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1. E os on ovon oson 90 oson oson 09 09 SNLVLS WYN 5 42107105 435 0 40 6 640524 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 133HS AYN S 1 47813 6 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 435 4 5916 WHOS ou Jo 10 2020 28 180 y 10 12 1020 28 180 9U JO 12 pejndwog 0020 228 180 10 6610 28 180 bales teasing je1eued 8220 28 180 ft tt ft eee pene ei ole dee peewee pre eres eS ae ahs a SE a sii pt _____ ____ _____ __ __ TES ee
2. 1 5 1 9 0 1 7 Chapter 2 2 1 251 2 1 2 2 Part One Section Subject Area 2 3 2 3 Part One Section Duty Position Training Requirements 2 4 2 4 Part Two Critical 2 5 DISTRIBUTION RESTRICTION Approved for public release distribution is unlimited This publication supersedes STP 8 91P15 SM TG 9 September 1994 STP 8 91P15 SM TG Chapter 3 MOS Skill Level 5 2 2 1 2 3 1 Skill Level 1 Subject Area 1 General Medical 081 823 0306 HANDLE PATIENT USING PROPER BODY 3 1 081 823 0312 ASSESS PATIENT CONDITION BEFORE 3 3 081 823 0316 MAINTAIN RADIOLOGY EMERGENCY EQUIPMENT TRAY CART 3 4 081 831 0007 PERFORM A PATIENT CARE 3 5 081 831 0035 MANAGE A CONVULSIVE AND OR SEIZING PATIENT 3 7 081 831 0018 OPEN 5 3 10 081 831 0019 CLEAR AN UPPER AIRWAY 3 12 081 831
3. N A Evacuated the casualty Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 36 STP 8 91P15 SM TG References Required Related None BTLS FOR PARAMEDICS EMERGENCY CARE 3 37 STP 8 91P15 SM TG APPLY RESTRAINING DEVICES TO PATIENTS 081 833 0076 Conditions You have identified the patient and explained the procedure An assistant is available You will need a bed wrist and ankle restraining devices ABD pads padding materials litters flexible gauze Kerlix Kling rifle slings web belts elastic bandages bandoleers cravats and sheets Standards Applied restraining devices to a patient without causing injury to the patient or yourself Performance Steps NOTE a field environment the need for restraints be your own decision especially in the absence of senior medical personnel 1 Apply wrist and ankle restraints NOTE lf you apply ankle restraints also apply wrist restraints WARNINGS 1 Do not attempt to apply restraining devices by yourself Get adequate help 2 A patient who is depressed or has an altered level of consciousness should be positioned on the stomach with the head tu
4. os on ovon oson 90 oson oson 90 09 09 arias cae AGEN SNLVLS 6 3 01065 Y3SN OL JO 8 SdOSDq 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 1 Mood 1 91913 9 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 136 4 9915 JO YUN AydesBolpey 0002 9610 28 180 LO e1edeld 8610 28 80 10 108609014 Pied eredaid 2910 28 190 yun 6 0 28 80 MM wun 2 SAINdIA 2610 228 80 wasis 2568 50 SAINAI 2610 28 180 seis Nek a ete aes asennad 104 JUSWSAOW 104 0021 10 2220 228 180 5 10 060 628 180 os on ovon oson oson oson oson 09 09 IGE SNLVLS
5. 3 125 STP 8 91P15 SM TG Performance Measures 9 Positioned the leg a AP view b Lateral view 10 Placed a sandbag against the sole of the foot or toes 11 Placed the appropriate identification marker on the cassette 12 Placed the lead apron across the patient s lap 13 Gave the patient the pre post exposure instructions 14 Made the exposure 15 Developed the exposed cassette s with patient identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None 3 126 Related BONTRAGER KENNETH STP 8 91P15 SM TG X RAY THE KNEE 081 823 0121 Conditions You have a request for a radiologic examination of the knee You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sandbags lead shielding letter markers and various positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materi
6. 081 823 0175 MANIPULATE COMPUTERIZED IMAGE FOR INTERPRETATION 081 823 0176 PRINT A COMPUTERIZED 081 823 0177 DISPLAY IMAGES FROM DIGITAL 081 823 0178 ACQUIRE IMAGES USING COMPUTED RADIOGRAPHY PICTURE ARCHIVAL AND COMMUNICATION SYSTEM CE GS 081 823 0203 ARCHIVE IMAGES TO OPTICAL DISK SYSTEM 081 823 0321 DIGITIZE CONVENTIONAL RADIOGRAPHIC 5 081 823 0324 TRANSMIT IMAGES USING TELERADIOLOGY SOFTWARE AND HARDWARE 081 823 0328 INITIATE CR APPLICATIONS SOFTWARE AND HARDWARE Subject Area 12 Film Processing 081 823 0170 MAINTAIN THE AUTOMATIC FILM PROCESSOR 081 823 0179 PROCESS FILM USING AN AUTOMATIC FILM PROCESSOR 081 823 0241 MAINTAIN 081 823 0242 MAINTAIN INTENSIFYING SCREENS AND 5 Subject Area 13 Field Set Up 081 823 0154 PREPARE THE DARKROOM TENT FOR FIELD 081 823 0186 PREPARE THE FIELD X RAY PROCESSOR FOR OPERATION 081 823 0187 PREPARE THE COMPUTED TOMOGRAPHY CT SCANNER OP BD IM stage nes 081 82
