chest radiology pfn: somxrl06 - jsomtcjsomtc,swmg(a) slide25 chest radiology principles fields...
TRANSCRIPT
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Slide 1JSOMTC, SWMG(A)
Chest RadiologyPFN: SOMXRL06
Slide 2JSOMTC, SWMG(A)
Terminal Learning Objective
Action: Communicate knowledge of “Chest Radiology”
Condition: Given a lecture in a classroom environment
Standard: Received a minimum score of 75% on the written exam IAW course standards
Slide 3JSOMTC, SWMG(A)
References
Accident & Emergency Radiology: A Survival Guide (2nd edition; 2005; Raby, Berman, and Lacy)
Learning Radiology: Recognizing the Basics (2nd edition; 2012; Herring)
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Slide 4JSOMTC, SWMG(A)
Reason
As Special Operations Combat Medics you will need to have a basic understanding of common radiological studies and how they can be used to aid in the diagnosis and treatment of your patients.
Radiology a is vital component of medicine!
Slide 5JSOMTC, SWMG(A)
Agenda
Identify a technically adequate chest x‐ray
Utilize radiological principles to evaluate the structure and function of the chest
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A Technically Adequate Chest X‐ray
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Slide 7JSOMTC, SWMG(A)
Adequate Chest X‐ray
AdequacyAs realistic image of internal structures as possible
Clinical correlation
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If not adequate, the image is worthless!
Adequate Chest X‐ray
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Adequate Chest X‐ray
Adequacy The best views
• PA• left‐lateral
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AP PA
Adequate Chest X‐ray
Affects of Magnification
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Adequate Chest X‐ray
RIP ‐ Rest In Peace R
I
Penetration
spiration
otation
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The spinous process equidistant from clavicular articulation
NO ROTATION
R
Adequate Chest X‐ray
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8‐10 visible posterior ribsINSPIRATION
I
10th
Adequate Chest X‐ray
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Visible T‐spinePENETRATION
P
Adequate Chest X‐ray
Slide 15JSOMTC, SWMG(A)
Rotation
Penetration
Inspiration
R
No Rotation
PenetrationInspiration
P
I YES!
Adequate Chest X‐ray
Is this image adequate?
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Slide 16JSOMTC, SWMG(A)
Radiological Principles to Evaluate the Structure and Function of the
Chest
Slide 17JSOMTC, SWMG(A)
Chest Radiology Principles
Structural Density Contrasting shades
• normal or dysfunctional?
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Chest Radiology Principles
Anatomical Awareness Trachea/bronchi Ribs ClaviclesArteriesHeartDiaphragms Lungs/pleura Stomach
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Chest Radiology Principles
A B C D E F GAirway Bones Cardiac silhouetteDiaphragms Effusions FieldsGastric bubble
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Chest Radiology Principles
Airway
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Chest Radiology Principles
Bones
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Chest Radiology Principles
Cardiac Silhouette
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Chest Radiology Principles
Diaphragms
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Chest Radiology Principles
Effusions
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Chest Radiology Principles
Fields
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Chest Radiology Principles
Gastric Bubble
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Chest Radiology Principles
Case StudyAdequate? (RIP) Systematic evaluation (A‐G)
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Chest Radiology Principles
Case StudyAdequate? (RIP) Systematic evaluation (A‐G)
Slide 29JSOMTC, SWMG(A)
Questions?
Slide 30JSOMTC, SWMG(A)
Terminal Learning Objective
Action: Communicate knowledge of “Chest Radiology”
Condition: Given a lecture in a classroom environment
Standard: Received a minimum score of 75% on the written exam IAW course standards
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Slide 31JSOMTC, SWMG(A)
Agenda
Identify a technically adequate chest x‐ray
Utilize radiological principles to evaluate the structure and function of the chest
Slide 32JSOMTC, SWMG(A)
Reason
As Special Operations Combat Medics you will need to have a basic understanding of common radiological studies and how they can be used to aid in the diagnosis and treatment of your patients.
Radiology a is vital component of medicine!
Slide 33JSOMTC, SWMG(A)
Teleconsultation FormatGet a second opinion tele‐consult from medical specialists by submitting a non‐secure email message with relevant attachment (JPEG,ECG,etc)
Used by deployed healthcare professionals Physician, PA, Nurse, SF/IDMT, Medic
No Patient identifying informationNo classified informationPatient Demographics:
Age, Branch of Service, LocationDuration of problemsSymptoms now
Getting Better? Worse? Staying Same?Previous Treatment & Outcome/Effectiveness
Tests & ResultsYour Differential DiagnosisLimitations to Care for Patient
Medications? Procedures? Evacuation?Attachments
Digital Images, Scanned EKG Lab Findings, Radiographs
Include Physician in emailConsults Answered 7 Days/Week
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Teleconsultation FormatConsultation with established contact groups:Burn – Trauma:[email protected]:[email protected]:[email protected] Disease:[email protected] Medicine:[email protected]:[email protected]:[email protected]:[email protected]
Orthopedics:[email protected];[email protected] Medicine/ Occupational Medicine:[email protected]:[email protected] Brain Injury:[email protected]:[email protected]:[email protected] consultations for all other specialties emailMr.(LTC‐retired) Charles Lappan:
[email protected] Telemedicine Teleconsultation Project Manager
Slide 35JSOMTC, SWMG(A)
Break