HLTDEN007 Apply the principles of radiation biology and protection in dental practice
Assessment
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Please read through the following case studies. Reflect on your learning and your research. You may wish to review units of competency already completed when preparing responses. Your response must reflect your knowledge, skills, and application for this unit.
Case Study 1
| You have been asked to prepare a patient for intraoral X-rays. |
Explain what you need to consider to maintain paramount radiation protection for the patient. What implications does film speed have on potential radiation exposure?
| As Low As Reasonably Achievable (ALARA) is a principle concerned about radioprotection and it states that when giving patients dozes, or whenever ionizing radiation is being applied to human beings, both patients and operators, it must be kept minimum as possible. Among radiation protection principles, it is the one that is fundamental. To maintain paramount radiation protection for the patient, there are several factors to be considered. -First, all the X-ray equipment being used by the operators must meet and comply with the guidelines and specifications endorsed by AS/NZS3200.2.201. -Secondly, a radiograph is to be prescribed under one condition, if it is the only way out and only when it is necessary. -Also, when a radiograph is prescribed, it should be of consistent diagnostic quality. -An operator should position the film in the correct area and should ensure that the right exposure time is made. – When ensuring consistency and providing the diagnostic quality, an operator should use the fastest speed of the film. -To standardize the technique of the user, an image receptor should be applied. – Also, films should be handled carefully, and to produce high-quality radiographs, all film processes should be made correctly. – A patient’s record should be the one to be used when filing radiographs. – A lead apron should be availed to the individual assisting the patient. In most cases, it is an adult who acts as assisting personnel. In any case, a pregnant woman should never be used as an assisting adult. The assisting person should either be a parent or an accompanying adult who participates in supporting a child or disabled patient when the patient is under radiation exposure. To understand how film speed influences the radiation exposure, it is vital to understand its definition. Film speed means the efficiency of the light-sensitive crystals when the film emulsion reacts to X-rays. The effectiveness of the film depends on the speed; faster film speeds are more efficient when used to detect X-rays than the slower ones. It means that the amount of radiation used when exposing the film and the one used to produce diagnostic radiograph decreases as the speed of the film increase. In other words, the quantity of radiation when the patient is in exposure decreases. Therefore, it means that the fastest film speed should be used since it ensures that the patient experiences the least possible radiation dose. By doing so, consistent and the best diagnostic quality is provided.
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Case Study 2
| You have been asked by your operator to view and assess several X-rays recently taken. You are to use a reference X-ray for comparison. You notice that of two films processed manually, one has been overexposed whilst another has film fog. Moreover, a film processed using an automatic processor is underexposed. |
Answer the following questions:
- What is a reference X-ray, how is it produced, and what purpose does it have in the surgery?
| A reference X-Ray is also called a reference radiograph, and it is a type of radiograph of an image that is encompassed and oriented to reflect the quality of all radiographs that are being expected and taken at the surgery. A reference radiograph is produced under different optimal conditions. They are produced when: – A new film which has been stored in a cool and dry place is used. Also, the new film should be stored in a place away from radiation, and the area should not be contaminated with chemical fumes. – Precise exposure conditions and especially the ones recommended by the manufacturer are observed. – A fresh mixture of chemicals is used. – The correct temperature of processing chemicals is used, the one recommended by the manufacturer. A reference x-ray has a vital purpose in surgery. A Radiograph is selected daily and it is chosen at random provided it has already been processed. The range of densities of the radiograph is compared to the one of reference radiograph. The changes in density, whether minor or major ones, would imply problems with the exposure, chemical solutions, or processing, and thus corrective action should be made. The reference X-ray is essential as it helps in performing daily quality checks. Therefore, any type of problem can be detected at an early stage before affecting the diagnostic quality of the patient’s radiograph.
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- For each X-ray outlined above, describe what may have caused the processing error and how it could be corrected.
| The dark (overexposed) image may have resulted from:
–First, the developer solution used was too warm. It can be corrected by lowering the temperature of the developer solution. A Time-temperature chart should be applied. -Secondly, the time of developing the image was too long. It can be corrected by using the time-temperature chart to adjust the development time of the picture. -Also, the developer solution might have been too concentrated. The fault can be corrected by following the mixing guidelines recommended by the manufacturer.
The Film fog the image may have been caused due to: -Either, the film that was used had expired. It can be corrected by discarding the old films and management of the stock control to be improved. – Also, stray radiation might have been exposed to the film packet. The film should be stored in protective containers that are not exposed to heat nor radiation. – Films might have been stored in a dark room that leaks light. It can be corrected by sealing all regions that leak light. – Faulty safelight might have been used. It can be fixed by using the correct wattage bulb and also using a proper filter. – They might have been contamination from chemicals; it can be corrected by ensuring that the darkroom is maintained clean such as cleaning up any spills swiftly. When using an automatic processor, an underexposed (light) image may have been caused by: –The cycle used might have been too short. It can be corrected by improving the cycle time. Increasing the solution temperature would also be used as a corrective measure. – The temperature of the solution may have been too cold. It can be corrected by adjusting the temperature control or by repairing it if it’s damaged. – The solution used might have been depleted. It can be fixed by replacing the solution. -The levels of the solution may have been too low. It can be corrected by replenishing the solution. -The contamination of the transport system. It can be rectified by frequently cleaning the transport system per the manufacturer’s instructions. – The solution used may have been too diluted. It can be corrected by using the correct concentration of the solution.
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