69p Rad Sop Field Unit

Standard Operating Procedures Radiology 1. PURPOSE: a. To provide maximum quality radiographs in an efficient amount of time. b. To establish responsibilities, procedures, policies, and techniques which prevent excessive radiation exposure to patients and staff. c. To set guidelines to be followed for checking radiology systems performance and maintaining optimum image quality and equipment safety for the technologist who operate these systems and the patients as well. 2. SCOPE: This SOP is applicable to all personnel assigned to 4th Division, 3rd Brigade, 64th Brigade Support Battalion, and all Physicians Assistants (PAs) attached. . RESPONSIBILITIES: d. NCOs: i. Responsible for professional radiation and basic radiology training of medical personnel assigned 64th Brigade Support Battalion. ii. Ensure that all radiology equipment is accounted for at all times. iii. Ensure adequate level of medical supplies and equipment are available when needed. iv. Notify Medical Maintenance for repair of any equipment not working or in need of repair, when needed. v. Recommend protective measures to eliminate or reduce radiation hazards to patient or staff during field exercises and or deployment. vi.

Informing all personnel of any changes in procedures that may affect them. 4. PROCEDURES: e. The following complete skeletal survey images will be taken in all cases coming through the radiology section. Anterior Posterior (AP) Chest Anterior Posterior (AP) Pelvis (to include middle and lower lumbar spine, sacrum, and coccyx) f. All extremities will be done separately to include both joints. All extremities will have an AP and LAT (Lateral) views taken. g. All personnel not assigned to the exposure room/area will not be allowed inside or within a 15ft radius during any procedures. h.

Technologists will finish examinations in their rooms as quickly as possible and then prepare for the arrival of injured patients. i. All exams will be treated as STAT. j. Collimation- Restricting the area of the patient irradiated is one of the most effective ways to reduce patient exposure. You should expose as little of the patient as possible. k. Patient Information- Every film must indicate at least three pieces of information vii. Patient name or social security number viii. Date of examination ix. Facility where study was preformed. l. Positioning- Every film will be marked with Left or Right positioning markers.

Without them it may be impossible to tell which side of the patient a particular finding is. m. Gonadal Shielding-will be provided to every patient with “reproductive potential. ” n. All personnel will abide by ALARA x. ALARA-“as low as (is) reasonably achievable,” which means making every reasonable effort to maintain exposures to ionizing radiation as far below the dose limits as practical, taking into account the state of technology. xi. Time, Distance, and Shielding Doses can be minimized by taking advantage of the following simple methods: 1. Reduce the amount of time spent near the radioactive material/source 2.

Increase the distance from the source, by at least 6 feet. 3. Use appropriate shielding (lead aprons and vests) whenever possible ALARA Plan Goals and Investigation Levels| | Regulatory Limit| Goal| Level I| Level II| Whole Body Exposures| 5000 mrem/y| 500 mrem/y| 125 mrem/q| 375 mrem/q| Lens of the Eye| 15000 mrem/y| 1500 mrem/y| 375 mrem/q| 1125 mrem/q| Skin and/or Extremity| 50000 mrem/y| 5000 mrem/y| 1250 mrem/q| 3750 mrem/q| Minors (whole body)| 100 mrem/y| 50 mrem/y| 10 mrem/q| 30 mrem/q| Embryos/Fetus| 500 mrem/9 mnth gestation| 50 mrem/in 9 month gestation period| 10 mrem/q| 30 mrem/q| Member of Public onsite (EPA)| 00 mrem/y whole body exp. | 20 mrem/y| 5* mrem/q| 15* mrem/q| Member of Public offsite (EPA)1| 10 mrem/y with less than 3 mrem due to radioiodine from airborne releases | 3 mrem/y| 1* mrem/q| 3* mrem/q| Environmental Releases2| 10 CFR 20 Appendix B averaged over one year at the unrestricted area boundry. | 10% of 10 CFR 20 Appendix B averaged over one year at the boundary; or listed value at the stack| 10% of 10 CFR 20 Appendix B averaged over the calendar quarter at the boundary; or listed value at the stack. 30% of 10 CFR 20 Appendix B averaged over the calendar quarter at the boundary; or listed value at the stack. | 5. Terminology: o. AP, PA, Lateral xii. Anterior-Posterior (AP)- radiographs that are taken with the patient facing the x-ray tube. So that the x-ray beam enters their anterior side, and exits posteriorly. xiii. Posterior-Anterior (PA)- radiographs that are taken with the patient facing away from the x-ray tube. So that the x-ray beam enters their posterior side, and exits anteriorly. xiv. Lateral (LAT)- radiographs that are taken while the patient stands sideways to the x-ray tube.

