
Check request details match patients' symptoms

i.e. limbs Right/left.

Inform patient of basic procedure.

Position patient.

Position gonad protect if required.

Finalise exposure.

Rehearse any breathing /moving procedures.

Instruct patient and visually check them in respiratory manoeuvres or required movements.
Visually check all round to ensure it is safe to make exposure.
Expose
Inform patient to relax and breath normally
Remove cassette to a safe place
Proceed with the next position etc.
When finished escort patient to waiting cubicle and instruct to wait and or to redress if required.
Mark name on films and process.
Complete documentation on request form and in computer.

Assessing the Radiograph
Place the radiograph correctly on the viewing box.
Check.
Identification, name date, hospital, registration number.
Check anatomical marker/legend correct R/L and AP/PA.
Area under examination, limits of examination.
Correct protection. Patient position, MSP, RBL, etc. direction and centering of X-Ray beam.

Exposure, Contrast (Kv) Density (mAS)

Unsharpness, movement, photographic, geometric.

Collimation, suitability of film size.

Artifacts, patient and radiographic / processing.

Anatomy and pathology.

Need for repeats
Need for further projections. 
     Is the radiographic information sufficient to make the required diagnosis?

Departure of the Patient
Inform patient examination is completed.
Return any jewellery or artifacts removed.

Inform patient that any dietary preparations are finished and any side / after effects of any drugs or medication e.g. white stools after Barium examinations, blurred vision after muscle relaxants.