Tuesday, July 16, 2013

My Kind Of Day

I did my clinical rotations today, and it was one of those days. I've been trying all week to get the "perfect" lateral knee radiograph. It boils down to getting the perfect patient, the perfect tech, and the perfect schedule, or as the students at school call it: Winning the trifecta.

The "perfect" lateral knee x-ray

FYI, this isn't any of my knee x-rays today. The first knee that I got today belonged to an older gentleman, and his knee had swollen to the size of a grapefruit, and very sensitive to the touch. Needless to say, that touching the epicondyles on the femur was a big no-go. The image was rotated, ergo unacceptable for my last lower assessment.

I did a few more x-ray routines, and had the opportunity to get a pre-comp for a cervical spine. It takes two pre-comps then the next one is considered a comp that you take to your advisor to validate the x-ray. Anyways, the poor guy comes in and is unable to lift his chin even a few inches, and he is standing all lopsided as a bonus. I try to angle the x-ray to compensate for the limited range of motion of the top of the spine, but was unable to get the Odontiod through the open mouth. I had to call in a registered tech to show me another way of capturing the image. Fail number two, for those keeping score.

After a few more routines, I notice that there is another knee in the line up for x-rays. I asked around to see if anyone else needed a knee, and it was all mine. I went to one of the four x-ray rooms, and got it ready for the patient. The Ortho clinical wanted a weight-bearing bilateral knee.No problem. I head to the waiting room, and call the name of the  patient. Guess what? A 70+ year old sits up and hits the knob on his wheelchair and speeds towards me. Great! We chitchat a little bit on the way to the examine room, and find out he is able to stand for a few minutes at a time. "Well, at least I've got a chance", and it's a bilateral, so I have two chances!

We get to the room, and he drops the bomb on me that he has had a stroke, and when he stands he has a constant case of vertigo. He is deaf in the right ear and has 70% hearing loss in his left ear. To recap, the Doctor wants a standing x-ray on an elderly man, in a wheelchair, that is mostly deaf, and has the same balance as a drunken sailor. 

I drop the bucky board, the image receptor, down to knee level and get him into a standing position. On his right is a staircase that we use for weight-bearing feet x-rays, so he is able to hold onto the railing to steady himself. The tube is close enough in front of him, in case he leans too far forward. On his left, he has the hand rails, that is attached to the bucky board for chest x-rays, all within a cozy 40" radius. One problem solved!

Now keep in mind that I have to crawl through the handrail fortress to get him into position, and correctly mark each image. I hurriedly take the two front shots of the right and left knee before he has to "take a rest." No problem, I've got all day, and I need him fresh and steady for the harder lateral images. I get him back to the chair, and we take about a ten minute break.

I get him back onto his feet, and one leg in front of the other. At this point, he is swaying around like he is being repeatedly being punched by Mike Tyson. He's holding on fast, while I rotor up the x-ray tube, and try to time the x-ray when he is in the correct position.

I came pretty darn close! There is a little rotation, but I should get extra bonus points for this one. I'll run it by my advisor tomorrow, and see if I get the green light. Everyone keep their fingers crossed for me.

Oh!, and as an added bonus the next guy that I had was a foot x-ray. I sail through the first two x-rays and I get him in the next position, and he farts in my general direction! Simply Wonderful and all before lunch.

The rest of my day pretty much played out the same, and by 3:00pm, I'm sure that it is 5 o'clock somewhere!

Josh, my friend and classmate, is taking Advanced Patient Care with me and we had our last test today. I scored 28/30 while he scored 30/30 - both A's. This Saturday, we are taking Advanced Cardiac Life Support (ACLS) certification. When we pass the certification, it will count as a 100% for the final exam and we will both finish the course with A's.

K:     319.00/338
Josh: 323.00/338

Josh won the friendly competition this semester by 4 points, and I'll buy him a beer at the next opportunity as a congratulations. 

We walked out of the library, and the Express shuttle bus was just pulling up to take us to the student parking lot. How perfect was that? We talked about how the day had gone, and that we would take many more bad days at clinical to have it end so well.

Keep Right On Prepping - K

(All images were taken from Google Images with no HIPAA violations)

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