Quality Assurance and Quality Control (QAQC) Midterm PDF

QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila ACCESSORY EQUIPMENT (MIDTERM) Cables....

QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila ACCESSORY EQUIPMENT (MIDTERM) Cables. Plugs. Topic Outline: Light bulb. Collimator Light/X-ray beam alignment. Cassettes and Intensifying Screens Grid Accuracy of scales test: Lead rubber apron, Gloves and Sheets Not everyone uses the aperture size scales Viewing box on the col-limator to set the aperture size, it being Patient positioning aids more common practice to use visual assessment of Patient measuring calipers the light field size. However if staff do practice this method, it is advisable to make sure that the scales COLLIMATOR are accurate. Visual inspection. Inaccuracy of scales may lead to inaccurate Accuracy of scales. collimation. Change a light bulb. Light beam/X-ray beam alignment and Frequency of test: centring. 6 monthly. Lead shutter efficiency. Equipment required: COLLIMATOR Collimator to be tested. The collimator, sometimes referred to as the 100cm rule. light beam diaphragm (LBD), provides the radiographer with an easy to use, accurate, method Method: of controlling the size of the X-ray field and placing Set 100cm focus to tabletop distance. it over the area of interest, thus reducing the Using the 100 cm FFD (SID) scale on the radiation dose to the patient and improving the collimator, set various aperture sizes with quality of the image. the light on and measure the resultant light The collimator receives much use and is areas at table top level. vulnerable to knocks, often resulting in inaccuracy Compare with settings on the collimator. of the light beam/X-ray beam coincidence, blown light bulbs, electrical and mechanical problems. Evaluation: Light area measured should be the same as Visual inspection: the setting on the collimator. Rotation. Stability. Action: Knobs for shutter control. If settings are not accurate and the solution Accuracy of shutter setting scales (if is not a simple one, call an X-ray engineer. present). File a report. Shutter chain drive. Shutters. Changing a light bulb: Housing. A light bulb can fail at any time without Window. warning. It is important then, to have the correct Light timer. spare bulb readily available. Timer switch. Shaina Baula | 14 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Staff should be capable of replacing a faulty Equipment required: bulb. DO NOT ATTEMPT THIS UNLESS YOU One 24 × 30cm loaded cassette. HAVE HAD ADEQUATE INSTRUCTION. If unsure, Alignment test tool. Commercially made test call an electrician. tools are available, but a simple alternative is to use eight coins or four paper clips (see Frequency: Fig 2-1, Fig 2-2). As necessary. Lead marker or ninth coin. Equipment required: Method: Suitable light bulb. Make sure that the table is level and the Cloth or tissue. central ray at 90° to the tabletop. Screwdriver. Place a loaded cassette on the tabletop face up. Method: Set a FFD (SID) of 100 cm. Switch off the power. Switch on the collimator light. Remove relevant collimator housing. Center to the middle of the cassette. Check that the spare is the correct type. Collimate to within the edge of the cassette, Before removing the old bulb, check to see leaving a 3cm border all round, that is if the replacement bulb must be fitted a outside the light field. specific way round. Place the coins in pairs, so that, where the Replace faulty bulb with the new one. coins touch, coincides with the edge of the If the bulb is of the quartz type, ensure that light area. it is not handled with bare fingers, as body All four borders of the light must be marked oil on the bulb will shorten its life. in this way. Replace housing and tighten screws. Place the lead marker within one corner of Test. the light field so that the film can be related Ensure that the spare bulb is replaced as to the light/X-ray field and hence the soon as possible. collimator shutters. Make an exposure sufficient to blacken the Light beam/X-ray beam alignment test: film. The purpose of the light in a collimator is to Process the film. allow more accurate collimation of the X-ray beam. The light must, therefore, coincide with the X-ray Alternative method instead of using coins: beam. The light beam relies on the accurate Use four paper clips, each bent to form right positioning of the light bulb and angled mirror inside angles. the collimator. Place paper clips at corners of the light field. Should either the mirror or light bulb be Note: Collimators are known to become less dislodged, then errors in collimation could occur, accurate as the field size is increased. To check resulting in areas of interest being excluded from this make two flash exposures on the same film, the field, or too large an area being irradiated. following the method described above, using different field sizes, remembering to reposition the Frequency of test: markers for the second exposure. 