Patient Care Test 1 PDF

Topic 1: 1. Overview of Diagnostic Imaging Technology Medical Imaging (Diagnostic Imaging): Hands-on profession using specialized equipment and radiation to visualize internal structures of the body. Modalities of Diagnostic Imaging: Radiography & Radioscopy, Bone Densitometry...

Topic 1: 1. Overview of Diagnostic Imaging Technology Medical Imaging (Diagnostic Imaging): Hands-on profession using specialized equipment and radiation to visualize internal structures of the body. Modalities of Diagnostic Imaging: Radiography & Radioscopy, Bone Densitometry, CT (Computed Tomography), Angiography: Use x-ray radiation. Magnetic Resonance Imaging (MRI): Uses radio waves and a strong magnetic field. Ultrasound: Uses sound waves (primarily for vessel localization in Diagnostic Imaging). 2. The Role of the Diagnostic Imaging Technologist Primary Responsibilities: Create diagnostic images based on physicians' orders. Understand and apply principles of anatomy, physiology, pathology, and medical terminology. Ensure radiation protection for patients and self by applying ALARA (As Low As Reasonably Achievable) principles. Administer medications and perform procedures like venipuncture under medical supervision. Ensure patient safety and comfort, addressing their physical and emotional needs. Provide quality assurance for imaging procedures, including equipment maintenance. Critical Skills: Communication: ○ Serve as the liaison between patients and medical teams. Ethical Judgment: ○ Use critical thinking and professional integrity in patient care. Continual Learning: ○ Engage in ongoing education to improve patient care and technological competence. 3. Scope of Practice for Technologists Patient Care: Ensure patient needs are met before, during, and after procedures. Prepare patients physically and mentally for diagnostic procedures, ensuring consent and patient comfort. Document procedures and patient interactions in medical systems (HIS & RIS). Radiation Safety: Follow ALARA principles to minimize exposure during procedures. Use protective devices and optimize exposure settings. Emergency Response: Be prepared to identify and respond to emergency situations in a clinical setting. 4. Legal and Ethical Obligations Professional Membership: Technologists must be registered and provide proof of license annually. Code of Ethics: The OTIMROEPMQ code emphasizes ethical conduct, patient safety, confidentiality, and continuous professional development. ○ Mandate of the OTIMROEPMQ is to protect the public 5. Characteristics of a Technologist Problem-Solving & Critical Thinking: Technologists face unique challenges that require independent judgment, often involving patient-specific considerations. Personal Traits: Empathy, calm demeanour, technical proficiency, and effective communication are crucial. 6. Critical Thinking Skills Problem-Solving: Interpret patient behavior to assess cooperation and take appropriate actions. Evaluate and adapt procedures based on the patient’s physical and emotional needs.  Explain procedures clearly** to ensure patient understanding and cooperation. Reflect on outcomes and improve future practices. Judgment & Flexibility: Decisions are influenced by professional ethics, safety protocols, and patient conditions. 7. The Radiologist vs. Technologist Radiologist: A medical doctor who interprets imaging results and diagnoses. Technologist (MIT): Conducts imaging procedures but does not interpret the images. Works closely with radiologists and follows their orders. 8. Types of Patients Age groups: Pediatric: ○ Neonates: 0 to 4 weeks ○ Infants: 1 to 12 months ○ Toddles: 1 to 3 years ○ Preschooler: 3 to 6 years ○ School children: 6 to 12 years Adolescents: ○ Adolescents: 12 to 19 years Adult: ○ Young adults: 19 to 25 years ○ Adults: 25 to 45 years ○ Middle age: 45 to 65 years Geriatric: ○ Mature: 65 years and older Pediatric Patients: Communication adapted for age, understanding, and physical capabilities. Techniques include the use of immobilization devices and a child-friendly demeanour. Adolescent Patients: Sensitive to body image concerns; technologists should ensure privacy and treat adolescents with respect as they value independence. Adult Patients: Communication focuses on addressing concerns about health while maintaining responsibilities. Adult patients often appreciate clear, respectful communication. Geriatric Patients: Require more time for movements and positioning, and may have multiple health conditions. Patient handling should be gentle, and technologists should ensure comfort and clarity in communication. 9. Special Patient Populations Inpatients: Admitted to the hospital and often stressed or confused. Technologists must build trust. Outpatients: Often expect quick service. Must be treated with the same care as inpatients. Emergency Patients: May display anxiety or confusion due to pain and stress. Technologists must work efficiently while maintaining communication and observing vital signs. Patients with Disabilities: Technologists must adapt to the patient’s needs, using alternative communication methods (e.g., touch, pantomime for hearing impaired). 10. Communication and Emotional Intelligence Effective Communication: Understanding and managing patient emotions is key to providing patient-centered care. Emotional Intelligence (EI) involves recognizing and handling one’s emotions and patient interactions empathetically. Nonverbal Communication: Includes tone, body language, and proximity, which can greatly affect patient cooperation. 11. Ethical Considerations and Confidentiality Confidentiality: Health information must remain private unless explicitly required to be shared within legal or professional guidelines. Patient Rights: Patients have the right to respectful, considerate care without discrimination. 