5 Tips for Taking Better X-Rays

5 Tips for Taking Better X-Rays

When I was a student, the most difficult x-rays for me to get right was the lateral knee. No matter what I did or who helped me, the radiograph would always turn out being either over rotated or just funky looking. Eventually, I figured out that by shooting the lateral knee cross-table, that I could get the condyles to perfectly superimpose almost everytime, thus producing a good lateral knee image!

Is there one single view or a series that has been your Achilles heel (pun intended)?

Through my time working in radiography departments, emergency rooms, ortho offices, and, as a mobile radiography tech I have picked up a few tips on what has helped me to get a good radiograph, most of the time.

TIP #1: Learn the Equipment

This sounds like a no-brainer, but not all equipment or imaging rooms for that matter are the same. I have worked at places where each room seemed to have a mind of their own. What I mean by this, is that what worked perfectly in on room would not always work in the other.

Often this was due to having different manufacturers equipment from room to room. For example, one room would have a state of the art Siemens DR equipment where another would have a CR based Philips system dating back to the civil war!

In order to best prepare yourself for success, you need to know the nuts and bolts of these rooms and how each manufacturers equipment works. Here are some examples.

  • Is there auto-collimation or do you have to do all collimation manually?
  • Are the techniques saved within the imaging system accurate?
  • Are there any weird bugs in the room that might cause the tube and IR to not line up correctly or drift?
  • Do you fully understand how to navigate within the imaging system’s computer interface?
  • Is one room better for table work where another has a better upright bucky?

Knowing these points, will not only dramatically increase your chances of success but will also save you from looking confused once you are in the room with the patient.

TIP #2: Learn from your co-workers

I know there can be a tendency within some radiography departments to want to be known as a “RADTECH SUPERSTAR!”

I would be lying if I said that I have not struggled with this in the past, but at the end of the day our job is to help people get better not get a big head because we can get the odontoid 90% of the time!

The way I learned how to get rockstar lateral knee x-rays was that I ate a little crow and asked a senior tech to show me his technique. By doing this, I was able to learn a few simple tips that would have otherwise taken me ten years and over 100 retakes to figure out. This tip was to always shoot the lateral knee cross-table and to have the IR parallel to the femur no the tube. WARNING this technique might not work for you since there are some nuances, but for me, it tends to get the job done.

Tip #3 Learn from bad images

Next time you over rotate an oblige lumber spine or clip the pubic symphysis on a KUB, instead of just repeating the image, take a second to either take a mental note or actually write down what you think caused the image to need repeating.

I am not saying that everytime you have to repeat an image it is your fault, all I am saying is that you can learn a lot from your mistakes.

For example, say your lateral wrist x-rays never seem to be 100% superimposed, and you just can’t seem to figure out if you are rotating too much internally or externally.

Instead of continually making the same mistake, you can purchase an imaging critique book or find some information onlinewhich will help show you what an over or under rotated lateral wrist x-ray looks like. From there, you can try to look at your old images and see if your lateral wrist x-rays look like they are typically over-rotated or under-rotated. Doing this is extremely useful for extremities and spines.

Tip #4: Do the same thing every time

There is a saying in the hospital world, “first time every time.” At my old job, we use to say this about the endoscopy department. It seemed like every case was their first. They would call us 5 seconds before the physics was ready for images (GERRRR!!) and they never knew any of our names (we had all been there for years), and the list goes on and on.

Don’t be the endo department of x-ray! What I mean by this is that you should try to do the same thing every time, IE having a system.

For example, when I am performing an exam, I will always do the same thing in the same order (if possible). This includes (before I get the patient), getting the room ready, pulling the patient’s information up on the computer, having the correct exposures set on the imaging system, having the cassette in the buck (if the room is not DR) having the tube set to correct SID, and so on. When the patient is in the room. I will always say the same thing and do the images in the same order (AP, OBL, LAT). Doing this helps me not only be efficient but also very consistent. After I started doing this, it was like my brain already knew what the next step was, so I could focus on if the anatomy was positioned correctly collimation, and imaging factors.

