Podcast
Questions and Answers
What principle requires that the exposure of personnel to radiation should be kept as low as reasonably achievable?
What principle requires that the exposure of personnel to radiation should be kept as low as reasonably achievable?
Which of the following is NOT a challenge associated with field radiography?
Which of the following is NOT a challenge associated with field radiography?
What must be present before performing any procedures involving ionising radiation?
What must be present before performing any procedures involving ionising radiation?
What is the primary responsibility of employers regarding ionising radiation regulations?
What is the primary responsibility of employers regarding ionising radiation regulations?
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What is the significance of placing generators on a stand during field radiography?
What is the significance of placing generators on a stand during field radiography?
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In which situation should radiographic use be justified?
In which situation should radiographic use be justified?
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How many people are recommended to be involved in taking a radiograph of a horse's limb?
How many people are recommended to be involved in taking a radiograph of a horse's limb?
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What is a key responsibility of employees concerning radiation exposure?
What is a key responsibility of employees concerning radiation exposure?
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Which standard radiographic view is NOT typically used for the hock?
Which standard radiographic view is NOT typically used for the hock?
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What is one reason why neck and back radiographs are better taken in a clinic rather than the field?
What is one reason why neck and back radiographs are better taken in a clinic rather than the field?
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Which additional view may be used depending on pathology for the stifle?
Which additional view may be used depending on pathology for the stifle?
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What practice is emphasized for ensuring safety during field radiography?
What practice is emphasized for ensuring safety during field radiography?
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Which of the following is NOT mentioned as a recommended practice in field radiography?
Which of the following is NOT mentioned as a recommended practice in field radiography?
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What is the maximum allowable occupational radiation exposure for an employee over the age of 18 in one year?
What is the maximum allowable occupational radiation exposure for an employee over the age of 18 in one year?
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Which of the following is NOT a type of dosimeter mentioned?
Which of the following is NOT a type of dosimeter mentioned?
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What is the primary reason for using gloves and gowns during procedures in field radiography?
What is the primary reason for using gloves and gowns during procedures in field radiography?
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What sedation method is considered short acting for horses preparing for radiography?
What sedation method is considered short acting for horses preparing for radiography?
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Why is it important to clean the area thoroughly before radiographing a horse's hoof?
Why is it important to clean the area thoroughly before radiographing a horse's hoof?
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When adjusting the exposure settings, what should be increased if the tissue thickness is greater than what is typical?
When adjusting the exposure settings, what should be increased if the tissue thickness is greater than what is typical?
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What is a potential risk of using heavy sedation in horses during radiographic procedures?
What is a potential risk of using heavy sedation in horses during radiographic procedures?
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What is typically done to the hoof before taking a radiograph?
What is typically done to the hoof before taking a radiograph?
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What is the primary purpose of having three people involved in taking an equine radiograph in the field?
What is the primary purpose of having three people involved in taking an equine radiograph in the field?
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What is a crucial factor when selecting a site for taking radiographs?
What is a crucial factor when selecting a site for taking radiographs?
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What is the risk radius for scattering radiation near a horse during radiographic procedures?
What is the risk radius for scattering radiation near a horse during radiographic procedures?
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Which statement about protective clothing for personnel in the controlled area is incorrect?
Which statement about protective clothing for personnel in the controlled area is incorrect?
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How far does the controlled radiation area extend in the direction of the X-ray beam?
How far does the controlled radiation area extend in the direction of the X-ray beam?
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What should all personnel assisting with radiographic procedures have in common?
What should all personnel assisting with radiographic procedures have in common?
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Why is it recommended to avoid taking radiographs in a stable?
Why is it recommended to avoid taking radiographs in a stable?
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Which method can help reduce exposure risk during radiographic procedures?
Which method can help reduce exposure risk during radiographic procedures?
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What is the primary consideration when positioning a horse for radiography?
What is the primary consideration when positioning a horse for radiography?
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When processing images in a digital radiography (DR) system, what is essential to ensure?
When processing images in a digital radiography (DR) system, what is essential to ensure?
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Where should markers be placed during radiography?
Where should markers be placed during radiography?
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Which of the following conditions requires a referral due to higher exposure needs?
Which of the following conditions requires a referral due to higher exposure needs?
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What is the standard view for assessing the pedal bone in the foot?
What is the standard view for assessing the pedal bone in the foot?
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Which view is NOT part of the standard series for fetlock radiography?
Which view is NOT part of the standard series for fetlock radiography?
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What additional view might be taken for pathology in the carpus?
What additional view might be taken for pathology in the carpus?
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Which positioning format is required for the limb or joint during imaging?
Which positioning format is required for the limb or joint during imaging?
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Which series is standard for metacarpus/metatarsus radiography?
Which series is standard for metacarpus/metatarsus radiography?
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Study Notes
Field Radiography
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Learning Objectives:
- Apply safe radiation use in field settings.
- Understand the balance between safe ionising radiation use and equine handling safety.
- Optimise image quality for equine radiographs.
Ionising Radiations Regulations 2017
- Approved code of practice and guidance.
- Dose limits set.
- Estimate doses to members of the public.
- Outline duties of employees and employers for regulatory compliance.
Health and Safety Executive (HSE) 2021 Update
- All generators must be placed on a stand.