12. Patient Comfort and Hospital Environment Patient Comfort: Technologists should ensure patients feel physically comfortable and emotionally supported, using pillows, padding, and sponges. Environmental Conditions: Optimal temperature: 18.3°C to 20°C (65°F to 68°F). Humidity: 40-60%. Proper ventilation and lighting to ensure patient comfort and avoid fatigue. 13. Importance of Courtesy and Respect Respect: Every patient must be treated with respect, regardless of their background. A polite, considerate approach fosters cooperation and trust during medical procedures. Topic 2: 1. Microorganisms and Pathogens: Microorganisms (microbes) are small living organisms, some beneficial and others pathogenic. Microbial flora are microorganisms that live inside or on the body and do not cause infections or diseases. Pathogens are microbes that cause infections, leading to diseases if the infection impacts the body's vital functions. 2. Cycle of Infection: Infectious organisms or pathogens ○ Bacteria, viruses, fungi, protozoa Reservoir ○ Humans, animals, plants, water, food, soil Portal of exit ○ Any route where blood, body fluids, excretions; feces and urine or secretions; saliva, tears, mucous Mode of transmission ○ Direct contact, indirect contact, airborne, vectors, vehicles Portal of Entry ○ Open wounds, respiratory/GI/GU tracts. Host ○ A susceptible individual with weakened immunity Breaking the cycle: Infection can be prevented by disrupting any of these links. 3. Modes of Transmission: Direct contact: ○ Skin-to-skin or through bodily fluids. Indirect contact: ○ Touching contaminated objects (fomites). Airborne: ○ Small particles that remain suspended in the air.  Vector-borne: ○ Carried by insects or animals (e.g., mosquitos). 4. Asepsis Techniques: Medical Asepsis: Reduces the spread of microorganisms (hand hygiene, surface disinfection). Does not eliminate microbes completely but decreases the probability of infection Surgical Asepsis: Complete destruction of all microbes The absolute killing of all life forms is termed sterilization Handwashing: The most effective method for preventing infection. Soaps are effective at removing some fragile bacteria, such as pneumococci and meningococci PPE (Personal Protective Equipment): Used to prevent direct exposure to infectious materials (gloves, gowns, masks). 5. Hand Hygiene: Handwashing steps: Scrub for at least 20 seconds, ensuring to clean all surfaces. Hand sanitizers: Must contain at least 70% alcohol but are less effective when hands are visibly dirty. 6. Nosocomial Infections (Hospital-acquired infections): Common in healthcare settings due to compromised immune systems. Prevention: Proper aseptic techniques, cleaning, and use of PPE. 7. Types of Microorganisms: Bacteria: ○ One-celled microorganisms that consist of a single prokaryotic cell (no nucleus) without organelles (mitochondria and chloroplasts) or true nucleus ○ Can live in aerobic or anaerobic environments. Some bacteria produce spores, which are harder to destroy. ○ Contain BOTH DNA & RNA ○ A person may be more prone to bacterial infections when the immune system is compromised by a virus The disease state caused by a virus enables normally harmless bacteria to become pathogenic ○ Antibiotics are used to treat bacterial infections Shapes of Bacteria: Spherical (cocci) ○ Streptococcus Occurs in chains sore throat, diarrhea ○ Diplococcus Occurs in Pairs (two joined cells) Pneumococcal pneumonia ○ Staphylococcus irregular clusters (grapelike bunch) Ie: skin infections; pneumonia ○ Gaffkya occurs in groups of 4 Can cause meningitis, endocarditis etc Cylindrical (bacilli) ○ rods shaped Helicoidol (spirillum) ○ corkscrew-like Viruses: ○ Small pathogens that require a host to reproduce. They can remain dormant and reactivate later (e.g., herpes).  ○ Viruses contain either deoxyribonucleic acid (DNA) or ribonucleic acid (RNA) but never both DNA and RNA are the two types of nucleic acids found in cells Nucleic acids are the biological molecules that code for genetic information and proteins ○ Antibiotics are ineffective as a treatment because they do not kill viruses ○ Antiviral medications can sometimes be used, depending on the virus ○ Common diseases: measles, mumps, influenza, hepatitis, AIDS ○ Cause Theories: increased stress, excessive use of drugs, poor nutrition ○ Some viruses can travel into the nervous system and emerge at the nerve ending, causing symptoms. ○ Common viral illnesses in humans include the common cold (caused by the rhinovirus), and warts (caused by the papillomavirus). Fungi: ○ Microbes that contain a nucleus and organelles, protected by a membrane and a thick cell wall ○ Aerobic organisms that thrive in moist environments. Some can cause infections ○ Anti-infective drugs are not effective ○ Yeasts one-celled animals that reproduce by budding (asexual)—(outgrowth and separation) some yeasts can be harmful and cause infectious diseases, for example: thrush also called Candida Albicans. & hard to kill Some yeasts are useful in the production of beer, wine and bread ○ Molds Form multicellular colonies and produce spores (cells) They live almost anywhere indoors and outdoors thrive on moisture and are usually harmless in small amounts Parasites: ○ Parasites are microorganisms that live in or on a host and feed from the host Three main types of parasites that can cause disease in humans: ○ Protozoa  complex one-celled micro-organisms that can live and multiply in the body and able to move from place to place by pseudopod (false “feet”) formation, by the action of flagella, or by cilia (hair like projections) Diseases caused by protozoa affect the gastro-intestinal (GI) tract, the genitourinary (GU) tract, and the circulatory system ○ Helminths larger, multi-celled organisms known as parasitic worms can live for long periods of time in the human G.I. tract. Examples: enterobiasis (pinworm infection) Commonly found in children which is spread by swallowing or inhaling the tiny eggs of the pinworm ○ Ectoparasites multi-celled organisms that live on or feed off your skin, including some insects, such as ticks, bed bugs and mosquitos 8. Sterilization and Disinfection: Sterilization: ○ Complete destruction of all microorganisms. Disinfection: ○ Use of chemicals to kill or reduce the number of harmful organisms on surfaces. Topic 3: 1. The Infection Process Six Stages of Infection: 1. Encounter: ○ The host's first contact with the microbe. 