They can be done with either the patients left or right side next to the film. Left lateral x-rays are done with the patients left side against the film, Right laterals are done with the patients right side against the film. xv. Oblique- radiographs that are taken halfway between AP or PA and LAT. The patient will be rotated about 45 degrees from lateral or frontal. 1. Left Oblique- Patients left side is closest to the film and the right side is away. 2. Right Oblique- Patients right side is closest to the film and the left side is away. vi. Focal Film Distance (FFD)- describes the distance between the source of the x-ray beam (the focal spot) and the film surface. Also known as Source-Image Distance (SSD), this measurement effects magnification, distortion and x-ray beam intensity. To help reduce variability in these factors, we use only two standard focal-film distances. A long one 72 inches and a short one 40 inches. xvii. Tube Tilt/Angle- some procedures require that the x-ray tube to be angulated either up (cephalad) or down (caudal) a certain number or degrees. xviii.

Central Ray- is an imaginary x-ray that comes right down the center of the entire x-ray beam. We use the central ray (CR) to point the x-ray beam where we want it to go. Most x-ray views will have a specific anatomical point where the CR should be placed. The collimator of the x-ray machine contains a light bulb that illuminates what anatomy is going to be exposed. The center of that light field is marked by cross hairs, which represent the CR. 6. QUALITY CONTROL AND PERIODIC MAINTENANCE p. Daily Tests (conducted by technologists) xix. Inspect system operation and verify operational status. x. Wipe and clean cassettes before and after use. xxi. When performing image QC, look for dust particles, scratches, and mechanical friction marks in the images. If present, immediately remove the corresponding cassette/IP (image plate) and clean as necessary according to the manufacturer’s instructions. Remove IP’s that cannot adequately be cleaned from the inventory. q. Monthly Tests (conducted by technologists) xxii. Erase all plates in the inventory. 7. Equipment r. VERTX READER COMPUTED RADIOGRAPHY xxiii. NSN 6525-01-564-5639 xxiv.

Distributor’s PHONE: (847) 564-0323 FAX: (847) 564-9040 Manufacturer’s PHONE: (310) 921-9559 FAX: (310) 921-2559 Distributor’s Website: ;http://www. minxray. com; xxv. Manufacturer’s Website: <http://www. icrcompany. com/> <http://icrcompany. com/Computed-Radiography/vertx. html> USAMMA POC: Customer Relations Management 301-619-1288/4301 – DSN 343-1288/4301 UNIT PRICE: $73,811. 00 xxvi. System Description: The VertX is the innovative, next generation, truly portable CR at only 59 pounds; it measures 33 by 20 by 6. 7 inches (H x W x D).

It is especially designed for military, mobile, ICU, OR, and all portable applications. It’s patented design incorporates a True Flat Scan Path, an ultra precise scan mechanism, and protective cassettes to produce 300,000+ high resolution images per plate. It accommodates 10- by 12-inch and 14- by 17-inch image plates. The engineering behind the VertX is second to none. It is designed to withstand any environmental conditions while producing superior quality images. Paired with Windows based QPC XSCAN32 software, this machine is by far the easiest CR to operate for all mobile computed radiography applications. ———————————————— PANASONIC TOUGHBOOK WITH DVD RW PART # CF-52 NSN 7010015392249 ACCESSORY & SCANNER CASES| 4 4 READER COMPUTED RADIOGRAPHY PHYSICAL & ENVIRONMENTAL SPECIFICATIONS Item Dimensions| Height (Inches)| 34| | Width (Inches)| 20| | Length (Inches)| 9| | Cube (Cubic Feet)| 3. 5417| | Weight| 59 lbs| Ship Dimensions| Height (Inches)| 43| | Width (Inches)| 28| | Length (Inches)| 20| | Cube (Cubic Feet)| 13. 9352| | Weight| | Storage Temp| | 160 °F| Operating Temp| | 32 to 105 °F| Storage Humidity| | 15 to 95%|