7. a 9120 228 180 9020 228 180 os on ovon oson 90 oson oson 09 09 SNLVLS WYN 5 42107105 435 Ol 30 640524 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 133HS AYN S 1 47813 2 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 116 4 5916 WHOS sesnuls 9610 228 180 INAS 92 0 228 780 9010 28 180 E SPU 10 4 9010 628 180 926 10 10924 einsodxy 01 0 629 180 Gis 104 00 28 80 pue 10 SEW 1010 28 180 6100 1 8 480 i i precede Weal seed einsseld Squened INSE N 2100 18 180 Pe eis Herel 0 00 8 80 EA asind
8. Removed the pipe assembly lower section with gear box assembly from the reusable container and prepared it for use Slid the pipe assembly lower section forward approximately one inch and lifted the two locking handles up to the vertical lock position 3 247 STP 8 91P15 SM TG Performance Measures GO 86 4 Removed pipe assembly upper section from the reusable container prepared for use Cranked gear box assembly up to a comfortable working height Removed cross arm assembly from side of stand assembly Lifted x ray generator assembly from the reusable container Lifted control assembly out of reusable container and prepared it for use Attached line cord to control assembly LINE IN connector N Attached exposure switch cable to control assembly HAND SWITCH connector and connected end of the interconnect cable to the control assembly LINE OUT connector and the remaining end to the x ray generator assembly connector Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None CUSWORTH RITA J RADIOLOGY BRANCH SOP 3 248 STP 8 91P15 SM TG PREPARE FOR
9. 6 Allowed software based initial Self Test to assess operational status NOTE Self Test should have taken less than 5 minutes from power initiation to complete In the event that it did not complete this function in the allotted time or identified system software problems soldier notified qualified repair personnel immediately 7 Entered user name and password when prompted 8 Selected appropriate application from menu Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 225 STP 8 91P15 SM TG Subject Area 12 Film Processing MAINTAIN THE AUTOMATIC FILM PROCESSOR 081 823 0170 Conditions You have an automatic processor that needs to be cleaned You will need cleaning supplies protective apron goggles replenishing solutions developer recirculation filter water source cleaning materials manufacturer s instructions for the developing and fixing chemicals starter and disposable towels Standards The automatic processor produced consistent quality radiographs Performance Steps 1 Gather the following materials a Cleaning supplies b Protective apron and goggles c Disposable towels d Replenishing solutions e Starter
10. einseaW 1100 4 8 80 Aunfuy feuds peyedsns podsuesL 2600 229 180 seoed Bulujensey Addy 9200 88 180 os on ovon oson 09 90 oson oson o9 90 09 09 AEE EA SNLYLS JWYN 6 3 01065 NOILY NddY Y3SN Ol 30 2 640524 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 133HS Mood 1 91913 A 3 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 435 4 5916 WHOS L 9110 28 180 Ui E a weno ine 2110 28 180 1110 28 190 ss a a ESS a a Poa We 2 y 2710 8 80 pi ty saan oa a ie i 8610 228 180 os on ovon oson 90 oson oson 90 09 09 SNLVLS WYN 5 42107105 435 0 30 640524 5 Aouebe y 76 066 YY 998 10 SIY
11. os on ovon oson 90 oson oson o9 90 09 09 SNLVLS 6 3 01065 Y3SN 40 9 640524 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 Mood 1 91913 7 STP 8 91P15 SM TG 90 09 oson 09 09 11410560 SI 28 40 NOILIGS SNLYLS 0 302 133 8 8 30108 98 438 4 9918 YA 17 0 28 180 10 00014 ue 2014 6210 228 180 1 0210 228 180 9 YUI 8260 629 180 7220 228 180 Z4 IA 1220 228 180 wayshs 2020 228 180 8210 228 180 eysa 2710 28 180 e yud 9210 28 180