6 monthly. As necessary. Shaina Baula | 15 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Evaluation: Evaluation: For perfect alignment, the light field (where Study the film. If the shutters are efficient the coins touch) should coincide with the the film will not have been affected by X-ray field. radiation. The irradiated area must not be greater than the area covered by the light. Action: At 100cm FFD (SID) the irradiated area If the shutters are allowing radiation to pass, must not be more than 10 mm smaller than call an X-ray engineer. the area covered by the light. This represents a 1% tolerance. CASSETTE AND INTENSIFYING SCREENS Visual inspection. Action: Light tightness of cassette. If the alignment is unacceptable it must be Film/Screen contact. adjusted. Intensifying screen light color emission. Call an X-ray engineer. Care and cleaning. Note: Cones and diaphragms can also be checked using a similar method. CASSETTE AND INTENSIFYING SCREENS Cassettes are the light tight containers that Shutter efficiency test: hold the X-ray film between the intensifying Closing the shutters in the collimator fully screens. They are available in a range of sizes to should prevent any radiation from reaching the film. suit every need. Intensifying screens fluoresce Useful for testing radiation safety when discharging when struck by radiation, the light emitted capacitor discharge mobiles or making tube warm significantly contributing to the blackening effect on up exposures. the film. Cassettes are easily damaged and likely to wear, resulting in possible light leakage and poor Frequency of test: film screen contact. Intensifying screens deteriorate 6 monthly. over time and are easily damaged. Foreign material on their surface or damage will create marks on Equipment required: films. All cassettes should be clearly numbered on One loaded 24 x 30 cm cassette. the outside. A corresponding number is placed inside, on the edge of one of the screens, using an Method: indelible marker, where it will not affect the image, Place the cassette on the tabletop face up. but is visible on the radiograph. All cassettes Set a FFD (SID) of 100 cm. should be marked on the outside, identifying the Set an exposure of approximately 80 kV type of intensifying screens fitted. If different and 40 mAs. film/screen combinations are used in the Open one set of shutters fully, leaving the department, screen speed should be clearly other closed. indicated on the outside of the cassette. It is usual Make an exposure. for manufacturers to supply appropriate labels with Fully close the open shutters and open fully their screens. Both cassettes and screens should the closed ones. be inspected and cleaned regularly. Records must Make another exposure. be kept of all inspections, maintenance and Process the film. replacements. Shaina Baula | 16 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila CASSETTE INSPECTION: Evaluation: Black fogging around the edge of the film is Frequency of inspection (of cassettes): an indication of light leakage. Yearly. As necessary. Action: Repair or replace cassette. Equipment required (for cassettes): File report. Cassettes to be inspected. Note: Similar fogging can be caused by a lid being left off a box of film or the film hopper left open, Method (for cassettes): allowing white light exposure of the upper edge of Inspect: the films. Hinges. Catches. INTENSIFYING SCREENS Casing. Most cassettes are fitted with a pair of Cleanliness. intensifying screens and should be used with double emulsion film. Blue light emitting screens Evaluation (of cassettes): should be used with blue light sensitive film. Green Faulty parts, distortion and inadequate light emitting screens should be used with green cleanliness must be attended to. light sensitive film. Any damage, deterioration or foreign matter will be seen in resultant images. Action: Repair faults or replace cassette. INTENSIFYING SCREEN INSPECTIONS: Carry out film/screen contact tests. Clean with damp cloth and wipe dry. Frequency of inspection: Keep records of work carried out. Monthly. File report. Equipment required: LIGHT LEAKAGE TESTS: Screens to be inspected. Frequency of test: Method: Yearly. Inspect in bright light conditions. As necessary. Screens firmly fitted. Correct screens fitted (see label on back of Equipment required: cassette). Cassettes to be tested. Correct number on edge of screen (see number on back of cassette). Method: Condition of screen surface. Load cassette with new film. Place the cassette under bright light for Evaluation: approximately 15 to 30 minutes. Abrasions. Turn the cassette and repeat. Foreign material on the surface of the Process film. screen. Discolouration (an indicator of deterioration). Shaina