Introduction The role of the radiologist is to select the appropriate imaging methods for each radiographic examination and to determine whether the radiographs produced answer the clinical question indicated in the request form. For a radiologist to fulfill their role, they must be able to evaluate patients' clinical information, reason clinically, solve problems and reflect on their practice. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay For this assessment, a radiologist's actions during an observed exam will be described, explained, and justified. The requested examination was that of a 50-year-old man, whose elbows were x-rayed in the radiology department of the emergency room. Discussion Justification for why the exam was requested Justification of a radiographic exam according to Vom et al (2017), is the process by which a professional evaluates the requested medical record exam to see if it is appropriate. The Ionizing Radiation (Medical Exposures) Regulation (IR(ME)R 2000) states that patient exposure to ionizing radiation must not occur without prior justification. Therefore, before undertaking the exam, the radiologist checked that the request form was correctly filled out (i.e. the right name was written on the form) and that the clinical indications and requested tests noted were adequate and justified. The radiologist also checked that the request has been authorized (signed by a registered medical professional who has the right to act as contact person, e.g. a doctor, a radiologist). Under the IR(ME)R Regulations (2000), hospitals are required to provide a list of medical and non-medical contact persons in all areas of the department so that the radiologist can verify that the request is authorised. In this scenario, the clinical notes since the patient stated that he fell with his hands outstretched (FOOSH) and had a painful bilateral radial head, therefore radiographs of both elbows in antero-posterior and lateral projections were requested. The radiologist deemed the exam justified, according to the International Commission on Radiological Protection (ICRP), because the exposure would be more beneficial than harmful because it would allow doctors to see if there is any fracture. Knowledge of a fracture would change and improve the course of treatment for the patient thus overcoming the risk. For professionals to effectively assess whether the benefits of an exposure outweigh the risk, sufficient information must be present in the referral form. This is why the IR(ME)R (2000) requires that submitters provide sufficient information under clinical indication in the submission form so that the clinician can correctly determine whether radiation exposure is or will be beneficial or will affect patient treatment. Positive Patient Identification CheckThe patient's name was called outside the waiting room and the patient was greeted when entering the x-ray room. The provider introduced himself and other people in the room to the patient as a way of establishing a friendly relationship with the patient (Whitley et al 2016). The radiologist proceeded to establish the patient's identity by asking him to state his full name, address and date of birth in accordance with the Trust Ionizing Radiation (Medical Exposures) Regulations (IR(ME)R 2000). This establishes that the operator (individual carrying out the exposure) is responsible for correctly identifying the patient undergoing the medical exposure. The patient's response is then cross-referenced with the formrequest to ensure it matches and that the right person has been identified for the exam. The patient was also asked to confirm that they had requested an examination, to indicate which area or body part needed to be examined and also when the last x-ray examination was carried out. This was done as another means of ensuring correct patient identification and a means of verifying that the referral or clinical indications stated by the referrer match what the patient says. The patient may have already performed the same exam but the images were not uploaded to the PACS and the doctor was able to repeat -examine the patient without knowing that the exam had previously been performed. Therefore, asking the patient to confirm which part of the body needs to be examined and when the last x-ray was taken is a good practice because it reduces the possibility of the patient receiving an excessive dose of radiation by ensuring that the right anatomical area is examined and prevents further tests unnecessary tests in progress due to lack of communication. The Care Quality Commission (CQC) revealed in its 2013 annual reports that incorrect tests resulting from failed identification processes were found to have been reduced by such additional checks of clinical information and previous image checks. It is also advised by the Society of Radiographer (SOR, 2016) that in addition to confirming the patient's name, address and date of birth, practitioners should also confirm clinical information and previous imaging and information with patients, in order to minimize incorrect examination thereby reducing the dose to the patient and ensuring patient safety. The entire process of checking patient identification was carried out within the x-ray room