Operating Humidity| | 15 to 95%| Amps| | 3. 5 max| Watts| | 1610 max| Power Requirements| 100-240 VAC, 47-63 Hz| Notes| Scan Cycle Time:72 plates per hour (14 by 17 cassettes)40 second access time (14 by 17 plate)50 second cycle 14 by 17 @ 200 micron scan resolutionBit Depth Resolution: 16 bits/pixel source file 65k shades of grayComputer Configuration:Pentium 4 Class40 GHD 1 Gb RAM (minimum) Windows XP or VistaUSBII high speed interface 1280 by 1024 monitor setting700 to 1 contrast ratio (minimum)| READER COMPUTED RADIOGRAPHY ACCESSORIES & CONSUMABLES – STARTUP

NSN| Notes| Nomenclature| MFR PN iCRco| DIST PN MinXRay, Inc. | QTY| UI| Unit Price| Total Price| Shelf Life Mon. | 6525015645639| Reader Computed Radiography| DSC-VTX- G00-H00| 1| EA$73,811. 00| $73,811. 00| N/A| 6130015928093| Power Supply Uninterruptible| 900-0125| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525015749493| Cap Grid Computed Radiography 14 X 17| RENIARenia GridGRIDCap 14 XCAP17 14X17| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525015749619| Cap Grid Computed Radiography 10 X 12| RENIARenia GridGRIDCap 10 XCAP12 10X12| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 525015749909| Cassette Computed Radiography 10X12| 500-0002-iCRco0910X12CASS| 4| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525015750039| Cassette Computed Radiography 14 X 17| 500-0002-iCRco0814X17CASS| 4| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525015929307| Conversion Mounting Suspension Kit VertX| 50094-01SuspensionKit| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525015929416| Monitor, High Resolution FIMI 2MP| 900-0140-Monitor03Ampro2MP| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525015929473| Test Tool Computed Radiography| EZCR/DR EZCR/DRDINDIN| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525015998096| Switch ComputedRadiography Reader 5-Port Networking| 5 PORT5 PortSWITCHSwitch| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525016009717| Vertx Scanner Case| VRTXVertxSCANNER ScannerCASECase| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525016010809| Case Monitor Computed Radiography| VRTXVrtx AccACCCase 2CASE 2| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525016010810| Case Accessory Reader VertX Laptop| VRTXVrtx AccACCCase CASE| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 525016011615| Stand Computed Raiography Reader 21x11x1| 500-0206- Vertx Base01Stand| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 6525016011623| VertX CR 500-0176-01| 500-0176-iCRco01SCANNER| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| 7010016011384| Computer System Digital Laptop Dell 6400 Non- Touchscreen| 900-0134-10| 2| EAIncl w/NSN5639| Incl w/NSN5639| N/A| NSN Not Required| Cat5E Patch Cable 100’| 100’Cat5ECat5ECable 100 PATCH| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| NSN Not Required| Cat5E Patch Snag 15’| 15’ CatECat5EPATCHCable 15| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| NSN Not Required| Envelopes for CD’s – 100’s| ENVELOP CD Sleeves ES CD| 4| 100/PG Incl w/NSN5639| Incl w/NSN5639| N/A| NSN Not Required| External Hard Drive 160GB 160GB HDExternalHD 160GB| 1| EAIncl w/NSN5639| Incl w/NSN5639| N/A| ACCESSORIES & CONSUMABLES – STARTUP NSN| Notes| Nomenclature| MFR PN iCRco| DIST PN MinXRay, Inc. | QTY| UI| Unit Price| Total Price| Shelf Life Mon. |