This was particularly helpful when doing mobile radiography since with this kind of work; you never know what situation you are going into.

Tip #5 Be patient

No one likes to hear this, but it takes a while before you get good at this.

I get it when you are a new tech you want to take over the world and have statues made of you to commemorate you as being the god amongst all other technologists!

Sorry, but it does not work that way. Taking great x-rays is an art, and you are going to have to take a lot of them before you get good at this.

With that said, I am 100% confident that if you follow the steps I have outlined, you will become a better technologist much faster then if you just did nothing.

I would love to continue this conversation.

What can you add to this blog post that may help others take better x-rays?

Written by Ari B – Founder of Radtechbootcamp.com

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4 Steps for CRUSHING the ARRT Radiography Exam

Ok, so you took all the classes, worked for free (clinical), and paid a bunch of money. You have taken your LAST X-Ray tech school exam and are now ready to sit for the ARRT Radiography Certification Exam. If you are human, you are now probably freaking out on the inside! I mean, what if you fail? How could you ever face your friends or classmates? Ok, it’s not that big of a deal, many students have to retake their ARRT Certification Exam, and at the end of the day, the only thing you are out of is time and money.

Here at Clover learning, we take radiography education pretty seriously, I mean that is why we built RadTechBootCamp!

Our team of instructors traveled to our undisclosed underground bunker with the sole mission to create the best 5 step Radiography blog post of all time. I think we have succeeded in this mission. So without further ado, here are the 5 steps to crushing the ARRT Certification Exam.

Step 1: Stop FREAKING OUT!

Seriously, even though this seems like the biggest single moment of your life, it really isn’t. As I mentioned, this is just a test. Say, the worst case scenario is that you do not pass the radiography exam the first time around, you can always reschedule and simply take the exam again. The American Registry of Radiographic Technologists (ARRT) allows for the Radiography certification exam to be taken up to three times. Not that it will come to that, but it is always nice to know you have multiple attempts!

Stress decreases your memory.

An article by www.bebrainfit.com titled “12 Effects of Chronic Stress on Your Brain” outlines the neurological effects stress can have on individuals. The article explains that stress increases cortisol (the stress hormone) within our bodies. Although cortisol is good in some cases, when overproduced the outcome can result in decrease working memory. The article goes on to talk about how stress also causes the down-regulation of the neurotransmitters dopamine and serotonin. For those not familiar, these neurotransmitters are how your brain stays happy. Often low levels of serotonin and/or dopamine lead to clinical depression.

What I recommend individuals do to decrease stress is simply put everything in perspective. Like I mentioned earlier, THIS IS JUST A TEST! Even if you do not pass the first time around, you still have a family who loves you, friends that support you, and hopefully a roof over your head. Since passing a test will not affect any of these things, you need not make it this gigantic impending thing.

Take a few deep breaths in and out and begin to look at the ARRT Radiography certification exam as simply the culmination of your radiography education. Look, you have made it this far so obviously you are capable of passing a test.

Step 2: Study smarter not harder.

I am going to tell you a little secret… Most of what is in your ARRT certification exam prep book will probably not be on your board exam.

When I was preparing for my ARRT certification exam I had the prep book, I had the online practice test subscription, and I had the HUGE pile of flashcards. My “strategy” for taking the board exam was to simply memorize everything before the big day. I spent hours upon hours doing mock exams, going over flashcards, and highlighting everything in my exam prep book. Yes, I passed my board exam the first time around, but even after all that studying, there were still concepts like the line-focus principle that I did not fully understand.

In retrospect, I could have saved myself TONs of time and possibly even increased my test score by simply identifying the key subjects that I did not really understand. Instead of trying to memorize everything, I could have spent a bulk of my time, REALLY learning those topics. This philosophy was actually my motivation for creating the RadTechBootCamp.com website.

Let me explain, if you really look at the test prep books, they are only asking you the same basic questions in different ways. What I discovered is that when you ACTUALLY understand the underlying concepts (like the line-focus principle), you can significantly decrease study time.

