Portable X-rays are a critical part of a radiologic technologist’s role, especially in fast-paced hospital environments. Whether you're imaging ICU patients, ER trauma cases, or post-op individuals, portable exams require a unique set of skills, adaptability, and efficiency. Unlike working in a controlled imaging room, performing mobile radiography comes with challenges that demand preparation, critical thinking, and confidence. Here’s how to excel at portable exams.
1. Know Your Equipment
Portable X-ray machines are different from stationary units, and proficiency with them is essential. Before heading out on an exam, ensure you’re familiar with:
- Machine Operation: Learn how to adjust mA and kVp settings to optimize image quality while minimizing dose. Understand tube movement and how to adjust the angle to properly align with the detector placement.
- Battery Life: Always check battery levels before leaving for an exam, and plug in the unit when not in use. If the portable unit is digital, verify the battery life of the detector as well to ensure it is in working order.
- Collimation & Grid Usage: Proper collimation reduces scatter, and knowing when to use a grid improves image quality.
2. Plan Before You Move
Portable exams often require navigating tight spaces, critical-care environments, and unfamiliar layouts. Before setting up:
- Assess route(s) to the rooms requiring portables: If multiple portable exams are occurring simultaneously, evaluate the STAT exam location relative to the others to minimize travel time.
- Communicate with nursing staff: Inform them that you are there for the ordered exam and take the opportunity to ask about the patient’s condition. Are they aware of their surroundings? Can they sit up? Are there any lines that need to be moved out of the way? If patient positioning will be difficult, request assistance from staff before proceeding.
- Confirm patient identity: Always perform the required identification checks before exposing.
- Assess the room: Identify where essential equipment, monitors, and IV lines are located.
- Know patient positioning: ICU beds and surgical positioning may affect how you acquire images.
- Understand different procedures and anticipate what will be needed.
- Know where the patient will be positioned (supine, prone, lateral, etc.).
- Determine which side of the patient you will be on.
- Understand what anatomy the doctor wants to be viewing.
3. Radiation Safety & Communication
Portable exams require extra attention to radiation protection and effective communication. As the tech delivering the radiation, you are responsible for minimizing exposure and ensuring a smooth workflow:
- Communicate with nursing staff before entering the room to confirm patient condition and any necessary assistance.
- Introduce yourself to the patient upon entering the room and let them know you will be performing their exam.
- Explain the process to the patient when possible to ease discomfort or anxiety.
- Assess the patient’s condition to determine mobility, ability to follow instructions, and any obstacles that may interfere with positioning.
- Ask visitors to leave the area while the exam is taking place. Reassure them that the portable exam is very quick, typically taking around 5 to 10 minutes to complete.
- If the patient is sharing a room, inform the neighboring patient that you will be imaging next door. Let them know they do not need to leave, but any visitors should step out. Offer shielding to the neighboring patient.
- Adjust exposure settings to ensure appropriate technique while keeping dose low.
- Set up the exam and maximize distance: Position the equipment in a way that allows for as much distance as possible before making the exposure. Fully extend the exposure cord to maximize distance from the radiation source.
- Announce exposure: Clearly state that an exposure is about to be made so that everyone in the area is aware.
4. Positioning Challenges & Solutions
Unlike imaging in a controlled room, portable exams often mean working around patient limitations. Be prepared to adapt:
- Chest X-rays: Ensure the patient is as upright as possible, use the detector at the correct height, and angle the beam properly.
- Abdomen Exams: A grid will most likely need to be used. Ensure the tube angle is aligned correctly with the grid to prevent grid lines from appearing on the image.
- Ensure full anatomy is captured: Repeat images may be necessary if sections are cut off or misaligned.
- Extremities & Post-op Imaging: Check for weight-bearing restrictions and ensure you’re imaging the correct area per the surgeon’s request.
- Use laterality markers: Always include an "L" or "R" marker to indicate the correct side being imaged.
Final Thoughts
Portable exams demand a combination of technical expertise, adaptability, and professionalism. By mastering your equipment, planning ahead, prioritizing safety, and refining communication skills, you’ll become a more efficient and confident mobile radiologic technologist. Every portable exam is a learning opportunity—embrace the challenge, and you’ll continue to grow in your career.
For more guides and insights into radiologic technology, stay tuned to the Radiography Roadmap series here on the Imaging Staff Blog!