2. Entry: ○ Microbes may be eliminated or enter the body, possibly leading to disease. 3. Spread: ○ Microbes spread within the host, which must overcome immune defenses. 4. Multiplication: ○ Microbes multiply to exert an effect.  5. Damage: ○ Direct: Destruction of host cells or toxin release. ○ Indirect: Weakening the host’s immune or inflammatory response. 6. Outcome: Three possibilities: ○ Host eliminates the microbe. ○ Microbe overcomes the host and causes disease. ○ Microbe and host coexist without harm. Stages of Infection: Latent Stage (chronic): ○ The period between exposure and infection without clinical symptoms or signs of infection in the host Incubation Stage (acute): ○ The period between exposure and onset of clinical symptoms. The disease process begins as the microorganism reproduces/begins to multiply. Prodromal Stage: ○ pathogenic microorganism continues multiplying, and the host begins to experience visible signs and general symptoms of the disease, due to the activation of the immune response, (fever, pain, soreness, swelling, or inflammation) ○ Highly contagious. Actual/Full Disease Stage: ○ Most communicable; signs and symptoms of disease are most visible ○ Most contagious, (specific symptoms of the disease). Convalescence Stage: ○ Symptoms diminish and eventually disappear. Some diseases go into a latent stage and reoccur from time to time. (TB, Herpes) 2. Body's Defense Mechanisms Non-Specific Defenses (Natural Resistance): Skin, hair, mucous membranes, acidic body linings, urine flow, and enzymes (e.g., lysozyme in tears). Specific Defenses (Immune System):  White blood cells (WBC): ○ Lymphocytes, neutrophils, and monocytes help destroy invading pathogens. Vaccines: ○ Treatment against a disease ○ Develop immunity by mimicking infections. Interferon: ○ A natural substance produced by the body to increase, direct and restore body's immune system ○ Natural proteins that block viral replication and trigger immune cells to fight invaders. Antigens ○ Foreign substances—toxins invade the body & induce it to produce ANTIBODIES (e.g., Immunoglobulins; proteins used by the immune system to neutralize pathogens) for immunity to further fight infection Gamma Globulin or Immunoglobulin ○ A class of blood plasma proteins including antibodies that help fight infections and disease 3. Risk Factors for Infection Stress: Weakens the immune system. Medical Devices: Increased risk with catheters, IV lines. Age: Newborns and elderly are more vulnerable. Pre-existing Conditions: Illnesses like cancer or lack of immunization increase infection risk. 4. Nosocomial (Hospital-Acquired) Infections Common Sites: Urinary tract infections (UTIs) from catheters. Wound infections after surgery. Respiratory tract from respiratory therapy equipment. IV catheters and venous access points. Prevention: Continuous infection surveillance. Written guidelines and strict aseptic techniques.  Hand hygiene: The best prevention measure. Ultrasound transducers: Require strict infection control. 5. Methicillin-Resistant Staphylococcus Aureus (MRSA) Nosocomial bacterial infection with resistance to several types of antibiotics Typically attacks elderly or critically ill patients (immunosuppressed patients) Transmission: ○ Via contaminated hands of healthcare workers (HCW) or surfaces. Signs & Symptoms: ○ Fever, and headaches, UTIs, pneumonia and even death Prevention: ○ Handwashing, isolation of infected patients. Treatment: ○ Vancomycin (antibiotic). 6. Vancomycin-Resistant Enterococcus (VRE) Bacteria that lives in the digestive system & urinary tract Patients with weakened immune systems are more susceptible to contracting it It may be present in the stool for weeks to months Transmission: ○ Contact with contaminated surfaces/equipment or HCWs. Signs & Symptoms: ○ UTIs, fever, back pain. Prevention: ○ Handwashing, and strict disinfection of equipment. Treatment: ○ Amoxicillin (antibiotics). 7. Clostridium Difficile (C. diff) Is a bacterium associated with diarrhea and intestinal inflammation among elderly patients who are more at risk in the hospitals Transmission: ○ Via fecal matter, commonly from individuals with diarrhea. Signs & Symptoms ○ Watery diarrhea, fever, nausea, and abdominal pain.  Prevention: ○ Handwashing, isolation, and disinfection. ○ HCWs and visitors are required to wear a gown, mask and gloves to prevent transmission Treatment: ○ Vancomycin (antibiotics). 