Post on 27-Jan-2021
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Slide 1JSOMTC, SWMG(A)
Chest RadiologyPFN: SOMXRL06
Slide 2JSOMTC, SWMG(A)
Terminal Learning Objective
Action: Communicate knowledge of “Chest Radiology”
Condition: Given a lecture in a classroom environment
Standard: Received a minimum score of 75% on the written exam IAW course standards
Slide 3JSOMTC, SWMG(A)
References
Accident & Emergency Radiology: A Survival Guide (2nd edition; 2005; Raby, Berman, and Lacy)
Learning Radiology: Recognizing the Basics (2nd edition; 2012; Herring)
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Reason
As Special Operations Combat Medics you will need to have a basic understanding of common radiological studies and how they can be used to aid in the diagnosis and treatment of your patients.
Radiology a is vital component of medicine!
Slide 5JSOMTC, SWMG(A)
Agenda
Identify a technically adequate chest x‐ray
Utilize radiological principles to evaluate the structure and function of the chest
Slide 6JSOMTC, SWMG(A)
A Technically Adequate Chest X‐ray
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Slide 7JSOMTC, SWMG(A)
Adequate Chest X‐ray
AdequacyAs realistic image of internal structures as possible
Clinical correlation
Slide 8JSOMTC, SWMG(A)
If not adequate, the image is worthless!
Adequate Chest X‐ray
Slide 9JSOMTC, SWMG(A)
Adequate Chest X‐ray
Adequacy The best views
• PA• left‐lateral
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AP PA
Adequate Chest X‐ray
Affects of Magnification
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Adequate Chest X‐ray
RIP ‐ Rest In Peace R
I
Penetration
spiration
otation
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The spinous process equidistant from clavicular articulation
NO ROTATION
R
Adequate Chest X‐ray
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8‐10 visible posterior ribsINSPIRATION
I
10th
Adequate Chest X‐ray
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Visible T‐spinePENETRATION
P
Adequate Chest X‐ray
Slide 15JSOMTC, SWMG(A)
Rotation
Penetration
Inspiration
R
No Rotation
PenetrationInspiration
P
I YES!
Adequate Chest X‐ray
Is this image adequate?
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Slide 16JSOMTC, SWMG(A)
Radiological Principles to Evaluate the Structure and Function of the
Chest
Slide 17JSOMTC, SWMG(A)
Chest Radiology Principles
Structural Density Contrasting shades
• normal or dysfunctional?
Slide 18JSOMTC, SWMG(A)
Chest Radiology Principles
Anatomical Awareness Trachea/bronchi Ribs ClaviclesArteriesHeartDiaphragms Lungs/pleura Stomach
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Chest Radiology Principles
A B C D E F GAirway Bones Cardiac silhouetteDiaphragms Effusions FieldsGastric bubble
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Chest Radiology Principles
Airway
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Chest Radiology Principles
Bones
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Chest Radiology Principles
Cardiac Silhouette
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Chest Radiology Principles
Diaphragms
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Chest Radiology Principles
Effusions
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Chest Radiology Principles
Fields
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Chest Radiology Principles
Gastric Bubble
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Chest Radiology Principles
Case StudyAdequate? (RIP) Systematic evaluation (A‐G)
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Chest Radiology Principles
Case StudyAdequate? (RIP) Systematic evaluation (A‐G)
Slide 29JSOMTC, SWMG(A)
Questions?
Slide 30JSOMTC, SWMG(A)
Terminal Learning Objective
Action: Communicate knowledge of “Chest Radiology”
Condition: Given a lecture in a classroom environment
Standard: Received a minimum score of 75% on the written exam IAW course standards
11
Slide 31JSOMTC, SWMG(A)
Agenda
Identify a technically adequate chest x‐ray
Utilize radiological principles to evaluate the structure and function of the chest
Slide 32JSOMTC, SWMG(A)
Reason
As Special Operations Combat Medics you will need to have a basic understanding of common radiological studies and how they can be used to aid in the diagnosis and treatment of your patients.
Radiology a is vital component of medicine!
Slide 33JSOMTC, SWMG(A)
Teleconsultation FormatGet a second opinion tele‐consult from medical specialists by submitting a non‐secure email message with relevant attachment (JPEG,ECG,etc)
Used by deployed healthcare professionals Physician, PA, Nurse, SF/IDMT, Medic
No Patient identifying informationNo classified informationPatient Demographics:
Age, Branch of Service, LocationDuration of problemsSymptoms now
Getting Better? Worse? Staying Same?Previous Treatment & Outcome/Effectiveness
Tests & ResultsYour Differential DiagnosisLimitations to Care for Patient
Medications? Procedures? Evacuation?Attachments
Digital Images, Scanned EKG Lab Findings, Radiographs
Include Physician in emailConsults Answered 7 Days/Week
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Teleconsultation FormatConsultation with established contact groups:Burn – Trauma:burntrauma.consult@us.army.milCardiology:cards.consult@us.army.milDermatology:derm.consult@us.army.milInfectious Disease:id.consult@us.army.milInternal Medicine:im.consult@us.army.milNephrology:nephrology.consult@us.army.milNeurology:neuron.consult@us.army.milOphthalmology:eye.consult@us.army.mil
Orthopedics:ortho.consult@us.army.milPediatrics;picu.consult@us.army.milPrevent Medicine/ Occupational Medicine:pmom.consult@us.army.milRheumatology:rheum.consult@us.army.milTraumatic Brain Injury:tbi.consult@us.army.milToxicology:toxicology.consult@us.army.milUrology:urology.consult@us.army.milFor consultations for all other specialties emailMr.(LTC‐retired) Charles Lappan:
chuck.lappan@us.army.milOTSG Telemedicine Teleconsultation Project Manager
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Break