When considering which positioning aid or devices are best suited to a patient’s needs, doctors and radiologists can choose from a wide range to enable correct patient positioning for accurate diagnostic imaging. Radiology positioning devices are available in disposable foam or reusable plastics, both in static and non-static forms, which vary in price according to complexity. In selecting radiology positioning devices, doctors should choose which device best supports the patient’s needs, taking into consideration age, injury, physical capabilities and whether reusable positioning devices meet policy regarding infection control and FDA guidelines.
For less problematic injuries such as a fractured wrist, positioning blocks can be used. Positioning devices are made of foam, with some containing sand. These items are considered easy to store and cost effective; however, they provide very little versatility, especially for disabled patients or those with awkward injuries. They do not provide a solution for patients susceptible to movement difficulties due to illnesses such as Parkinson’s disease, which can incur errors in the image capturing process.
Patient immobilizers reduce mobility but can increase anxiety, especially in vulnerable patients. Pediatric patients may benefit from devices such as a chair designed for infants through to toddlers (max. four years), which is only secured once but rotates to provide for a range of images to be collected, including the skull, which often presents challenges for radiologists. There is also a specialized immobilizer for infants aged eight months and over. For adults, immobilizers provide an effective way of capturing optimized images; caution is advised when using such restraining devices that haven’t been developed with geriatric, disabled or very young patients’ needs in mind. Care should be taken to provide a calm and supportive atmosphere when using any form of immobilizing positioning device.
Whilst cost effective in terms of providing a simple solution, accessories such as straps, ties, compression bands and restraints provide limited support and increase the potential for error in image capturing as patients across all age ranges and abilities are able to move. They are useful for minor fractures and less complex injuries but they are not recommended for complex injuries. However, they can be discarded, reducing the risk of infections.
Platforms optimize capturing feet and must be checked for weight restrictions; they should also provide support for patients. To optimize static imaging, doctors should consider using plastic boards with arm grips and leg boards to reduce movement. A leg board or knee crutch, in the shape of a U, allows the radiographer to take many different views.
Fundamental principles of radiation protection are justification, optimization and time. Consequently, this must form part of the selection process when considering the uses of immobilizers, positioning aids and devices. Radiologists should select positioning devices based on the needs of the patient, taking into account the risks involved, including exposure to radiation.
Doctors should also note the FDA classification of radiology positioning devices and conduct a full risk analysis of devices used.
Dave Campbell is a freelance writer currently specializing in the technology and medical sector