Communication with the patient and their family members or close ones has an essential role in patient care. In order to create a feeling of safety, it is important that the patient can speak their native language.
An 80-year-old man has been brought to hospital due to deteriorated general state and chest pain when straining himself. The patient is wheeled from the emergency unit to the x-ray department. A native thorax image has been ordered. The radiographer has already examined the patient’s history.
R: You’re here for x-rays of your lungs, right?
P: Yes.
R: How do you feel? Can you stand up for the examination?
P: Yes I can.
R: Please stand up with your chest against this frame, holding the handles behind the device. Keep your shoulders relaxed.
P: Should I remove my watch?
R: No need to, it won’t be seen in the image.
R: I’ll give you breathing instructions now. Fill your lungs with air! Hold your breath! You can breathe now.
R: Now turn so that your left side touches the device. You can hold this IV stand. Take a little step backwards and
lean forward a little. Bring your chin up. Raise your chin.
R: Fill your lungs with air! Hold your breath! You can breathe now.
R: Good, we’re done with the imaging now and the images will be forwarded directly to the doctor.
P: So what did the pictures show then?
R: We just take the images here. The doctor will say more about them.
R: The examination is done now. Someone will take you back to the emergency department.
An EMS nurse brings a TIA patient to the radiology department to have a native CT performed on his head. The patient is non-communicative.
R: What’s the patient’s name and personal identity code?
Pm: Matti Meikäläinen, 010243-5678.
R: Thank you. Let’s move the patient bed next to the examination table at a suitable height.
Pm: Alright. Where is the oxygen point? The patient is given extra oxygen 3l.
R: It’s on the wall here on the left. Let’s place a transfer board under the patient’s back.
Pm: (talking to the patient): You’re now in the x-ray department and you will have your head scanned. I’ll turn you
towards me and we’ll place a transfer board under your back, so we can move you onto the examination table.
Nothing to worry about, just stay still.
R: We’ll count to three and we’ll start moving on three, 1…2…3… Let’s move the patient a bit more on the examination table so we can position the head for the imaging.
Pm: Is this good?
R: Yes it is!
R: (talking to the patient): Just relax and stay still, it’s important not to move. The examination won’t take long.
We’ll start the imaging now.
After the imaging.
R: (talking to the patient): We’re ready. From here you will be transferred for further treatment. We’re now going to move you from the examination table back onto your bed.
Pm: (talking to the patient): We need to lay you on your side again and place the board under your back. Let’s move 1…2…3…
R: Thank you. The patient will be taken directly to the thrombolysis unit from here.
Pm: (talking to the patient) Thank you, the nurse and the doctors will continue from here. Have a good day!
A 45-year-old woman with cough, shortness of breath and deteriorated general state comes to an imaging examination. She is transferred into the CT room from the emergency department. The radiographer has already examined the patient’s history.
R: You will be undergoing a computed tomography of the lungs to see if you have pulmonary embolism. We’ll place a hard transfer board under your back and move you onto the imaging table now.
R: During the examination we’ll give you contrast medium. Have you had contrast medium before?
P: No, I haven’t. Should I drink it?
R: No, you won’t drink it. It will be administered through your vein into your blood circulation. Has the cannula been inserted already?
P: I had this cannula inserted in the crook of my arm here…
R: That’s fine, let’s test the cannula with saline, to make sure it works… Does it hurt or sting?
P: no..
R: Good. We’ll administer the contrast medium through this cannula. It may cause a sensation of warmth all over your body, or a metallic taste in your mouth, and you may also feel like you’re wetting yourself. These are all normal sensations, and there’s no need to get frightened. Will you be able to bring your arms above your
head on the examination table?
P: Yes, but it hurts. Do I have to stay in this position for long?
R: The imaging will take a few minutes. We can see and hear you all the time. Let us know right away if there are any problems.
P: Alright. I guess I can manage.
R: During the imaging you will be given instructions. When you’re asked to draw air into your lungs, it’s important to breathe in just lightly, and then hold your breath. Do not fill your lungs with air completely. If you don’t have any questions, we can start.
After the imaging
R: The imaging is over now. Did the contrast medium give you any sensations?
P: Yes, I did have a sensation of warmth.
R: That’s normal. Do you feel otherwise normal now?
P: Yes. Was there something in the pictures?
R: The doctor will review and report the images during the day. The results will be sent to the ward. We’ll now move you back onto your own bed in the same way as before.
The patient has come to the emergency room due to numbness in their hands and feet. The patient is hyperventilating intensely. The doctor has requested blood tests, an ECG, and a capillary blood gas sample.
Before sampling the biomedical laboratory scientist has checked the patient’s personal details, which has been challenging due to intense hyperventilation.
B: The sample is taken from your fingertip, which is why I need to warm your fingers. This will take about 5 minutes…
B: Now your fingertip feels warm enough, I’ll cleanse it, and then it will pinch a little.
B: We didn’t get a successful sample. I’ll apply a plaster here. I’ll warm your fingers again and then we’ll try again.
B: Let’s try another finger. I’ll cleanse the skin and you’ll feel a pinch again.
B: Now the blood flows fast enough. We need to fill two capillary tubes. I have to turn around your hand a little. Keep your hand completely still now. I’ll apply a plaster on the puncture site now.
B: Thank you, I’ve got the samples now. These will be sent for analysis and the results will be sent to your doctor.
A 15-year-old has fallen in a PE class at school and hurt her right wrist. She has come from the emergency clinic to x-ray imaging.
R: Can you tell me your identity code again? Is it possible that you could be pregnant?
P: 1212034321, and no it’s not.
R: Good. You can now sit down on that chair beside that table with your face and feet towards the same direction. Your feet mustn’t be under the table.
R: Let’s place an x-ray -shield on your lap. Then you can lift the injured hand on this plate so that your palm rests on the plate.
P: Like this?
R: Just like that, yes. Which part of the wrist hurts the most?
P: Right here.
R: Ok, I’ll place the hand in the correct position. Tell me if it hurts.
R: I’ll lift the table now. Stay still and gaze away from the wrist. I’ll go and take the image.
The radiographer leaves the imaging room, takes the image and checks that the quality of the image is good. After this the radiographer returns into the imaging room.
R: Turn your hand so that your palm is facing to the side. I’ll lower the table now.
P: Will it take long?
R: One more image, it won’t take long. Gaze away from the wrist. I’ll go and take the image.
The radiographer takes the image.
R: That’s it, we’re ready! The images are good and they’ll be forwarded to the doctor directly from here.
P: Shall I go back to the emergency clinic?
R: Yes, the doctor will review the images and explain the situation.
The patient comes to the abdominal CT scan. The radiographer has already checked the patient’s personal details.
R: You’re going to undergo a CT scan of your abdomen. Have you ever had an imaging examination with iodinecontaining contrast medium?
P: Yes, I’m going to have that examination, but I haven’t had an imaging examination before.
R: Do you have any allergies?
P: I’m allergic to pollen.
R: It doesn’t matter, as long as you don’t have any other allergies. Are you on medication for your diabetes?
P: Yes, but I haven’t taken the medicines for two days as was instructed.
R: Good. And what is your weight?
P: 86 kilos.
R: Expose your upper body and remove your necklace, please. In the imaging room your trousers will be pulled
halfway down your thighs.
R: During the imaging you will be given breathing instructions that you will have to follow. The idea is that you’ll fill your lungs with air, and then hold your breath for a few seconds until the device lets you breathe normally. Before injecting the contrast medium we’ll make sure that everything works fine.
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