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Observation Essay

During my clinical observations, I spent a total of 19 hours at the imaging center, emergency room, as well as the computed tomography departments. The facility practices state of the art digital radiography, which is a world away from my original clinical observations of the late eighties when film was used. I found, the advantages of using digital radiography include time efficiency through bypassing chemical processing and the ability to digitally transfer and enhance images.

Through the use of digital radiography, I was able to view every image as it was happening, which made my experience flow much more smoothly than the original observations of the late eighties. Even though many procedures were observed during my clinical observations, my time in the fluoroscopy department was truly intriguing. Initially, I would observe a lumbar puncture while in the fluoroscopy department. Before the patient entered, the radiographer ensured the room was sterilized and all instruments were accessible.

The patient was placed lying in the prone position on the examination table at which time the radiologist arrived and explained the procedure to the patient. A ruler was then placed on the patient’s spine to mark a guide point by the radiologist and an image was taken. The area of the spine was then sterilized, draped, as well as injected with anesthetic while patient stayed very still. Once the area was numb the radiologist carefully inserted a needle into the lumbar area of the back while images were being taken.

The live images were taken until the needle reached the spinal canal at which time five samples of cerebrospinal fluid were collected. The needle was removed slowly and a band aid placed. I would also observe a myelogram which was conducted the same way; however, this procedure would be completed in the CT department. Because of this, I would see everything as it happened with the lumbar puncture with the exception of contrast being injected into the spinal canal rather than cerebrospinal fluid being collected.

The difference with a myelogram also included the table angled with the patient’s head towards the floor for an image to be taken to ensure contrast was flowing correctly. Next, a few void cystograms were observed. These procedures once again began with radiographer explaining the procedure to the patient upon arrival. A nurse then inserted a catheter into the urethra. At this time the radiologist arrived, and the bladder was filled with an iodine solution until full.

The radiologist took continuous images to see bladder filling. The patient was then asked to void or empty their bladder on the table while images were continuously taken until bladder was empty. Following the void cystograms, an upper gastrointestinal (GI) series was observed. This consisted of the patient drinking a barium solution while standing, and images taken continuously. The patient was then asked to lie down on his side while images were taken, as well as turn to the prone position for more images to be taken.

Patient then moved to the supine position at which time the table was raised till patient was standing and more images were taken. The table was then lowered till patient was once again lying down and a final image was taken. My final observation with the fluoroscopy department was a barium enema. As with all procedures, the technician explained the procedure to patient upon his arrival. A preliminary image was then taken of the abdomen and sent to the radiologist.

The enema was then inserted into the patient’s rectum, and the patient was positioned on his side while air was added to fill a balloon which would hold the enema in place during the procedure. Upon the arrival of the radiologist, the patient was moved to a supine position and procedure was explained once again by the radiologist. Barium was then injected through the enema, with images being taken to view the path of the barium. The patient was moved many times with air being injected through the enema while images were taken.

After the radiologist departed, patient was then released to the restroom for a bowel movement and returned for a final x-ray. As mentioned earlier, many procedures were observed during my nineteen hour clinical observation. From the intravenous pyelogram observed in the computed tomography department, to the multiple chest x-rays viewed in the emergency department, as well as the multitude of fluoroscopy procedures, my excited towards the radiology program has only grown from this experience. With that said, I look forward to beginning my education to become a radiographer.


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