Core HIPAA concepts to memorize:
● Minimum necessary -- access and share only the PHI needed for the
task.
● TPO -- PHI may be used for Treatment, Payment, and healthcare
Operations without separate authorization; most other disclosures
require written authorization.
● Patient rights -- patients may access and request amendment of their
records and receive an accounting of disclosures.
● Disclosures required by law -- mandatory reporting (for example,
certain communicable diseases or suspected abuse) is permitted even
without authorization.
The ARRT Standards of Ethics
● Code of Ethics -- aspirational
● Rules of Ethics -- mandatory and enforceable
● Administrative Procedures -- how violations are investigated and
sanctioned
● Normal adult vital ranges: pulse 60-100 bpm, respirations 12-20/min,
SpO2 95-100% (hypoxemia below 90%), oral temperature about 98.6 F
(37 C), and blood pressure around 120/80 mmHg.
Per the 2017 ACC/AHA guideline, hypertension in adults begins at 130/80
mmHg or higher, while hypotension is generally a systolic below 90
mmHg.
Pediatric patients have faster baseline pulse and respirations than adults
(for example, infants roughly 100-160 bpm and 30-60 breaths/min), so
'normal' is age-dependent.
A focused clinical history uses the sacred-seven and open/closed
questioning to capture onset, location, duration, and the reason for the
exam that the radiologist needs.
Menstrual and pregnancy screening (last menstrual period, the 10-day
rule, and the '28-day rule' concept) is required
● before elective abdominal/pelvic imaging on patients of childbearing
potential.
●
,●
,Key line and tube rules:
● Foley (urinary) catheter: keep the drainage bag below the level of the
bladder to prevent backflow, and never pull or kink the tube during
positioning.
● Chest tube (pleural drainage): keep the drainage unit upright and below
the level of the chest; never clamp or raise it above the chest, which can
cause a tension pneumothorax.
● Nasogastric (NG) tube: avoid dislodging; it drains or feeds the stomach
and its tip should stay in place.
● Central venous line / PICC: tip lies near the SVC/right atrium; handle
sterilely and never tug.
● IV and oxygen tubing: keep patent and untangled; move the pole and
lines with the patient so nothing is pulled out.
Atomic Structure & Electromagnetic Radiation
● Each electron shell holds a maximum of 2n2 electrons (K=2, L=8, M=18,
N=32); the outermost shell never exceeds 8 (octet rule).
The K-shell binding energy of tungsten (Z=74), the standard x-ray target,
is approximately 69.5 keV.
All electromagnetic radiation travels at c = 3 x 10^8 m/s; c = f x lambda,
so wavelength and frequency are inversely related.
Photon energy is directly proportional to frequency and inversely
proportional to wavelength (E = h x f).
, X-rays are ionizing radiation because their photon energy exceeds
electron binding energies, ejecting electrons and creating ions.
Beam Quality/Quantity & Interactions with Matter
● Beam quantity (number of photons) is directly proportional to mAs,
proportional to kVp squared, and follows the inverse square law with
distance.
Beam quality (penetrating power) is measured by half-value layer (HVL)
● Minimum necessary -- access and share only the PHI needed for the
task.
● TPO -- PHI may be used for Treatment, Payment, and healthcare
Operations without separate authorization; most other disclosures
require written authorization.
● Patient rights -- patients may access and request amendment of their
records and receive an accounting of disclosures.
● Disclosures required by law -- mandatory reporting (for example,
certain communicable diseases or suspected abuse) is permitted even
without authorization.
The ARRT Standards of Ethics
● Code of Ethics -- aspirational
● Rules of Ethics -- mandatory and enforceable
● Administrative Procedures -- how violations are investigated and
sanctioned
● Normal adult vital ranges: pulse 60-100 bpm, respirations 12-20/min,
SpO2 95-100% (hypoxemia below 90%), oral temperature about 98.6 F
(37 C), and blood pressure around 120/80 mmHg.
Per the 2017 ACC/AHA guideline, hypertension in adults begins at 130/80
mmHg or higher, while hypotension is generally a systolic below 90
mmHg.
Pediatric patients have faster baseline pulse and respirations than adults
(for example, infants roughly 100-160 bpm and 30-60 breaths/min), so
'normal' is age-dependent.
A focused clinical history uses the sacred-seven and open/closed
questioning to capture onset, location, duration, and the reason for the
exam that the radiologist needs.
Menstrual and pregnancy screening (last menstrual period, the 10-day
rule, and the '28-day rule' concept) is required
● before elective abdominal/pelvic imaging on patients of childbearing
potential.
●
,●
,Key line and tube rules:
● Foley (urinary) catheter: keep the drainage bag below the level of the
bladder to prevent backflow, and never pull or kink the tube during
positioning.
● Chest tube (pleural drainage): keep the drainage unit upright and below
the level of the chest; never clamp or raise it above the chest, which can
cause a tension pneumothorax.
● Nasogastric (NG) tube: avoid dislodging; it drains or feeds the stomach
and its tip should stay in place.
● Central venous line / PICC: tip lies near the SVC/right atrium; handle
sterilely and never tug.
● IV and oxygen tubing: keep patent and untangled; move the pole and
lines with the patient so nothing is pulled out.
Atomic Structure & Electromagnetic Radiation
● Each electron shell holds a maximum of 2n2 electrons (K=2, L=8, M=18,
N=32); the outermost shell never exceeds 8 (octet rule).
The K-shell binding energy of tungsten (Z=74), the standard x-ray target,
is approximately 69.5 keV.
All electromagnetic radiation travels at c = 3 x 10^8 m/s; c = f x lambda,
so wavelength and frequency are inversely related.
Photon energy is directly proportional to frequency and inversely
proportional to wavelength (E = h x f).
, X-rays are ionizing radiation because their photon energy exceeds
electron binding energies, ejecting electrons and creating ions.
Beam Quality/Quantity & Interactions with Matter
● Beam quantity (number of photons) is directly proportional to mAs,
proportional to kVp squared, and follows the inverse square law with
distance.
Beam quality (penetrating power) is measured by half-value layer (HVL)