12. 3 113 STP 8 91P15 SM TG Performance Measures 12 Gave the proper pre post exposure instructions 13 Made the exposure 14 Processed the film with the patient s identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None 3 114 Related BONTRAGER KENNETH STP 8 91P15 SM TG Subject Area 5 General Radiography Lower Extremities X RAY THE FOOT 081 823 0117 Conditions You have a formal request for a radiologic examination of the foot You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Tape Positioning sponges Lead shielding Calipers
13. 3 259 OPERATE CR EXAMINATION 3 260 OPERATE CR ACQUISITION 3 261 OPERATE CR PLATE READER 3 263 OPERATE ACR 2000 COMPUTED RADIOGRAPHY UNIT 3 265 Subject Area 15 Field Movement PREPARE THE DARKROOM TENT FOR 3 267 PREPARE DEPMEDS RADIOGRAPHIC UNIT CS 8952 FIELD DEPLOYABLE X RAY SYSTEM CONTINENTAL FOR MOVEMENT 3 269 PREPARE DEPMEDS RADIOGRAPHIC UNIT PICKER CLINIX FOR MOVEMENT 3 271 PREPARE DEPMEDS PORTABLE RADIOGRAPHIC UNIT MODEL 1200 FOR 3 273 PREPARE THE FIELD X RAY PROCESSOR FOR 3 275 PREPARE THE COMPUTED TOMOGRAPHY CT SCANNER FOR MOVEMENT 2 3 276 PREPARE ACR 2000 COMPUTED RADIOGRAPHY UNIT FOR 3 277 Subject Area 16 Quality Control EVALUATE DEVELOPED 3 279 PERFORM SCREEN FILM CONTACT TEST 3 281 TEST FOR SECONDARY SCATTER 3 283 FORMULATE TECHNIQUE CHARTS FOR RADIOGRAPHIC Skill Level 2 Subject Area 17 Admin SL2 PERFORM COLLIMATOR QUALITY CONTROL 3 289 DEVELOP A STANDING OP
14. 4 Correct or report unacceptable deficiencies to the appropriate authority Performance Measures GO 1 Gathered the proper materials 2 Followed the correct procedure cleaning the processor a Drained the tanks b Thoroughly cleaned racks and rollers and inside of processor c Properly refilled tanks 3 Checked the following Developer temperature Fixer temperature Wash temperature Replenishing rates Water flow rate Processing time 4 Corrected or reported unacceptable deficiencies to the appropriate authority Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C 3 227 STP 8 91P15 SM TG PROCESS FILM USING AN AUTOMATIC FILM PROCESSOR 081 823 0179 Conditions You have a fully operational automatic processor and a processing darkroom with which you have to process film You will need an automatic film processor manufacturer s instructions for the operation of the automatic film processor an exposed radiographic film and processing chemicals Standards Produced films of consistent quality and free of artifacts IAW the manufacturer s
15. 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use 1 2 of a 10 X 12 cassette for each view 7 Place the cassette on the table crosswise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the portion of the film being used d Adjust the conefield to full field coverage for the 1 2 of the film 9 Position the elbow a AP view 3 92 STP 8 91P15 SM TG Performance Steps 1 Place the arm in full extension with the palm facing up and the shoulder at the same level as the cassette 2 Position the epicondyles parallel to the cassette 3 Center the elbow to the appropriate half of the cassette 4 Center the midepicondylar plane to the cassette b Lateral view 1 Flex the elbow to 90 degrees 2 Position the epicondyles and styloids perpendicular to the cassette 3 Ensure the shoulder is on the same plane as the cassette with the humerus in contact with the tabletop 4 Center the elbow to the appropriate half of the cassette 5 Center the lateral epicondyle to the cassette NOTE The humerus should enter the upper edge of the cassette with the forearm exiting the lateral edge 10 Immobilize the body part
16. Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central Set the control panel Selected the proper size film cassette Placed the cassette in the bucky lengthwise Positioned the overhead tube iLi f 8 ON DO A Positioned the lumbar spine a AP view 3 175 STP 8 91P15 SM TG Performance Measures b Lateral view c L 5 S 1 Spot 10 Placed the appropriate identification marker on the cassette 11 Placed the lead apron across the patient s lap 12 Gave the proper pre post exposure instructions 13 Made the exposure 14 Developed the exposed film with the patient s identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None 3 176 Related BONTRAGER KENNETH L STP 8 91P15 SM TG X RAY THE SACRUM AND OR COCCYX 081 823 0134 Conditions You have a formal request for a radiologic examination of the sacrum and or coccyx You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes
17. Identified the standards that guide the service performance Identified the staffing guide and job descriptions Identified the standards for the performance of specific procedures and functions applicable to the radiology service Identified the names of those licensed or authorized to request Imaging services Identified any references used in the development of the SOP document Radiologist Director of Radiology or senior authority for the radiology service or department GO 3 293 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related 10 CFR 20 TB MED 521 AR 11 9 AR 40 66 DA PAM 611 21 JCAHO MANUAL 3 294 STP 8 91P15 SM TG REQUEST SUPPLIES AND EQUIPMENT 101 92Y 1111 Conditions a classroom given authorization document s a computer with FED LOG CD ROM drive and a forms program student handouts with all required forms and publications pens and pencils and practical exercises PE Standards Prepare a supply request without rejection from the source of supply SOS IAW DA Pam 710 2 1 AR 25 400 2 and ULLS S 4 EM Performance Steps 1 Determine authorization documents required
18. References Required Related None CUSWORTH RITA J MOSS ALBERT A RADIOLOGY BRANCH SOP 3 215 STP 8 91P15 SM TG Subject Area 11 Computed Radiography CR PROCESS AN IMAGING PLATE 081 823 0174 Conditions You have exposed the patient The processing terminal is on line The CR plate reader is on line You will need imaging plate bar code scanner and Defense Imaging Network Picture Archiving and Communications Systems DIN PACS operating instructions Standards Processed an imaging plate IAW manufacturer s specifications Performance Steps 1 Take exposed imaging plate s to the processing terminal 2 Ensure that the processing terminal is on line and ready 3 Scan the patient information barcode or select patient information from the acquisition work list to enter patient s imaging information 4 Check the patient information to ensure that the correct plate is registered to the performed examination 5 Register imaging plate information using plate barcode and scanner 6 Insert radiographic cassette into plate reader 7 Remove freshly loaded cassette Performance Measures GO 1 Took exposed imaging plates to the processing terminal 2 Ensured that the processing terminal was on 3 Scanned the patient information barcode or selected the patient from the acquisition work list to enter the patient s information 4 Verified the patient information to ensure that the correct plate was to
19. Removed the thermometer and wiped it down with gauze square Read the scale I A Placed the thermometer the proper used canister or disposed of the plastic sheath as appropriate 3 55 STP 8 91P15 SM TG Performance Measures GO 8 Recorded the temperature to the nearest 0 2 F the appropriate forms and reported any abnormal temperature change immediately to the supervisor Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 56 STP 8 91P15 SM TG Subject Area 2 Basic X Ray Skills MAKE CALCULATIONS FOR mA AND TIME RELATIONSHIP 081 823 0101 Conditions You have any two of the following factors mA time S or mAs Standards Calculated the third factor without error Performance Steps 1 Calculate the third factor using one of the following formulas mAs mA xS mA mAs S 5 mAs mA Performance Measures GO 1 Calculated the third factor using one of the following formulas mAs 5 mA mAs S S 5 Evaluation Guidance Score each soldier according to the performance measures in the evalu