8. Hemagglutinin Type 1 & Neuraminidase Type 1 (H1N1) A subtype of influenza A virus Children under 5, pregnant women and elderly people over 65 are more at risk All respiratory secretions and bodily fluids are potentially infectious The incubation period: ○ 1 to 4 days Transmission: ○ Contact from hands of infected person or fomite ○ Droplet exposure from the nose, mouth and respiratory secretions (cough & sneeze) Signs & Symptoms: ○ fever, sore throat, runny nose, headache, chills, fatigue, diarrhea, nausea and vomiting Prevention: ○ Isolation precautions for an infected patient ○ HCWs are required to wear an N95 mask, gloves and gown when in contact with infected patients Treatment: ○ Vaccine 9. Blood-Borne Pathogens, Acute Viral Hepatitis Hepatitis A (HAV): Infectious and inflammatory liver disease that has in the past been called infectious or epidemic hepatitis; affects liver function The infected individual can spread the virus 2 weeks before any symptoms begins to 2 Weeks after the symptoms end. (WHO states 14 to 28 days) Incubation period: ○ 15 to 50 days (from initial contact to onset of disease)  Transmission: ○ Fecal-oral route, sexual contact, contaminated food, or water. ○ It does not spread through sneezing or coughing Symptoms: ○ Fatigue, headaches, anorexia/loss of appetite, fever, nausea and vomiting as well as jaundice (skin /white of the eye appear yellow), and dark urine. ○ Appear 2 - 6 weeks after being exposed Prevention: ○ Vaccination; HAVRIX, VAQTA, TWINRIX, TWINRIX Junior and good hygiene. Hepatitis B (HBV): Inflammation of the liver is potentially life-threatening Incubation period: ○ 30 to 180 days (average 75-90 days) Transmission: ○ By contact predominantly by the parenteral route (by injection), by infected blood/blood products (I.V. drugs) ○ Blood, semen, vaginal fluids. Symptoms: ○ Mild fatigue, lassitude (no energy) and sometimes fever. Nausea, vomiting and diarrhea are not uncommon and aversion to both food and cigarette smoking. ○ In more severe cases, jaundice appears. It is a “silent epidemic” as most people do not have symptoms when they are newly infected and can unknowingly spread the virus to others Treatment:: ○ Vaccination; ENGERIX-B, HEPLISAV-B, RECOMBIVAX HB, RECOMBIVAX HB-Pediatric Hepatitis C (HCV): Infectious virus that affects the liver Can live outside the body for up to 3 weeks Incubation period ○ 2 weeks to 6 months Transmission:  ○ Blood, primarily through IV drug use or blood transfusions. ○ Not spread by casual hugging, kissing, sneezing or found in food or water Symptoms: ○ Fatigue, fever, nausea, vomiting, loss of appetite and jaundice ○ If the body is not able to fight off the virus, chronic hepatitis may develop which can lead to cirrhosis (liver scarring), liver failure and even liver cancer. Like chronic hepatitis B, chronic hepatitis C is a “silent” disease because often no symptoms appear until the liver has been damaged Treatment: ○ Direct-acting antivirals (DAAs); no vaccine available. Prognosis: ○ Chronic hepatitis may progress and become cirrhosis or finally carcinoma. In a few cases, Hepatitis B progresses to massive hepatic necrosis ending in death (1 to 2% mortality) 10. HIV & AIDS Pathogen → HIV: Human Immunodeficiency Virus – a viral infection that causes AIDS ○ HIV specifically infects and kills the immune system’s CD4+ T cells in a human host ○ CD4+ T cells are WBC called T lymphocytes or T cells that play the important role of fighting infection as part of the immune system ○ A 10:1 solution of H2O to household bleach will destroy the HIV on any surfaces in the department Disease → AIDS: Acquired ImmunoDeficiency Syndrome ○ AIDS virus is NOT: easily acquired transmitted by casual contact such as touching, shaking hands, eating food prepared by an infected person, from drinking fountains, telephones, toilets or other surfaces o an airborne disease 49% survival at 1 year 15% survival at 2 years few patients live beyond 3 years  It is a retrovirus - the viral material converts from RNA to DNA once it has penetrated the host cell. These retroviruses have the enzyme reverse transcriptase which enables them to replicate and destroy the host cell. They then infect other cells. Transmission: ○ For HIV: resevoir→portal of exit→transmission→portal of entry Host→open wound→blood,semen→host ○ Blood, semen, vaginal fluids, and perinatal transmission. ○ Occupational exposure of the MIT/HCW: needle stick Symptoms: ○ Fatigue, fever, weight loss, and opportunistic infections (e.g., Pneumocystis carinii pneumonia). Pneumocystis Carinii Pneumonia (PCP): a rare infection caused by a fungus attack commonly found in immunocompromised patients Kaposi's sarcoma (KS): a form of cancer, a malignant tumour of the epithelium that causes pink, brown or purplish skin blotches which develops quicker in patients with HIV/AIDS Children and AIDS ○ 78% acquired perinatally may be traced to an IV drug user or mother's sexual partner ○ 12% associated with blood transfusion Prevention: ○ Safe sex practices, clean needles, HIV testing. No cure: ○ Antiretroviral therapy (ART) helps manage the disease. 11. Ebola Virus A rare and deadly virus/disease caused by infection with one of the Ebola virus strains The natural reservoir host of Ebola is animal-borne and that bats are the most likely reservoir Fatality rate: ○ 50% Transmission: ○ Direct contact with infected body fluids, broken skin, mucous membranes,fomites (like needles and syringes) or infected animals.  ○ Ebola is not spread through the air or by water, or by food Symptoms: ○ Sudden onset of fever, fatigue, muscle pain, headache and sore throat, followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g., oozing from the gums, blood in the stools). Prevention ○ Wearing appropriate PPE, and disinfecting contaminated surfaces. Incubation Period: ○ 2-21 days Treatment: ○ Two vaccine treatments (as recommended by WHO in 2023). 12. COVID-19 Infectious respiratory disease caused by a newly discovered coronavirus; it has become a widespread epidemic (PANDEMIC) Transmission: ○ Primarily through droplets from coughing, sneezing, or talking. Symptoms: ○ cough, fever or chills, shortness of breath or difficulty breathing, muscle or body aches, sore throat, new loss of taste or smell, diarrhea, headache, new fatigue, nausea or vomiting and congestion or runny nose. ○ If severe some cases result in death Prevention: ○ Vaccination, wearing masks, hand hygiene, and physical distancing. Vaccines: ○ Moderna, Pfizer, Johnson & Johnson. 