A Week in Fluoroscopy

This is the equipment used in my placement hospital, the Siemens Artis Zee

Stardate: 91823.58

It's that time again: placement! And for week one, I was placed in Screening (AKA Fluoroscopy); I was supposed to be in A&E, but it was changed at the last minute. If you didn't already know what fluoroscopy is, it's basically an imaging technique that uses real-time moving images of the internal structures.

The equipment I got the chance to learn to use properly was the Siemens Artis Zee Multi-Purpose, and it's controls, although they look confusing, take very little time to get used to. It's used in various types of fluoroscopic procedures:

• Root nerve blocks - an injection that is given close to a nerve as it leaves the spine; usually for sciatica pain.
• Facet joint injections - an injection of local anaesthetic or steroid which can anaesthetise the facet joint to block pain. Facet joints are small joints between each segment of the spine.
• Barium enema - an x-ray examination of the large intestine to help diagnose any existing problems affecting that area. The colon is filled with a contrast material containing barium, which is done by pouring the contrast into the rectum.
• Barium swallow - an x-ray examination of the upper gastrointestinal tract, including the oesophagus, and sometimes the stomach. The patient is asked to drink a suspension of barium sulphate, and the x-ray images are taken during the swallow. This procedure is done in various positions: AP, oblique and lateral, for a 3D assessment.
• Myelogram - an x-ray examination that uses an injected contrast material to view the fluid-filled space (subarachnoid space) between the spinal vertebrae. 

I witnessed these examinations, and there are more that are carried out on the department. I certainly got used to wearing lead rubber aprons, and quickly learnt to check the apron first, as instead of picking up the lighter 0.25mm apron, I picked up a heavy 0.35mm apron, which made me feel faint after a while! I also started using the thyroid shield, just to be on the safe side.

Despite what everyone first believes about barium enemas, you barely see (or smell) anything, and nearly all fluoroscopic procedures are painless for the patient (the barium mixture patients have to swallow has a pretty nasty after-taste, mind). 

Overall, it was nice to see what the department does, and what this technique involves. It certainly lets you know if you want to go into that sort of speciality, and it does actually seem quite interesting. You certainly see a good variety of patients, too. It's made me start seriously looking into what I want to do post-graduation (still definitely Forensic Radiography) as there are so many options with Radiography!

Until next time guys! Next week I'm in Clinical Skills, so we'll see how that goes.

LLAP!

References

1. Siemens Artis Zee Multi-Purpose, n.d. photograph, viewed 22 March 2014 <http://usa.healthcare.siemens.com/siemens_hwem-hwem_ssxa_websites-context-root/wcm/idc/groups/public/@global/@imaging/@angio/documents/image/mdaw/mtc0/~edisp/artis_zee_multi_purpose-00068177/~renditions/artis_zee_multi_purpose-00068177~10.jpg>.