Baula | 17 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Fitted correctly. Action: Correct screens. If dirt particles or smears remain, re clean. If, after repeated cleaning, dirt particles Action: remain, decide if they are likely to be a Loose screens should be re-fitted with problem. double-sided tape. If they are considered to be a problem, Surface damage or deterioration, which is replace the screens. unac-ceptable-replace screens. Clean if necessary. Film/screen contact test: File report. If an area of localized blurring is detected on a radiograph, poor film/screen contact INTENSIFYING SCREEN CLEANING: should be suspected. Frequency of cleaning: Frequency of test: Monthly. Yearly. As necessary. Equipment required: Soft brush. Equipment required: Puffer. Cassette to be tested. Lint-free cloth, such as gauze. Test tool (box of paper clips or sheet of Screen cleaner (available from perforated zinc or fine wire mesh, large manufacturer) or mild soap (not detergent). enough to cover a 35 × 43 cm film, with a square hole, about 10 cm from one edge, Method: approximately 2 to 2 cm square). in bright light conditions. Lead marker if cassettes do not have a lead Remove all loose dirt with a soft brush or blanked area for patient details. puffer. Fig 2-3. Film/screen contact test, using Apply screen cleaner sparingly, with a lint paper clips as a test tool free cloth, such as a gauze swab. Use circular motion over the whole surface. Method: Finish off with long strokes from top to Load the cassette to be tested and place it bottom. face up on the tabletop. Do not pour cleaner directly onto the Cover the whole of the cassette with the test screen. tool (if using paper clips, distribute evenly). Wipe with dry lint free cloth. Set a FFD (SID) of 150 cm (the longer FFD Stand the cassette open for 30 minutes to (SID) reduces geometric unsharpness). dry. Collimate to cover the whole cassette. Inspect. If appropriate, place the lead marker in the corner of the cassette face, in order to relate Evaluation: resultant radiograph to cassette. Have all dirt particles been removed? Make an exposure using about 50kV and 6 Are there any smears? mAs (film density of 1 to 2). Process the film. Shaina Baula | 18 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Evaluation: Set a FFD (SID) of 100 cm and collimate to If a densitometer is available the film density cover the open cassette. can be measured at the image created by Reduce room lighting to a minimum. the hole in the test tool. Make an exposure using a relatively high kv Inspect the image, looking for areas that and long time, e.g. 80KV and maximum look blurred. time possible. A noticeable area of unsharpness could be Observe the screens during the exposure. caused by: Remember to follow normal radiation safety ○ A damaged cassette. rules. ○ Screen packing, deterioration. ○ An air pocket. Evaluation: When using a close mesh wire test tool the Note the color of light given off by the poor film/screen contact areas may also screens. have a higher density. Note the intensity of the light given off by the screens. Action: Repair or replace cassette. Action: Replace packing. If the color sensitivity of the film is not the Re-test. same as the screen light emission color, you File a report. should change the type of film you use so that they are compatible. Film/screen compatibility—color of light If the light intensity comparison between emission test: pairs of screens is noticeably different, Different types of intensifying screens may check the labelling of your cassettes for emit different light colors and/or intensities. The screen type and/or carry out the intensifying color of light emitted by screens must be the same screen consistency test. as the color sensitivity of the film used with them. Re-label the outside of the cassette if Check with your film and screen suppliers if in necessary. doubt. If there is any doubt about the color compatibility of the light emitted by the screens, the Intensifying screens consistency test: following simple test can be used. The efficiency of screens tends to deteriorate over time. If you have screens of the Frequency of test: same type, but of differing ages, you cannot As necessary. assume that they will all give the same result. It is therefore necessary to check the efficiency of all Equipment required: screens periodically in order to achieve consistent Screens to be tested. results. Method: Frequency of test: Open the cassette. Yearly. Remove the film. As required. Place the open cassette, screen facing up, on the tabletop. Shaina Baula | 19 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila METHOD I this is unacceptable (densitometer readings of similar steps should be within 10% of Equipment required: each other). Step wedge Assess the density differences between the Loaded cassettes with screens to be tested strips. (all cassettes should be loaded from the same box of film). METHOD 2 Densitometer, if available. Equipment required: Method: Phantom (water filled flagon, or other Cut a sheet of film into strips large enough suitable, even density material, of at least to easily cover the step wedge. 