13. Post-Exposure Prophylaxis (PEP) For HIV: PEP involves taking antiretroviral drugs after potential exposure to prevent HIV infection. Timeframe: Initiate PEP ASAP, within 1 hour of exposure and administer PEP for 4 weeks if tolerated  Must be started within 72 hours of exposure, ideally within 1 hour. Follow-up: Includes regular testing and monitoring over a 4-week period. 14. Factors Contributing to Emerging Diseases Ecological changes, population growth, international travel, and overuse of antimicrobials contribute to the emergence of new diseases like Ebola, HIV, and COVID-19 Topic 4: 1. Standard Precautions Objective: To reduce the risk of transmitting infectious microorganisms from both recognized and unrecognized infection sources in healthcare settings. Historical Context: The term "Universal Precautions" was used in the 1980s due to the HIV/AIDS epidemic. In 1996, the CDC renamed it **Standard Precautions**, which includes isolation for body fluids and substances (blood, secretions, etc.). Key Principle: Treat all patients as potentially infectious. This eliminates the need for labeling patients as infectious. When to Use: Apply standard precautions when dealing with blood, body fluids, mucous membranes, non-intact skin, and contaminated items. 2. Goals of Standard Precautions Prevent transmission of infections (bloodborne and others) to healthcare workers (HCWs), patients, and visitors. Apply barrier precautions (PPE, hand hygiene) when there is a risk of exposure to infectious substances.  Protect the confidentiality of the patient. Understand the why behind infection control measures to ensure proper implementation. 3. Policies Blood and body fluids of all patients are treated as infectious. Personal Protective Equipment (PPE): ○ Each department should ensure PPE (gloves, masks, gowns, etc.) is readily available. Patients’ records should not be labelled as "infectious," and all specimens must be handled with care. Room allocation: ○ Nursing and Infection Control collaborate to determine patient room assignments for those requiring isolation. Transmission-Based Precautions (TBP) cards are placed outside patients' rooms to indicate the necessary precautions (contact, droplet, airborne) 4. Barrier Precautions Hand Hygiene: Most crucial in preventing hospital-acquired infections. Wash hands: Before and after patient contact. After touching contaminated surfaces. After removing gloves. Gloves: Wear when handling blood, body fluids, secretions, or non-intact skin. Gloves prevent contamination of hands and reduce transmission to patients and surfaces. Gloves must be changed between patients, and hands washed after removing them Masks, Face Shields, Goggles: Protect the mucous membranes (eyes, nose, mouth) from exposure to infectious materials. Gowns: Wear impervious gowns when at risk of contact with large amounts of body fluids. 5. Safe Handling and Disposal of Needles and Sharps Critical Practice: Safe handling and disposal of needles reduce the risk of exposure to bloodborne pathogens. Rules: Never recap needles; dispose of them immediately in rigid containers. Place sharp disposal containers near the point of use to avoid accidents. 6. Cleaning and Handling of Equipment and Spills Equipment: ○ Use proper PPE when handling soiled equipment. Clean contaminated equipment with a bleach solution or hospital-grade disinfectant. Linen: ○ Handle soiled linen carefully to avoid contamination of clothing and prevent airborne dispersion of pathogens. Spills: ○ Clean biological spills promptly while wearing appropriate PPE. Use designated disinfectants to clean and safely dispose of contaminated materials. 7. Transmission-Based Precautions (TBP) TBP are additional precautions for highly transmissible infections not contained by standard precautions alone: Contact Precautions: Transmission: Direct contact with the patient or indirect contact via contaminated surfaces or equipment. Examples: Methicillin-resistant Staphylococcus aureus (MRSA), Hepatitis A. PPE: Gloves and gown required. Droplet Precautions: Transmission: Through large droplets (coughing, sneezing, talking). Examples: Influenza, mumps, rhinovirus.  PPE: Mask, face shield, goggles as needed. Airborne Precautions: Transmission: Via small droplets that remain suspended in the air and can travel long distances. Examples: Tuberculosis (TB), COVID-19. PPE: N95 mask or respirator. 8. Isolation Techniques Physical Separation: ○ Isolation separates infected patients to prevent the spread of infectious diseases. Patient Impact: ○ Patients may feel isolated or "untouchable." Healthcare workers should reassure and maintain compassionate care. Medical Imaging in Isolation: Procedure Timing: ○ Perform imaging at the end of the day to minimize contamination. Technologist Roles: ○ Requires two technologists—one "clean" to handle equipment and one "dirty" to manage the patient. Post-Procedure: ○ Clean all surfaces and equipment used in the procedure. 9. Protective Precautions for Immunocompromised Patients Who is at Risk: ○ Patients with weakened immune systems (e.g., neonates, cancer patients, organ transplant recipients) need protection from potential infections. Special Measures: ○ handwashing, gowning, gloving, and cleaning equipment before entering the room. Specific signs indicate the type of precaution needed. 10. Personal Protective Equipment (PPE) Gloves:  ○ Protect against bloodborne pathogens and must be changed between patients. Masks & Respirators: ○ Protect against respiratory pathogens. Gowns: ○ Prevent contamination of clothing. Face Shields/Goggles: ○ Protect mucous membranes from splashes or droplets 11. Safe Specimen Handling Specimen Transport: Ensure specimens are safely transported to avoid contamination. Biohazardous Waste Management: Adhere to hospital protocols for safe disposal Topic 5 and 6 A: Patient Safety 1. Patient Positioning Purpose: Used in radiology to promote venous return, show gastrointestinal reflux, and assist in certain exams (e.g., thoracic and cervical myelograms). Helpful for patients with orthostatic hypotension or those who are post-anesthesia. Common Positions: Trendelenburg Position: ○ Patient lies with head lower than the body. Used for patients with orthostatic hypotension or vomiting. Sims' Position: ○ Patient lies on their left side with the right knee drawn up. Often used for inserting rectal enema tips. Fowler’s Position: ○ High Fowler: Head raised 45° to 90°. Used for respiratory distress.  ○ Semi-Fowler: Head raised 15° to 30°. Supports shoulder and foot to prevent strain. Lithotomy Position: ○ Used in gynecological and urological exams, where the patient’s legs are flexed and supported by stirrups. 2. Decubitus or Recumbent Positions Decubitus: Refers to lying down with a horizontal x-ray beam. ○ Dorsal decubitus: Supine position. ○ Ventral decubitus: Prone position. ○ Lateral decubitus: Patient lies on one side, with right or left side identified 3. Preventing Decubitus Ulcers (Bedsores) Elderly or immobile patients are prone to ulcers over pressure points like the scapulae, sacrum, and knees. Precautions: Change the patient’s position every 2 hours (in bed) or every 30 minutes (on a hard surface like an x-ray table). Use cushions and sponges to relieve pressure points. Ensure that lower extremities, especially for elderly patients, are protected from bumps or shearing forces, as their skin is more fragile. 4. Skin Care Key Points: Protect skin when moving patients to prevent injury from shearing forces. Change soiled linens immediately to avoid skin irritation. Immobilized patients should be rotated regularly to prevent pressure sores. Ergonomics, Body Mechanics, and Patient Transfer 1. Ergonomics Definition: The study of fitting the working environment to meet the worker's needs, aimed at improving efficiency and reducing injury risk. Importance: Reduces stress on the musculoskeletal system caused by awkward postures or repetitive movements. 2. Body Mechanics Principles of Proper Body Mechanics: Base of Support: Feet should be shoulder-width apart for stability. Center of Gravity: Keep your body weight low and balanced. Line of Gravity: Should pass vertically through the center of gravity. Proper Lifting Technique: Use leg muscles (not back) when lifting. Keep the object close to your body. Avoid twisting; instead, pivot with your feet. Reaching and Pivoting: Stand close to the object when reaching and avoid twisting your waist. Pivot with your feet when moving an object to prevent back strain. 3. Patient Transfer Equipment Transfer Methods: Draw Sheets and Slider Boards: ○ Help move immobile patients with minimal effort and reduce friction. Electric Lifts: ○ Can be used to transfer patients unable to assist in moving themselves. Wheelchairs and Stretchers: ○ Each requires proper technique for transferring patients to avoid injury. 4. Transfer and Moving Techniques Assessing the Patient:  Always assess the patient's ability to help with the transfer. Consider patient strength, mobility, and balance before attempting a move. Use verbal commands to guide the patient, and provide assistance if needed. Types of Transfers: Stretcher Transfer: ○ Support the patient’s head, trunk, and extremities, especially when the patient is unconscious. Wheelchair Transfer: ○ Be prepared to assist patients who may appear able but could be weak or dizzy. Ambulation: ○ Walking a patient is not advisable unless properly assessed. Stay beside the patient to offer assistance. 5. Important Considerations for Patient Safety Skin Protection: Protect the patient's skin, especially in vulnerable areas, during transfers or long procedures. Patient Belongings: Ensure patient belongings are safely stored or remain visible to the patient. For patients wearing jewelry, ensure it is safely stored or recorded in the radiology information system (RIS) if the patient refuses to remove it. Double Identification: Always verify the patient's identity using verbal identification and wristbands before any procedure or transfer. Topic 5 and 6 B: 1. Dressing and Undressing Patients General Guidelines: If the MIT (Medical Imaging Technologist) senses a patient will have difficulty undressing, assistance should be offered. Provide clear instructions and ensure enough clean gowns are available. Special Considerations: Children: ○ An adult should help dress and undress the child. Teenagers: ○ Privacy is important; always be professional and offer reassurance. Lower Extremity Disability: Assist patients by undressing the upper body first and then helping with lower garments like trousers or skirts. Disabled Patients: Undress the less affected side first. Redress the affected side first. If a patient is supine, have assistance to avoid injury. 2. Immobilization Techniques Purpose of Immobilization: To prevent movement that could interfere with diagnostic imaging or pose a risk to the patient. Immobilizers must be ordered by an MD and only used when absolutely necessary. Pediatric Immobilization Octostop: ○ A device for babies up to 1 year, with Velcro straps and the ability to rotate in 8 positions. Pigg-O-Stat and Pedia-Poser: ○ Used for upright chest and abdominal exams in children, securing the child’s arms and chin. Mummy Wrap: ○ Using a sheet to restrict movement. Papoose Board and Stockinette: ○ Useful for immobilizing limbs. Adult Immobilization Types of Restraints:  ○ Velcro straps, sandbags, sponges, limb holders, and immobilizing vests. Restraints should only be applied when the patient poses a risk to themselves or others, and they must be easily removable and not impair circulation or breathing. 