otherwise to maintain patient confidentiality, thus complying with the Health and Social Care Council guidelines on confidentiality (2017) which state that Patient confidentiality must be respected and protected at all times. Required Radiation Protection Considerations Having reviewed the application form and correctly identified the patient according to the Trust IR(ME)R 2000 procedures, the radiographer checked the PACS and RIS for any previous images the patient may have, from previous examinations in compliance with Local Rules (2017). This allows the radiographer to determine in which views the exam should be performed and whether it is necessary since the patient may have already had the exam but was still sitting in the waiting area. Prevents unnecessary tests thus reducing patient exposure to radiation. According to Whitley et al (2016) and local regulations (2017), X-ray doors must be closed and the radiographer must place the X-ray beam away from the door to reduce the likelihood of someone entering during the exposure thus ensuring safety public. The patient's companion was asked to wait outside as the only people allowed in the room during an examination are those whose presence is required for the examination according to the departmental Emergency Department rules (Local Rules 2017). Before the exposure, the radiologist ensured that all people in the room were behind the glass screen as required by local regulations (2017). Professionals are asked to ensure that they remain behind the glass screen during the exposure as it is made of lead (material which can inhibit radiation particles), therefore the radiation emitted from the X-ray tube cannot pass through it ensuring that all people are safe from diffuse radiation. At the end of the exam, the radiology technician made sure that the radiation dose received by thepatient was accurately recorded as required by (IRR, 1999) to enable dose monitoring for patients and dose assessment to ensure patient safety. According to the International Atomic Energy Agency (IAEA, 2016), radiation medical practice can be improved and radiation doses can be reduced without losing diagnostic quality by consistently and accurately recording doses to patients, reporting radiation incidents dose and analyzing all data on doses to patients. They also say that doses tracked for individual patients can help prevent unnecessary exposures, and the information obtained can also be used to establish diagnostic dose reference levels at a national or regional level. Methods used to reduce the amount of scattered radiation and radiation dose to the patient Scattered radiation can be defined as photons that are scattered within the patient's body or within the detector, as stated by Holmes et al (2013). It can also be defined as radiation that has been deflected from an object (e.g. the detector, a table, a wall), by the primary radiation beam leaving the X-ray tube. Scattered photons reduce contrast and image definition. the resulting image or x-ray. The amount of product spread depends on the size of the field or area of ​​the irradiated patient and the distance between the image source and receptor (SID). The increase in scattered radiation produced reduces image quality. To minimize the amount of scatter produced and avoid unnecessary irradiation of the tissue, the radiologist reduced the field size by collimating the X-ray beam to include only the area of ​​interest for the elbow. According to Holme (et al 2013) collimation improves image quality and reduces radiation dose to the patient and staff by minimizing dispersion. The patient was positioned correctly so that the resulting image showed the area of ​​interest and was not repeated as necessary (Whitley et al 2016). The radiologist also checked that the patient's lower limbs and torso were not under the imaging table and therefore not in the primary beam and gonadal shielding was also provided. This was done to protect the lower limbs and gonads from scattered radiation and, at the same time, to certify that the dose to the patient was kept as low as reasonably possible (IR(ME)R 2000). The radiographer took other actions to reduce radiation. dose admitted to the patient, this included preparing the room and primary exposure setting before inviting the patient into the room to minimize motion sharpness (image distortion caused by movement of the patient, equipment or film during exposure). This reduces the likelihood of repetitions thus reducing the dose to the patient. Explanation of the choice of exposure factors made and any manipulation of these carried out The radiographer used exposure factors of 60 kvp (kilovoltage) and 2 mA (milliampere seconds) for both the antero-posterior and the lateral projection of the elbow. According to Whitley et al (2016). KVp is the penetration power of the X-ray beam and mAs is the amount of radiation used. Low, high kVp and low mAs were used because the patient was very thin and the area of ​​interest was small, meaning the radiation did not go through much soft tissue. Therefore, a large amount of high-energy radiation is not necessary as this would unnecessarily increase the patient's dose. It would also be against the IRMER regulations which state that the operator must.