30 x 30 cm area. (See Appendix A, page Load each cassette to be tested with one 133). strip of film, placed centrally. Loaded cassettes with screens to be tested Place the first cassette on the tabletop, face (all cassettes must be loaded from the same up. box of film). Place the step wedge in the center of the Densitometer, if available. cassette so that it is directly over the film strip inside. Method: Set a 100 cm FFD (SID) and collimate to Place four of the cassettes together, face up cover the step wedge. on the tabletop, so that one corner of each Set an exposure that will give a full range of cassette meets the others and the densities on the step wedge image (you appropriate edges are in contact. may need to do test exposures first). Set a FFD (SID) of 100 cm. Expose. Center to the touching corners of the Process the film. cassettes. Repeat the procedure for all the other Place the phantom to partially cover all four cassettes being tested, using exactly the cassettes. same conditions. Collimate to within the phantom so that a Label the film strips with date and cassette portion of each cassette will be irradiated. number. Set an exposure that will produce a For accuracy of this test, the X-ray output measurable density on the film and expose. and processing must be consistent All screens to be assessed should be tested throughout. in this way, keeping one of the cassettes unchanged throughout. Remember to Evaluation: reload the control cassette each time. Place the test strips side by side on the Identify all films using the cassette numbers. same viewing box. Process the films as soon as possible using Compare the densities (a densitometer will the same processor. give a more accurate result). Assess the density differences between the Evaluation: strips. Compare the densities produced on each If the film strip images, using screens of radiograph (a densitometer will give a more similar types, are seen to vary noticeably, accurate result). Shaina Baula | 20 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Densitometer readings should be within The grid and cassette size must be 10% of each other. the same. The grid ratio is usually 6:1 or 8:1. Action: Cassettes are available with a built If significant differences are seen you may in, or added, grid. wish to re-screen all cassettes tested. 2. Moving If this is impractical, work out the exposure A grid used in a potter bucky differences to achieve similar results and system, which moves from side to label each cassette accordingly. side during the X-ray exposure, in When equipping a department with all new order to defuse the images of the screens it is advisable to carry out this test lead strips. as a basis for future comparison. The grid ratio is usually 10:1 or 12:1. The grid ratio should be 16: 1 if used GRID for high kV work. Grid types, ratio and line. 3. Parallel line Care and cleaning. Lead strips run parallel to one Visual inspection. another in one direction only. Grid line damage. There are two types of parallel line grid, focused and non-focused. GRID Moving and stationary grids are all The purpose of the grid is to reduce the parallel construction. amount of scattered radiation reaching the film. This greatly improves the quality of the image. Although the quality of the image is improved, it does mean a significant increase in exposure, and therefore dose to the patient. A grid looks like a simple thin sheet of soft 4. Cross-hatch metal, but it is in fact a precision made piece of Two sets of lead strips equipment and easily damaged. It is made up of a superimposed and running at 90° to large number of fine lead strips interspaced one another. between radiolucent strips. If the lead strips Generally a stationary grid, used become distorted the grid will be less efficient and only for relatively high kV work and irregular densities will be created on the film. when no tube angulation is If the grid is used wrongly, abnormal necessary. densities (grid cut off) will be produced. e.g. a This design is used only in stationary focussed grid used upside down will create a grids. reduction in density the further the area is from the center line. Grid types: 1. Stationary 5. Non-Focused A loose grid which can be placed A parallel line grid. directly over the face of the cassette. Relationship of lead strips uniform to one another throughout. Shaina Baula | 21 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila cen-tre of the grid on the tube side. Crosshatch grids have a second line running at 90° to the first. 