Sunday, February 24, 2008

Hands and Knees

I certed on my knee this past week and also re-certed on my AP cart, since I had to give that up in favor of keeping my finger cert (since I got them both on the same day and only one cert per day is allowed in my program).

I impressed myself with my knee images - I had been worrying about the tunnel and sunrise because the knee routine we practiced in school was AP, Oblique and Lateral. But mine came out pretty good! The only thing I don't like is the positioning used. For tunnels, every single tech uses the Beclere. In class, we learned that was one of the least desireable positions because of the OID. When using the DDR system, there isn't even a cassette to build up with towels or sponges. And for the sunrise everyone uses the inferosuperior position. I hate aiming the tube right at the patient. Even though I have the patient wear lead and I collimate down, it almost feels like pointing a loaded gun at someone. My positioning teacher is somewhat appalled and said there were so many other better ways to do the sunrise but when I brought that up at my site, I was told to get my license and then I could get the images however I wanted.

I've done hands before and they seem pretty straight forward, so I thought I was ready to cert on them this past week. I tried *5* times and messed up every single series. Mostly what I'm having trouble with is the oblique. I know I tend to overrotate any obliques and I really try to watch that. But I switched back and forth between over and under rotating, even with using sponges and wedges. And then I started getting frustrated and my fan laterals came out sloppy, too. By the end of the day, I swear, Bontrager himself could have come in, sat himself down and positioned his own hand and I probably still couldn't have gotten it then! I know I can do these - I just psyched myself out.

I can start comping on my chest category but I still need some certs to finish up the upper and lower extremity categories before I can start comping in those: hand, forearm, elbow, tib-fib and patella. This week's goals will be to conquer the hand and start the chest comping.

1 comment:

John Setzler said...

Sounds like you are making good progress! Under no circumstances should you ever, as a student, suggest altering protocols at your clinical site. It's usually just gonna get people who are in charge of you upset for lots of reasons. I'm in an ortho office at the moment, and they do some things out of the ordinary also, but they are done this way because the doctors want to see some specific things that show up better on one view than on another. Never rule that out. These positions all exist for a reason. If the "Beclere" position, for example, wasn't a valid method, it woudln't be taught. Just be careful with that stuff :)