Why is this?

This is because when you fully understand a key concept, you are now able to effectively identify the correct answers. By fully learning the main concepts within radiography, the confusion begins to lessen and the study time begins to plummet.

Time for a little self-promotion. This theory of learning vs. memorizing is the framework of what RadTechBootCamp.com is all about. We fundamentally believe that what sets us apart from all other websites is that we don’t simply test you on what you already know. Instead, we deliver the information in a way that “teaches” students the fundamentals. After you have learned the key concepts, you can then test that knowledge by taking quizzes or a mock exam.

Step 3 Crap in crap out.

I am sure you have heard the adage, “you are what you eat.” This is something I completely agree with! I am sure we have all heard stories of individuals going out the night before a big test to “have a few” and inadvertently waking up the next morning with a massive hangover. I have actually heard of people doing this the night before their ARRT certification exam! Now it is not my place to judge anyone, but seriously after all the work, time, and money you have put into your education couldn’t you wait one more night!?

This advice includes more than just alcohol though. This advice includes foods with high amounts of sugar (including sugar soft drinks), fried foods, sugar substitutes (like sweet’n low), and heavily processed foods (like white bread, pasta, and pizza). The effect these foods have on your brain is they can cause a condition commonly known as brain inflammation or brain fog. Brain fog is best described as those times where everything in your head just seems muddy like you are trying to remember a word and no matter how hard you try you just can not think of it. For me, brain fog is when I am trying to write, and the words just are not able to come out.

For best results, don’t just clean up your diet the night before the big test but instead try a MONTH or at least the week before.

Here are some recommendations for foods that actually make you smarter.

  • Lean beef
  • Green leafy vegetables (spinach, kale, swiss chard, romaine lettuce)
  • Avocados
  • Blueberries
  • Broccoli
  • Coconut Oil
  • High-quality eggs
  • Extra Virgin Olive Oil
  • Seeds and nuts

Step 4: Sleep

This is a huge one as well. In today’s culture of social media, Netflix, Hulu, and YouTube it is so easy to look up from your screen and realize it’s two hours past bedtime. What you might not realize is that if you are getting less than 7-8 hours of sleep a night, then your brain is probably not functioning as good as it could be. Here is a quote from a Physiological Review article. “Over more than a century of research has established the fact that sleep benefits the retention of memory.” I totally understand that there are some circumstances in where it is just not possible to get the recommended amount of sleep. For those individuals, I recommend doubling down on cleaning up your diet. For everyone else, I recommend trying to stick to a consistent bedtime schedule. For me, I try to alway go to sleep between 10 pm and 10:10 every night. I realize this is pretty early to some but with my lifestyle and family commitments this allows me to wake up at 6 am every morning rested and ready to take on the day!

Just like with the diet recommendation, I recommend sticking to a 7-8 hour sleep time, a good week or so before taking your ARRT Certification exams. Trust me on this, after about three good nights of sleep, your brain will feel like a well-oiled machine. You will be able to remember things that will even surprise you!

Step 5: Believe in yourself

In this final step, I simply want you to stop for a second and take a moment to do a heart check. As I mentioned, you have made it this far. You put up with all the mean, unhelpful techs at your clinical site, you passed all the required tests at your school, and you most of all put your life on hold for your radiography education. You can do this! Ok, so maybe you are not the best test taker in the world, or maybe you have zero confidence. I simply want you to take a few moments to reflect on all you have achieved so far and begin to start to believe that you can do it!

Ari Blum Founder: Clover Learning

5 Tips for Taking Better X-Rays

When I was a student, the most difficult x-rays for me to get right was the lateral knee. No matter what I did or who helped me, the radiograph would always turn out being either over rotated or just funky looking. Eventually, I figured out that by shooting the...

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Ok, so you took all the classes, worked for free (clinical), and paid a bunch of money. You have taken your LAST X-Ray tech school exam and are now ready to sit for the ARRT Radiography Certification Exam. If you are human, you are now probably freaking out on the...

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