5. Tube side The tube side is shown by a label 6. Focused stating TUBE SIDE, or an X-ray tube A parallel line grid. symbol. The lead strip's direction line Differs from the non focused grid also indicates the tube side. only in that the lead strips progressively incline more inward, Care of the grid: the further they are from the center Stationary grids should have an added, line, so that they are focused to a rigid, PVC protective cover. predetermined point above the grid. When a protective cover is added the grid specifications must be recorded on the new Structure: cover for future reference. Thin lead strips interspaced between Do not bend, drop or dent the grid. equally thin strips of radiolucent material. Clean regularly. Covered top and bottom with a thin Store in a safe place. aluminum sheet. Use of a stationary grid: Use a grid that is the same size as the cassette. Place the grid against the face of cassette with nothing between it and the cassette face. Specifications: Check that the tube side of the grid is The detail of the grid structure should be toward the tube. marked on the surface of the grid either by a Use strips of adhesive tape to hold the grid label or imprinted into the metal. in place. 1. Grid ratio Use the recommended focus film distance The ratio of the height of the lead (source image distance) for that grid. strips to the distance between them. The X-ray beam must not be angled across 2. Grid line grid lines. The number of lead strips in a grid. When using a grid cassette, only the last Stated as the number of lead strips two points are relevant. to the centimeter (or to the inch). 3. Focal range GRID LINE DAMAGE TESTS: Grids are designed to be used within given focus film distances (source Frequency of test: image distances) dependent on the 6 monthly. way the lead strips have been As necessary. focused. 4. Grid line direction Equipment required: The direction in which the grid lines Grid to be tested. travel is indicated by a line down the Shaina Baula | 22 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila One loaded cassette, same size as grid. LEAD RUBBER APRON, GLOVES AND SHEETS One lead marker. Lead readily absorbs radiation and is used in many forms and thicknesses in the field of METHOD radiation protection. e.g. lead sheet, lead acrylic. Lead rubber has the advantage of being flexible Visual inspection: and can therefore be made into items which can be Dents, bends, creases, damaged corners. worn e.g. aprons and gloves. Lead rubber tends to Specifications marked deteriorate over a period of time, with regular use Cleanliness. and mis-handling. Regular care, cleaning and testing are important X-ray: Place the cassette on the table top, face up. Other lead rubber items: Place grid to cover cassette, tube side up. Gonad shields. Set a FFD (SID) in the middle of the known Thyroid shields. focal range of the test grid or 100 cm. Small sheets of differing sizes. Center to the middle of the grid. Shielding on screening units. Central ray at 90° to cassette/grid. Collimate to cover cassette/grid. Care: Set an exposure of 50 kV 10 mAs (you may Weekly cleaning or as necessary. Clean need to experiment prior to the test). with soap and water. Expose. Never fold any item of lead rubber. Process film. Aprons should be hung up using strong, specially designed hangers. Evaluation: Store gloves flat or upright on a custom Is the grid line pattern regular? made holder. Is overall density even? Do not store near a heat source. Action: The lead equivalent (effectiveness) of all If the grid line pattern or density is forms of lead rubber should be known. Aprons for unacceptable repeat the test using FFDs instance are designed only to protect against (SIDs) of 10 cm either side of that used in scatter. They have a lead equivalent of between the first test. 0.25 mm and 0.5 mm. Lead sheet may have a lead If the images are still unacceptable, replace equivalent of 2.0 mm or 3.0 mm. the grid. File a report. VISUAL INSPECTION TEST: Note: This test can also be used to check the focal range. Frequency of test: 6 monthly. LEAD RUBBER APRON, GLOVES AND SHEETS As necessary. Visual inspection. Cracking. Equipment required: X-ray testing. Items to be tested. Care and cleaning. Storage. Shaina Baula | 23 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Method: Use a screening system to examine the Check effectiveness and condition of whole article. fastenings on aprons (if any). Use different kVs. Inspect surface covering for tears or signs If a general purpose X-ray unit is to be of deterioration. used, place cassettes under test articles Inspect all seams where appropriate. and make separate exposures. Ensure that Check flexibility, feeling for cracks not seen the whole article is examined. on the surface. Inspect for cleanliness. Evaluation: Check apron hanger devices. Look for cracks or other abnormal variations Assess