- Holding generators is unacceptable due to increased exposure risk and potential electric shock.
Radiation Safety - 3 Major Principles
- Clear clinical indications are required for any procedure involving ionising radiation.
- Avoid unnecessary X-ray safaris.
- Justify radiographic use with detailed clinical examination and diagnostic analgesia where applicable.
- Exposure of personnel must be kept as low as reasonably achievable (ALARA principle).
- Dose limits for individuals must not be exceeded.
Field Radiography Challenges
- Expensive equipment around large animals.
- Lack of permanent control zones; need to apply local regulations for ionising radiation.
- Variable facilities availability.
- Working with owners and untrained staff.
- Time constraints and pressures.
- Frightened horses make poor decisions.
Personnel
- Number of people required for equine limb radiographs.
Controlled Area
- Ideal locations for radiographs, avoiding stables where possible.
- Adequate space, level, dry ground.
- Power supply.
- Dark areas for clear visualisation of centering and collimation lights.
- Minimise traffic within the area.
Temporary Radiation Control Zone
- Biggest risk: 2m around the horse.
- Minimize personnel in the controlled zone.
- Maintain distance from the beam.
- Double the distance reduces exposure risk by 4x.
- The controlled radiation area for mobile X-ray is dependant on beam direction, distance attenuation and shielding.
Radiation Protection
- Personnel within the controlled area must wear appropriate protective clothing including lead-lined gowns, gloves, and thyroid protectors.
- Staff must also wear radiation dosimeters beneath protective clothing.
- Generator stands should be used.
- Cassette holders or plate blocks should be utilised.
- Personnel assisting should be over 18 years old and not pregnant.
- Obtain signed consent from clients assisting.
Personal Protective Equipment (PPE) considerations
- Avoid placing body parts behind the X-ray plate to avoid primary beam exposure.
- Be aware of scatter to protect all personnel.
- Gloves and gowns do not prevent primary beam exposure.
Personal Monitoring
- Specific dose limits for different classes of person.
- 20mSv/year for 18+ employees
- 6mSv for 16-18 year olds
- 1mSv for members of the public and others
- Electronic personal radiation dosimeters and film badge dosimeters.
Patient Preparation
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Horses must be adequately restrained with person controlling the head.
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Potential uses of stocks.
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Sedation options with considerations for appropriate level and potential adverse effects in field conditions for quality images:
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Light to moderate sedation using alpha-2 agonist (Xylazine, Detomidine, Romifidine). The effect on sedation differs between each drug.
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+/- Butorphanol for an additional moderate effect.
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Safety and better quality images.
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Sedation/movement considerations for proximal anatomy, duration of exposure.
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Ensure the horse is standing on a flat and even surface.
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Thoroughly clean the area with removal of mud and organic matter to avoid artefacts.
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Hoof preparation, potentially removing shoes where applicable and cleaning and preparing the hoof.
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Use Playdoh to remove air interface considerations.
Packing the Feet
- Method and considerations.
Exposure Factors
- Use exposure charts to reduce retake rate, specific to relevant equipment.
- Understand FFD (focus-to-film distance) for the generator.
- Increased tissue thickness requires more mAs
- Decreased tissue depth reducesmAs required accordingly.
- Considerations of kV (contrast) and mAs (opacity).
Positioning
- Considerations for the horse and area of interest.
- Limb and joint positioning.
- Location of X-ray generator and plate.
- Horse needs a firm, level standing with limbs squarely below.
- Foot blocks for foot series, positioning.
- Ensuring cable reaches both sides of horse.
Processing
- Selecting the correct body part in the DR (direct radiography) system.
- Algorithms; ensuring best quality is possible, cannot be changed after the fact.
- Marker placement dorsal or lateral to region being imaged, important for symmetrical areas such as foot and fetlock.
Spot the Difference
- Recognising areas/issues from images provided.
When to Refer
- Situations requiring higher exposures, (neck, back, chest).
- Limitations of portable generators (kV exposure range).
- Maintaining alignment between generator and plate in the field environment without a bucky. Need for grid in required conditions.
Anatomical Positioning Terminology
- Oblique views explanation.
Foot
- Standard radiographic series.
- Lateromedial
- Dorsopalmar/Dorsoplantar
- Dorsoproximal/Palmarodistal oblique.
- Additional views depending on pathology.
Fetlock
- Standard radiographic series.
- Additional views depending on pathology.
Metacarpus/Metatarsus
- Standard radiographic series.
Carpus
- Standard radiographic series.
- Additional views depending on pathology.
Hock
- Standard radiographic series.
Stifle
- Standard radiographic series.
- Consider additional views that may depend on pathology.
Others
- Radiographic areas that are best performed within a clinic.
- Heads /dental
- Neck
- Back
- Chest
- Abdomen
Take Home Messages
- Protecting the health and safety of all.
- Appropriate working practices.
- Appropriate restraint.
- Appropriate patient preparation.
- Good positioning
- Appropriate exposures.
- Collimation.
- Understanding of projections for each area.
- Understand limitations of field work.
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Description
This quiz explores the critical aspects of field radiography, including safe radiation practices, the Ionising Radiations Regulations 2017, and updates from the Health and Safety Executive. Participants will learn about balancing safe ionising radiation use with equine handling safety, image quality optimization, and the principles of radiation safety.