3. Pediatric Care in Radiology Communication: MITs should speak to children at eye level, using simple terms to explain the procedure. Parents can help by reassuring the child and assisting with positioning. Never leave a child unattended; ensure privacy even with parents present. Age-Specific Considerations: Neonates (0-28 days): ○ Keep warm and never leave unattended. Infants (1-12 months): ○ Maintain trust and ensure a safe environment. Toddlers (1-3 years): ○ Ensure privacy and explain the process to parents. Preschoolers (3-6 years): ○ Encourage independence but offer support. School Age (6-12 years): ○ Address privacy concerns and ensure understanding. Adolescents (12-19 years): ○ Address privacy and pregnancy concerns, especially for females. 4. Geriatric Care in Radiology Considerations: Elderly patients may have multiple chronic conditions (e.g., heart disease, diabetes, arthritis). Be patient and gentle as elderly skin is fragile, and they may bruise easily. Dementia and Alzheimer’s patients may require repeated instructions and a calm approach. Never leave elderly patients unattended on x-ray tables due to fall risk. Elder Abuse:  Types of elder abuse include physical, sexual, psychological, and neglect. Signs of abuse: bruises, fractures, pressure sores, poor hygiene, or malnutrition. MITs must report any suspected elder abuse to the appropriate authorities. 5. Moving and Transferring Patients General Guidelines: Move the patient toward their stronger side when possible. Use proper body mechanics to avoid injury: keep the load close, lift with legs, and avoid twisting the torso. When assisting a disabled patient, remove clothing from the unaffected side first, then assist with the affected side. Patients with Casts: Use a flat, open hand to support a cast, avoiding grasping with fingers. Patients with casts should be checked every 15 minutes for signs of impaired circulation or nerve compression. 6. Trauma Patients and Immobilization Spinal Cord Injuries: Trauma patients with suspected spinal injuries should not be moved without MD clearance. Use a cervical collar and backboard for immobilization until C-spine clearance is obtained via imaging. Horizontal beam imaging is used for lateral views without moving the neck. Fractured Extremities: Do not remove splints or antishock garments. Move limbs as a unit, avoiding excessive movement to prevent hemorrhage or further injury. Trauma Imaging Guidelines: Always take two images at 90-degree angles for each body part. Use PPE and avoid removing any impaled objects or pneumatic garments during imaging. 7. Child Abuse in Radiology Signs of Battered Child Syndrome: Multiple fractures, bruising, unexplained injuries, or signs inconsistent with reported trauma. Skeletal surveys (X-rays of the entire body) are performed when abuse is suspected. Shaken Baby Syndrome: ○ Diagnosed by metaphyseal corner fractures and multiple rib fractures, often indicative of child abuse. Legal Responsibility: MITs are legally obligated to report suspected child abuse to the appropriate person within the institution. It is not the MIT’s role to confirm the abuse but to report it. Topic 7 Purpose of PDSP Training Aimed at healthcare workers (HCW), caretakers, and managers in patient care facilities. Goals: ○ Equip caretakers with knowledge and skills to protect physical integrity during patient transfer tasks. ○ Understand risks and apply preventive measures. ○ Analyze transfer situations and implement corrective measures for safety. Key Principles PDSP: "Principes pour le Déplacement Sécuritaire des Bénéficiaires." Transfers are a type of care requiring consent and cannot be forced. Encourage and promote patient abilities while minimizing caregiver effort. Always prioritize the safest transfer methods. Patient’s maximum ability should align with the caregiver’s minimum effort. Musculoskeletal Disorders (MSKD) in Caregivers Account for over 50% of occupational injuries in healthcare. Prevention strategies: ○ Never manually lift patients. ○ Use mechanical aids for heavy or complex transfers. ○ Encourage patient participation based on their autonomy. ○ Implement structured MSKD prevention programs for continuous safety improvements. Global Approach to Transfers Factors influencing transfer safety: 1. Patient: Condition, capabilities, cooperation. 2. Task: Method and complexity of transfer. 3. Time: Time of day, task duration. 4. Environment: Space, obstacles, and layout. 5. Equipment: Availability and condition. 6. Organization: Policies, assignments, and communication. 7. Caregiver: Physical effort and posture. Levels of Assistance ○ The best level of assistance allows the patient/person to use their maximum ability and the caregiver to apply minimum force/physical effort 2. Supervision: ○ The patient performs most movements independently. ○ Requires guidance, verbal instructions, and encouragement. ○ Patient effort is greater than caregiver effort. 3. Partial Assistance: ○ The patient lacks strength for full movement but can bear weight. ○ Needs guidance in directing their actions/following instructions ○ Shared effort between patient and caregiver (20–80% caregiver involvement). 4. Complete Assistance: ○ Patient unable to perform or bear weight. ○ Caregiver effort is greater than patient effort. Assessing Patient Capabilities 1. Check attention span and cooperation through verbal cues and physical gestures. 2. Assess strength by asking the patient to move arms/legs or shift in position. 3. Confirm ability to maintain a seated posture and follow instructions. 4. Modify plans based on patient responses to ensure safety. Steps for Safe Transfers 1. Establish Contact: ○ Greet and maintain communication throughout the process. 2. Collect Information: ○ Evaluate patient condition, environment, and equipment availability. ○ Check charts for contraindications like dizziness, cognitive impairments, or MSK conditions. 3. Communicate Clearly: ○ Explain the procedure to patients and co-workers. ○ Use positive reinforcement and clear instructions. 