storage location. of density in the image. Evaluation: Action: General condition and cleanliness. Items found to be defective should be Possibility of cracks. replaced. Storage location and hanging devices. Items being withdrawn can be cut up into Are staff using the apron hangers? smaller pieces, avoiding the cracked sections. These can be used for gonad Action: shielding or shielding parts of the film. Initiate any repairs or cleaning required. File a report. Carry out X-ray check. Relocate storage location if unsuitable. VIEWING BOX Re-design hangers if unsuitable. Electrical inspection. Re-educate staff if they are not Efficiency/consistency. hanging/storing items correctly. Location. Replace if necessary. Cleaning. File a report. VIEWING BOX TEST TO DETECT CRACKING OF A viewing box, or light box, is a simple but APRONS AND GLOVES: important aid to viewing radiographs and is commonly used throughout X-ray departments. It Frequency of test: consists of an even light source of sufficient light Yearly. intensity to allow optimum viewing. As necessary. Viewing a radiograph under good viewing conditions is important in order to visualize the Equipment required: maximum amount of information. Regular Screening X-ray unit (if a screening unit is maintenance and cleaning should be carried out. not available, use a general purpose unit and 35 cm x 43 cm cassettes). All viewing boxes should: Items to be tested. Be conveniently placed. Be safely fixed to a wall or stable mobile Method: structure. Spread article to be tested on the tabletop. Be in good working order. Be of satisfactory design. Shaina Baula | 24 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Have an all over even light. Action: Be clean inside and out. Wipe over with a cloth. Be electrically safe. Use spirit to clean the window of Have an adequate light output. hard-to-remove marks. Design: Electrical check: Two parallel fluorescent tubes of equal light This check should be carried out by or out-put, with starters. under the supervision of an electrician. A built in, or attached, spotlight is an Switches, fluorescent tubes, starters and advantage. electrical connections should be checked. The film anchor should hold the film firmly. A good quality switch. Frequency of check: Safe electrical wiring. 6 monthly. Cleaning: Equipment required: Dust on the window or tube will reduce the Viewing box to be checked. light out-put. Marks on the window can be Screw driver. misleading. Method: Frequency of cleaning: Remove plug from socket. Outside daily. Remove the front window. Inside 6 monthly. Check the condition of the wiring. Check electrical connections. Equipment required: Check the stability of the switch. Viewing box to be cleaned. Check installation of fluorescent tubes and Clean cloth. starters. Screw driver. Replace front window. Replace plug in socket. Method: Test. Remove plug from power socket. Remove the front window. Evaluation: Clean window on both sides (intensifying Electrical connections firm? screen cleaner is a useful cleaning agent as Electrical wiring in good condition? it has anti static properties). Tubes and starters located properly and Clean the back plate and fluorescent tubes. working? Inspect window for damage. Light source even and comparable to other Make sure that tubes and starters are firmly viewing boxes? in place. Replacing fluorescent tubes at different time Replace the window. in-tervals, or with a different type of tube, Test. may produce a difference in light intensity from one side of the screen to the other or Evaluation: one viewing box to another. Any dust on the inside or outside? Any marks on the viewing window? Shaina Baula | 25 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila Action: Routine care: Tighten electrical connections. Care of positioning pads should be ongoing. Refit fluorescent tubes or starters. Try to minimize the risk of contamination by: Replace tubes or starters if necessary. ○ Contrast media If, after replacing only one tube, it is found ○ Plaster of Paris to be brighter than the remaining one, ○ Blood replace both. The working tube that has ○ Urine been removed can be matched with another Inspect and wash regularly. one at a later date. Do not use it for any other purpose. Replace any faulty parts. It may be preferable to cover with File a report. waterproof radiolucent material, or removable cotton covers or both. Viewing conditions: Room light levels in the film viewing area Positioning pad tests: should not be too high. Visual A bright spotlight should be available for X-ray viewing dark areas of the film. The viewing box should be mounted at the VISUAL TEST correct height for easy viewing. Light source should be even and the same Frequency of test: as other boxes. Weekly. As necessary. PATIENT POSITIONING AIDS Visual inspection. Equipment required: Radiolucency. Pads to