Fluorospot Compact Module 2 - Examination Workflow

Welcome to the Fluorospot Compact web based training series. This series of four modules will cover examination workflow, study and image handling, basic system setup, and postprocessing functions. In this module we will review Examination workflow, to include: starting an exam, verifying information, and performing Fluoro and Radiography Exams. By the end of this module you will be able to: Register a patient via Radiology Information System (RIS) or manual entry Add a study to an existing exam Verify patient information Manipulate technical factors during the exam Perform a Fluoroscopy exam ​ Perform a Radiography exam You should now be able to: Register a patient via RIS or manual entry Add a study to an existing exam Verify patient information Manipulate technical factors during the exam Perform a Fluoroscopy exam ​ Perform a Radiography exam.   In this section we will cover: Starting an exam from a RIS worklist or via manual entry Adding a study to an existing exam. The patient worklist (RIS worklist) is where scheduled patient exams originate. In order to update the worklist: Open the patient subtab Select one of the update RIS worklist buttons. Select the link below to see a demonstration of this process.    Demo - Start Exam from RIS Worklist Demo - Start Exam from RIS Worklist   If there is not a RIS to query or if a patient needs to be added manually use the Create New Study button on the Patient Subtab. All fields that are in bold letters are required fields All other fields are optional For the best workflow and if available enter the Accession number and select the Study Description based on the Exam ordered. Select the link below to see a demonstration of this process.   Demo - Workflow without a RIS worklist Demo - Workflow without a RIS worklist   In some cases, a New Study needs to be added to an Existing Patient.  Highlight the existing patient from the preregistered or examined patient list. Select the Add new Study button in the Patient subtab. New accession number and study description should be entered to create a new exam associated with the selected Patient. Mandatory fields in the pop up box will be grayed out as they won’t change. Fluoro images can be inverted to Bones White (BW) via the Postprocessing tab. The elapsed Fluoro time is defaulted to display in minutes and tenths of a second. Dose display will give the mGY/min (during radiation: Air kerma rate) and the mGy (during and after radiation: Applied dose).  Select Dominant To change the dominant please select the Measuring Fields button.  A drop down box will open and the desired dominant(s) can be selected. Store Image Store images can be sent to the archive node. Mark the store images in the documentation tab  Store Fluoro Tab 30p/s one loop can have approx. 60 s(seconds) 15p/s approx. 120 s 10p/s approx. 180 s 7.5p/s approx. 240 s 3p/s approx. 600 s. *Store Fluoro Loop is currently an option with the Fluoro systems.    Adjust Fluoro Settings Available pulses per second are, 3, 7.5, 10, and 15.  Technical factors: kV, mA, ms are set in the ogp and adjust automatically based on patient size. The millimeters of copper can be set in the fluoro triplet within the PEX Editor. Adjust Acquisition Settings Available frames per second are, 0.5, 1, 2, 4, and 8 Technical Factors: kV, mAs, ms Dose is the Dose per frame (micro Gray) Exposure Correction for DFR images will modify the brightness of the image while maintaining the Dose. DVD Record Option Recommended media DVD-R or DVD+R Multiple patients may be stored on one DVD depending on the size of the case. Reference Image Max of 16 reference images can be stored per study. Reference images are displayed on the Reference monitor which is an option with the fluoro system. Reset Fluoro Timer The timer will activate after 5 minutes of active fluoro time.   The Patient Position and View button is located at the top right of the Rad tab  This function is used to set: Patient Position (Head First, Feet first, etc.) View Position (AP, PA, etc.) Image Laterality (left, right, etc.)  Once a selection is made the parameters will display next to the button Siemens default is set for not defined and it is not required to make these selections prior to performing an exam The technical factors are preset in the PEX Editor for Radiographic exams.  Can be changed on the fly prior to making exposures.  kV and mAs: Click the drop down arrow and select a new value based off of the patient’s size and anatomy.  If the user desires to change the dose based on the patient size or anatomy, select the drop down and the appropriate dose. Exposure Correction can be increased or decreased via the drop down for images that utilize automatic exposure control (AEC). Copper filtration can also be added or removed.  The user can choose between a large or small tube focus as well as the desired tube load.   Increase Exposure or extended exposure is used with AEC when there is a need for a longer exposure time. Select the link below to view a rollover with additional information on technical factors   Rollover - Techincal Factors Rollover - Techincal Factors Base ImageHotspotsText BlocksImage FilemAskVDoseDensity CorrectionCopper FiltrationFocusAutomatic Exposure Control (AEC)Tube Load Select the appropriate Exam and OGP View Rad OGP Views begin with a corresponding letter based on where the exposure will occur When Radiographic OGP View is selected, the Rad Subtab is available for use Default OGP views C cassette T table W wall X table top Enter “Patient Mode” Select the detector overview icon at the bottom of the FLC in the information area.  Detector overview dialog displays all detectors that have been registered on the system   Types of available detectors: MAX wiD MAX Mini wiD Fixed MAX detector Select the link below to view a demonstration of Detector Overview Dialog Demo - Detector Overview Dialog Demo - Detector Overview Dialog   Current collimation is displayed below the Patient Position information.  Measurement unit can be set for centimeters or inches   Current SID and target SID will be displayed below followed by the current and target grid. Target values for both the SID and the grid come from the settings in the PEX Editor. Verify the correct Patient Name is displayed in the middle of the screen. In this example the patient's Accession number is displayed below the name   Verify the desired Organ Program (OGP) view is selected, these are displayed in the upper right hand corner of the FLC