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Portable radiography (also known as mobile radiography) is frequently performed in hospitals when patients are too unwell to transport to the imaging department. However, most health facilities endeavor to perform "departmental films", as image quality tends to be inferior when performed with a mobile x-ray system 1.
Mobile examinations are requested on patients who are unable to leave the ward for example:
- medical emergency
- requiring wall-suction
Most often, this projection is conducted on patients who are unable to move on their own and the position will be as the patient is. Therefore inevitably, radiographs are often suboptimal as even a good quality AP projection cannot be done, let alone a PA chest.
- chest radiography
- abdominal radiography
- supine view
- erect view
- pelvis radiography
- often performed in scenarios where patient is unable to be transported to the radiology department i.e. trauma, infectious
- AP view
Patients will most likely already be in a hospital gown. However, it is still important to check and remove any necklaces, Holter monitors, or ECG leads that cover the area of interest. In cases where ECG leads cannot be removed, they should be repositioned out of the field as much as possible.
- if poor radiographic technique is used, the patient's treatment plan may be affected, therefore great care must be taken in order to closely simulate x-rays taken in the imaging department
During the COVID-19 pandemic, portable radiography has become a heavily utilized form of medical imaging. To lessen staff exposure to infectious patients (and keep the machine clean) radiographers can x-ray through the glass of a patient's room with a slight increase to the mAs for a similar (almost the same) image quality 2-5.
Tips for portable radiography
- planning how to x-ray the patient before moving the patient will keep the patient comfortable for as long as possible, thus may increase patient compliance
- ensure that surrounding staff and patients are not pregnant; if a nearby patient is pregnant, staff will need to move them away temporarily
- advise all staff and patients to stand as far away as possible during exposure as doubling the distance will halve the scattered radiation dose 1
- before making an exposure, always produce an audible alert (i.e. "X-ray, Bed number _") to ensure all staff and patients nearby know an x-ray is about to be performed
- to maintain infection control, pillowcases or plastic bags can be used to cover the detector, and sanitiser wipes used to clean the equipment in between patients
- 1. A. Stewart Whitley, Charles Sloane, Graham Hoadley et al. Clark's Positioning in Radiography 12Ed. (2005) ISBN: 9780340763902 - Google Books
- 2. Brady Z, Scoullar H, Grinsted B et al. Technique, Radiation Safety and Image Quality for Chest X-Ray Imaging Through Glass and in Mobile Settings During the COVID-19 Pandemic. Phys Eng Sci Med. 2020;43(3):765-79. doi:10.1007/s13246-020-00899-8 - Pubmed
- 3. McKenney S, Wait J, Cooper V et al. Multi-Institution Consensus Paper for Acquisition of Portable Chest Radiographs Through Glass Barriers. J Appl Clin Med Phys. 2021;22(8):219-29. doi:10.1002/acm2.13330 - Pubmed
- 4. Rai A, MacGregor K, Hunt B et al. Proof of Concept: Phantom Study to Ensure Quality and Safety of Portable Chest Radiography Through Glass During the COVID-19 Pandemic. Invest Radiol. 2021;56(3):135-40. doi:10.1097/RLI.0000000000000716 - Pubmed
- 5. Rai A, Ditkofsky N, Hunt B, Dubrawski M, Deva D, Mathur S. Portable Chest Radiography Through Glass During COVID-19 Pandemic-Initial Experience in a Tertiary Care Center. Can Assoc Radiol J. 2021;72(1):175-9. doi:10.1177/0846537120942885 - Pubmed