be inspected. Condition. Cleaning. Inspect for: Likelihood of contamination. PATIENT POSITIONING AIDS General cleanliness. Positioning pads Shape. ○ A useful aid to maintaining the Smell. position of the patient. Particles breaking off. ○ A range of pad sizes and shapes Firmness. should be available in each X-ray room. They must be radiolucent. Evaluation: ○ Sets of firm foam pads are available Unhygienic? from manufacturers (a polyethylene Likelihood of contamination by radio opaque foam is commonly used). Pads may substances? be improvised using other materials Shape, firmness, general deterioration? but they must be checked for radiolucency. Action: ○ Fig 2-10. Positioning aids-selection Wash and re-test if necessary. of foam pads, sand bag & polystyrene block Shaina Baula | 26 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila If there is a likelihood of contamination with Continued use of the pad may be a ra-diopaque substance then carry out the considered, provided it is identified as X-ray test. containing radiopaque material and not If the pad has deteriorated to the extent that used where it might show on the films. it no longer fulfills its function effectively File a report. then replace it. File a report. Other positioning aids: A range of materials can be used to assist X-RAY TEST in positioning the patient in specific positions, some radiolucent and some not. Frequency of test: Care should always be taken to ensure that 6 monthly. radiopaque positioning aids do not obscure the As necessary. image. Sandbags Equipment required: ○ These are radiopaque. They should X-ray unit. have waterproof or removable cotton Pads to be tested. or linen covers that must be washed Loaded cassettes as necessary. regularly. Lead marker. Flour bags ○ Similar to sandbags but are Method: radiolucent. They mold to different Place a loaded cassette on the tabletop shapes more readily, but are not as face up. heavy as sandbags. Place the pad on the cassette (ensure that Compression band the cassette is big enough to cover the ○ If the band is linen, detach from the whole pad). end fixing mechanisms and wash as Set a FFD (SID) of 100 cm. necessary. Collimate to cover the pad. ○ If the band is plastic, simply wipe Place the marker in one corner of the X-ray over with a damp cloth. The ratchet field (note which corner of the pad it relates and fixing mechanisms should be to). inspected and tested six monthly or Set an exposure of 50 kV and 6 mAs. as necessary. The band should also Expose. be tested every six months, or as Process the film. necessary, for radio-paque substance contamination. Evaluation: Water Bottle Look for radio opaque shadows within the ○ Empty fixer or developer bottles full pad. of water are useful as cassette supports, or in weight bearing views Action: of a/c joints. Water is relatively If radiopaque shadows are detected, wash radiopaque. Little care is required, and dry the pad. simply wipe over the outside of the Re-test. bottle with a damp cloth as If opacities are still seen, replace the pad. necessary. Ensure that the lid is on Shaina Baula | 27 QUALITY ASSURANCE AND QUALITY CONTROL Name of Professor: Dr. Emerlinda Reyes | 3rd year, 1st semester | BSRadTech 3-1 A.Y. 2024-2025 | EAC-Manila tightly and that the bottle does not Method: leak. Check that the moveable arm is not loose. Polystyrene blocks used to pack equipment Measure the distance between the outer can be cut to required shapes. ends of the two arms at minimal, mid and Polystyrene chips used in packing can be maximum distances. sealed into suitable sized cotton or linen Repeat these measurements at the base of bags. the arms. Cardboard boxes can be cut down to Check against scale. suitable sizes and shapes and re-stuck. Wooden blocks can be cut to shape. Evaluation: Folded blankets can also be useful. The measurements should be accurate to Note: It should be remembered that any improvised within + or -2 mm. positioning aid must be checked as to its radiolucency before use. Action: If the measurements are not accurate, PATIENT MEASURING CALIPERS carefully bend the arm. Accuracy. If the arm is loose, attempt to tighten it. If Damage. unable to correct faults, arrange to have it repaired or replaced. PATIENT MEASURING CALIPERS File a report. Measuring calipers are a simple device that allow easy and accurate measurement of a body part. Calculating radiographic exposure factors can be made more accurate by relating them to the thickness of the body part. In order to do this, it is more convenient to use measuring calipers. Care: Handle with care as they are easily bent or broken. Any distortion may mean that they are no longer accurate. Store in a safe but convenient place. Clean regularly. CALLIPERS ACCURACY TEST Frequency of test: Monthly. As necessary. Equipment required: Calipers to be tested. Measuring device. Shaina Baula | 28