4. Analyze the Situation: ○ Ensure the chosen method matches patient needs and situational factors. 5. Prepare for Transfer: ○ Secure appropriate equipment and provide step-by-step guidance. ○ Ensure understanding with clear signals (e.g., "On the count of 3"). 6. Execute the Transfer: ○ Use natural movements, maintain a proper posture, and minimize physical strain. ○ Employ tools like mechanical lifts or sliding boards to aid movement. Transfer Techniques Lateral Weight Transfer: ○ Stand with feet apart, push objects (like a chair) without lifting. ○ Keep arms extended and back straight. Forward-Backward Weight Transfer: ○ Engage thigh muscles and gravity for movement.  ○ Common for turning patients or helping them stand. Stretcher Transfers: ○ Align stretcher height for easy patient movement. ○ Use draw sheets and secure patient torso while pivoting. Wheelchair Transfers: ○ Align the patient’s knees and feet for stability. ○ Provide guidance to encourage self-movement. Safe Practices Always encourage patient participation to maximize autonomy. Use friction-reducing aids like sliding boards. Avoid lifting over 16 kg; rely on mechanical aids for heavier loads. Maintain proper posture: wide base, back straight, elbows close to the body. Involve team members if additional support is required. Topic 8 Workplace Health and Safety Overview Regulatory Agencies: ○ International: WHO, CDC ○ National: Public Health Agency of Canada ○ Provincial: Quebec Health Record (DSQ) ○ Municipal: Santé Montréal Portal Safety Practices: ○ Clean imaging rooms, equipment, and accessories between patients. ○ Provide clean gowns, linens, and ensure surfaces like imaging tables are disinfected. ○ Regular maintenance of all electrical and mechanical equipment. ○ Adhere to Canadian Standard Association guidelines for electrical safety. Hygiene and Patient Safety Immunizations: Required for MITs (e.g., Hepatitis B, Mumps, Rubella). Personal Hygiene: ○ Nails clean and short; no nail polish. ○ Hair tied back and clean uniform. ○ Avoid wearing uniforms outside the hospital to prevent germ spread. ○ Use closed-toe, clean shoes to prevent injuries. Patient Comfort and Security: ○ Address patient fear and anxiety with reassurance, especially for children and the elderly. ○ Use pillows, blankets, and sponges to enhance comfort. Respect and Courtesy: ○ Greet patients warmly; explain procedures clearly. ○ Respect the dignity and personal attributes, regardless of demographics. Radiation Safety Pregnant women or MITs must not hold patients during X-ray exposure. Women of childbearing age (11–55) must be asked about pregnancy status before any imaging between the diaphragm and knees. Gonadal shielding should be used unless it obstructs the imaging area. Follow ALARA (As Low As Reasonably Achievable) principles: ○ Minimize exposure time. ○ Maximize distance from the radiation source (at least 6 feet for mobile radiography). ○ Use proper shielding for patients and staff. Fire Prevention and Response Chemistry of Fire: Requires heat, oxygen, and flammable substance. Common Fire Causes: ○ Spontaneous combustion. ○ Electrical failures (frequent in radiology due to equipment).  ○ Rarely, open flames in hospital kitchens or labs. Response to Fire: ○ Primary: Evacuate the area with the patient. ○ Secondary: Report fire location using hospital protocols (e.g., Code Red). ○ Shut doors, electrical equipment, and oxygen valves. ○ Use CO2 fire extinguishers for electrical fires. Incident Report What is an Incident? ○ Any event affecting safety (e.g., patient falls, equipment failure, errors in treatment). Steps to Handle Incidents: ○ Provide immediate care and notify the supervisor. ○ Report the incident promptly, even minor ones. ○ Record details factually in the incident report: What happened, when, where, who was involved. Actions taken, including medical assistance. ○ Sign the report and submit it according to institutional policies. Benefits of Reporting: ○ Creates a permanent record for legal and insurance purposes. ○ Identifies areas for safety improvement and risk management. Best Practices: ○ Avoid assumptions or assigning blame. ○ Document factual observations and direct quotes from witnesses. Medical Charts and EMR Medical Chart: ○ A complete record of a patient's clinical data and medical history (e.g., demographics, test results, diagnoses). ○ Ensures continuity and accuracy of patient care. Electronic Medical Records (EMR): ○ Digital version of patient medical charts. ○ Real-time, secure, and accessible to authorized healthcare providers.  ○ Reduces medical errors, avoids duplication, and streamlines care coordination. Québec Health Record (DSQ): ○ Provincial tool for collecting and sharing patient health data. ○ Improves emergency care efficiency, medication management, and interprofessional collaboration. Charting Medications Record all administered medications in the patient’s chart, including: ○ Date, time, drug name, dosage, and route of administration. Follow institutional charting procedures to ensure legal accuracy. Report any contrast media (CM) administration to the radiologist and nursing staff. Maintain complete and up-to-date medication lists for safety. Consent in Medical Imaging Special consent forms are required for specific procedures (e.g., stress tests, biopsies). Consent must be obtained from the patient or legal representative before proceeding. Interprofessional Collaboration Role of Technologists: ○ Collaborate with multidisciplinary teams during patient examinations or treatments. ○ Respect professional boundaries while contributing expertise. ○ Maintain effective communication and ethical standards. Benefits: ○ Ensures comprehensive care through shared knowledge and responsibilities. ○ Harmonizes team efforts to improve patient outcomes.