NSN Not Required| Formatted CD’s| CDCDFORMATT FormattedED100| 4100/PG Incl w/NSNIncl w/NSN56395639| N/A| NSN Not Required| Patient CD/DVD Software Module| 500-0112-06| 1EAIncl w/NSNIncl w/NSN56395639| N/A| NSN Not Required| Power Cord, VertX| 001-0500-01| 1EAIncl w/NSNIncl w/NSN56395639| N/A| NSN Not Required| QPX Xscan32 Viewing License| 500-0112-02| 1EAIncl w/NSNIncl w/NSN56395639| N/A| NSN Not Required| USB External Video Module| USB EXT VSB-EXT VID MOD| 1EAIncl w/NSNIncl w/NSN56395639| N/A| NSN Not Required| Xscan CR Scan ; Review Software| 500-0112-iCRco28VertxSoftware| 1EAIncl w/NSNIncl w/NSN56395639| N/A| READER COMPUTED RADIOGRAPHY ACCESSORIES ; CONSUMABLES – RESUPPLY NSN| Notes| Nomenclature| MFR PN iCRco| DIST PN MinXRay, Inc. | QTY| UI| Unit Price| Total Price| Shelf Life Mon. | 130015928093| Power Supply Uninterruptible| 900-0125| | 1| EA| $400. 00| $400. 00| N/A| 6525015749493| Cap Grid Computed Radiography 14 X 17| RENIA GRID CAP 14X17| Renia Grid Cap 14 X17| 1| EA| $1,100. 00| $1,100. 00| N/A| 6525015749619| Cap Grid Computed Radiography 10 X 12| RENIA GRID CAP 10X12| Renia Grid Cap 10 X12| 1| EA| $800. 00| $800. 00| N/A| 6525015749909| Cassette Computed Radiography 10X12| 500-0002-09| iCRco 10X12 CASS| 1| EA| $1,046. 50| $1,046. 50| N/A| 6525015750039| Cassette Computed Radiography 14 X 17| 500-0002-08| iCRco 14X17 CASS| 1| EA| $1,295. 00| $1,295. 00| N/A| 6525015929307| Conversion Mounting Suspension Kit VertX| 50094-01| Suspension Kit| 1| EA| $1,495. 00| $1,495. 0| N/A| 6525015929416| Monitor, High Resolution FIMI 2MP| 900-0140-03| Monitor Ampro 2MP| 1| EA| $898. 00| $898. 00| N/A| 6525015929473| Test Tool Computed Radiography| EZCR/DR EZCR/DRDINDIN| 1| EA| $935. 66| $935. 66| N/A| 6525015998096| Switch ComputedRadiography Reader 5-Port Networking| 5 PORT SWITCH| 5 Port Switch| 1| EA| $75. 00| $75. 00| N/A| 6525016009717| Vertx Scanner Case| VRTX SCANNER CASE| Vertx Scanner Case| 1| EA| $1,260. 00| $1,260. 00| N/A| 6525016010809| Case Monitor Computed Radiography| VRTX ACC CASE 2| Vrtx Acc Case 2| 1| EA| $910. 00| $910. 00| N/A| ACCESSORIES ; CONSUMABLES – RESUPPLY NSN| Notes| Nomenclature| MFR PN iCRco| DIST PN MinXRay, Inc. QTY| UI| Unit Price| Total Price| Shelf Life Mon. | 6525016010810| Case Accessory ReaderVRTXVrtx AccVertX LaptopACCCaseCASE| 1| EA| $910. 00| $910. 00| N/A| 6525016011615| Stand Computed500-0206- Vertx BaseRaiography Reader01Stand 21x11x1| 1| EA| $500. 00| $500. 00| N/A| 6525016011623| VertX CR 500-0176-01500-0176-iCRco01SCANNER| 1| EA| $25,515. 00| $25,515. 00| N/A| 7010016011384| Computer System Digital900-0134-Laptop Dell 6400 Non-10 Touchscreen| 1| EA| $0. 00| $0. 00| N/A| NSN Not Required| Cat5E Patch Cable 100’100’Cat5ECat5ECable 100 PATCH| 1| EA| $96. 00| $96. 00| N/A| NSN Not Required| Cat5E Patch Snag 15’15’ CatECat5EPATCHCable 15| 1| EA| $28. 00| $28. 0| N/A| NSN Not Required| Envelopes for CD’s – 100’sENVELOP CD SleevesES CD| 1| EA| $28. 00| $28. 00| N/A| NSN Not Required| External Hard Drive 160GB 160GB HDExternalHD 160GB| 1| EA| $180. 00| $180. 00| N/A| NSN Not Required| Formatted CD’sCDCDFORMATT FormattedED100| 1| 100/PG| $44. 56| $44. 56| N/A| NSN Not Required| Patient CD/DVD Software500-0112-Module06| 1| EA| $1,746. 50| $1,746. 50| N/A| NSN Not Required| Power Cord, VertX001-0500-01| 1| EA| $28. 00| $28. 00| N/A| NSN Not Required| QPX Xscan32 Viewing500-0112-License02| 1| EA| $1,365. 00| $1,365. 00| N/A| NSN Not Required| USB External VideoUSB EXT VSB-EXTModuleVID MOD| 1| EA| $258. 00| $258. 0| N/A| NSN Not Required| Xscan CR Scan & Review500-0112-iCRcoSoftware28VertxSoftware| 1| EA| $2,765. 00| $2,765. 00| N/A| s. MIN RAY- XRAY APPARATUS LOW CAPACITY PORTABLE xxvii. NSN 6525-01-523-1989 xxviii. Manufacturer Model# MINXRAY HF 120/60H POWER PLUS xxix. Distributor’s PHONE: (847) 564-0323 FAX: (847) 564-9040 xxx. Manufacturer’s Website: <http://www. minxray. com> xxxi. USAMMA POC: Customer Relations Management 301-619-1288/4301 – DSN 343-1288/4301 UNIT PRICE: $21,657. 60 xxxii. System Description: The Minxray portable medical x ray system package is a new standard for field deployable and battlefield portable diagnostic radiography.

