Here's a Quick Way to Speed Up Your Xray Exams

Beginning your clinical rotation in x-ray school can be overwhelming.  Not only are you plunged into a new environment, you are expected to pick up on a lot of information at a very fast pace.  Take a routine chest x-ray for example.  Positioning class teaches the appropriate guidelines for how to line the patient up for the central ray, which AEC cells to select, and what kind of breathing instructions to give, but it will not teach you how to become efficient while performing chest x-rays.  This must be accomplished with repetition and actual hands-on experience with the unique equipment you are using.

Here's some basic advice on how to develop a series of steps to perform for each x-ray exam that will improve your speed in a very short amount of time:

Develop an ABC system - You may notice seasoned technologists preparing for an exam in a specific order (prior to the patient entering the room).  For a standing chest x-ray, my order would be A - set a technique at the control panel, B - place a cassette in the upright bucky (if still using cassettes), and C - detent x-ray tube to wall buck and raise vertically to allow patient to walk under.  Only then will I bring the patient into the room.  

This way, when the patient is ready to be positioned, I only spend a few seconds adjusting the bucky height and placing the patient against it.  Then it takes about a few more seconds to lower the x-ray tube vertically and align it to the bucky (it's already locked in transverse and longitudinal planes).  Finally I can begin breathing instructions as I'm walking to the control panel (which has already been set up).  By the time my finger is on the exposure button, it's ready to be pushed and I've spent less than 20 or 30 seconds total for one exposure.  

You'll notice the same steps for my lateral exposure immediately following the PA, and telling the patient to breathe normally.  A - set new technique at the control panel, B - replace cassette in bucky, and C - position patient (bucky is already aligned).  You can literally get through a chest x-ray in 2 minutes or less for the average walking/talking patient.

I employ the same basic steps when doing exams on the x-ray table.  A - set technique at the control panel, B - place cassette in bucky, and C - position patient.  On the table, it will save you a lot of time to leave the tube and bucky aligned, and use the floating table top feature to move the patient as needed between positions.  Don't forget to have the tube out of the way while putting the patient on the table.  I usually detent in transverse and vertical planes and slide the tube past the head or foot-end of the table so all I have to adjust is the longitudinal plane once the patient is supine.

This is just one method to increase your exam efficiency.  The trick is, you'll have to make an effort to practice doing things in the same order every time.  After a few repetitions, you will find yourself performing these steps without having to think about it, much like driving a car... remember learning how to do that?  

You'll be concentrating on new positioning details and other new information throughout the majority of your x-ray program, and you'll be expected to apply them in clinical practice.  The less you have to strive to remember during an exam, the more efficient you will be.  And remember, practice makes perfect!

Do you have any proven methods to increase your exam speed?