This system consists of the Model HF120/60HPPWV PowerPlus high frequency portable x ray unit, the Model XGSMKIVLW gas spring portable mobile stand with 16-inch wheels, and the Model HF100HSTC Hardigg mil spec system transport case. ————————————————- GAS SPRING MOBILE STAND WITH 16 INCH WHEELS PART # XGSMKIVLW NSN 6525015231989 ————————————————- HARDIGG MILITARY SPEC SYSTEM TRANSPORT CASE PART # HF100HSTC NSN 6525015235953 X-RAY APPARATUS LOW CAPACITY PORTABLE PHYSICAL & ENVIRONMENTAL SPECIFICATIONS Item Dimensions| Height (Inches)| 9. 5| | Width (Inches)| 8. 8| | Length (Inches)| 16| | Cube (Cubic Feet)| 0. 7741| | Weight| 96. 5 lbs| Ship Dimensions| Height (Inches)| 33| | Width (Inches)| 27| | Length (Inches)| 61| Cube (Cubic Feet)| 31. 4531| | Weight| 221. 5 lbs| Storage Temp| | | Operating Temp| | | Storage Humidity| | | Operating Humidity| | | Amps| | | Watts| | 2,280 @ 120V, 2070 @230V| Power Requirements| Line Voltage: 100-260 VAC, 50/80 Hz| Notes| X Ray Tube: Superior SXR-130-15-1. 2Focal Point: 1. 2 mmAnode Heat Storage: 65 KHUTotal Filtration incl. Collimator: 3. 2 mm Al equivalentFrequency: 80 kHzLine Voltage: 100-260 VAC, 50/80 HzFuse Rating: 30 AElectrical Consumption: 19 A @ 120 V; 9 A @ 230 VMaximum Consumption: 3. 5 kVa ± 10%| X-RAY APPARATUS LOW CAPACITY PORTABLE ACCESSORIES & CONSUMABLES – STARTUP NSN| Notes| Nomenclature| MFR PN MinXRay, Inc. DIST PN| QTY| UI| Unit Price| Total Price| Shelf Life Mon. | 6525015231989| X-Ray Apparatus Low Capacity Portable| MINXRA Y HF 120/60H POWER PLUS| 1EA$21,657. 60$21,657. 60| N/A| 6150015287146See AdditionalNote Below| Cable Assembly Special Purpose Electrical 20′ (No Plug)| SJT-14/3 HG| 2EAIncl w/NSNIncl w/NSN19891989| N/A| 6525015235950| Gas Spring PortableMobile Stand w/16” Wheels| XGSMKIV LW| 1EAIncl w/NSNIncl w/NSN19891989| N/A| 6525015235953| Mil Spec Hardigg Sys Transport Case| HF100HSTC| 1EAIncl w/NSNIncl w/NSN19891989| N/A| 6525015242977| Exposure Cord (25’ Coiled)| 279-295| 1EAIncl w/NSNIncl w/NSN19891989| N/A| X-RAY APPARATUS LOW CAPACITY PORTABLE

ACCESSORIES ; CONSUMABLES – RESUPPLY NSN| Notes| Nomenclature| MFR PN MinXRay, Inc. | DIST PN| QTY| UI| Unit Price| Total Price| Shelf Life Mon. | 6150015287146See AdditionalCable Assembly SpecialSJT-14/31EA$19. 27$19. 27N/ANote BelowPurpose Electrical 20′ (NoHG Plug)| 6525015235950Gas Spring PortableXGSMKIV1EA$2,921. 10$2,921. 10N/AMobile Stand w/16” WheelsLW| 6525015235953Mil Spec Hardigg SysHF100HST1EA$2,250. 00$2,250. 00N/ATransport CaseC| 6525015242977Exposure Cord (25’ Coiled)279-2951EA$23. 53$23. 53N/A| X-RAY APPARATUS LOW CAPACITY PORTABLE ADDITIONAL NOTE: Start-up quantity or unit of issue is different from Resupply quantity/unit of issue Procedures & Positioning