20. Rotated and flipped image orientation if necessary Adjusted window level values Verified image performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 217 STP 8 91P15 SM TG PRINT A COMPUTERIZED IMAGE 081 823 0176 Conditions You have the appropriate privileges to print images Standards Printed a computerized image of diagnostic quality IAW DIN PACS and department SOP Performance Steps 1 Select the on line exam from the work list window 2 Select Display Exam from the Images menu 3 Select the printer from the Option menu 4 Select the number of images to be printed on a single sheet from the Format pop up menu Enter the number of copies the Copies field 6 Select Print Performance Measures GO 1 Selected the on line exam from the work list window Selected Display Exam from the Images menu Selected the printer from the Option menu is Selected the number of images to be printed single sheet from the Format pop up menu Entered the number of copies in the Copies field 6 Selected Print Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measu
21. 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the exposed cassette s with patient identification Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient 2 3 4 Measured the body part through the entry exit of the central ray 5 Set the control panel 3 148 STP 8 91P15 SM TG Performance Measures N 1 11 12 13 14 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Selected the proper size of film cassette Placed the cassette in the bucky according to the desired position Positioned the overhead tube Positioned the ribs Placed the appropriate identification marker on the cassette Placed the lead shield around the patient s waist Gave the proper pre post exposure instructions Made the exposure Developed exposed cassette s GO 8 performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 149 STP 8 91P15 SM TG X RAY THE STERNUM 081 823 0127 Conditions You have a request for a radiologic examination of the sternum You have the
22. 3 186 081 823 0146 ASSIST PHYSICIAN WITH SMALL BOWEL 3 189 081 823 0147 ASSIST PHYSICIAN WITH BARIUM ENEMA 3 191 081 823 0149 ASSIST PHYSICIAN WITH INTRAVENOUS 3 194 081 823 0238 ASSIST PHYSICIAN WITH 3 197 Subject Area 9 Other Procedures 081 823 0228 PERFORM X RAY STUDY DURING GENERAL SURGICAL PROCEDURE nee ene ence eres 3 200 STP 8 91P15 SM TG 081 823 0229 PERFORM SOFT TISSUE 0 Subject Area 10 Computerized Tomography CT 081 823 0199 PERFORM UNENHANCED COMPUTED TOMOGRAPHY CT OF 081 823 0200 PERFORM UNENHANCED COMPUTED TOMOGRAPHY OF cece 081 823 0201 PERFORM UNENHANCED COMPUTED TOMOGRAPHY OF THE ABDOMEN AND PELVIS wicccctcisssttsaccscsitecnsonansescesesessatieinecenaivceciedeaneent 081 823 0202 PERFORM COMPUTED TOMOGRAPHY CT EXAMINATION OF THE SPINE tat elias 081 823 0368 081 823 0379 PRINT IMAGES Subject Area 11 Computed Radiography CR 081 823 0174 PROCESS AN IMAGING
23. 9 Position the patient for the follow up radiographs a PA view 1 Place the patient prone on the table with their arms positioned at the side of their body 2 Position the midsagittal plane perpendicular to and over the centerline of the table 3 Place the iliac crest 5 inches below the center of the cassette b Lateral view 1 Place the patient in the right lateral recumbent position on the table 2 Flex both knees and position the arms at the right angle to the body 3 Adjust the coronal plane perpendicular to the table 4 Position the midpoint between the coronal plane and the anterior surface of the abdomen over the centerline of the table 5 Place the iliac crest even with the lower edge of the cassette c RAO view 1 Place the patient prone on the table 2 Rotate the coronal plane to form a 45 degree angle to the cassette 3 Center the trunk to the cassette 10 Tell the patient DO NOT BREATHE OR MOVE 11 Make the exposure 12 Tell the patient RELAX AND BREATHE NORMALLY 13 Develop the exposed film with the patient s identification Performance Measures GO 1 Selected the required view s based on the request 2 Gathered the necessary materials and supplies 3 Attached all required accessories to the table 4 Prepared the contrast medium NOTE Ensured the appropriate contrast medium was being used and verified the expiration date 5 Prepared the equipment for fluoroscop
24. NOTE Lead letter markers A and F can be used instead of the ninth penny g Center the beam alignment test tool to the cassette h Place the lead letter markers indicating the room number and the date i Make the exposure NOTE Recommended technique to use is 60 kVp and 5 mAs j Process the film 3 Evaluate the film a Verify the test tool dots NOTE The dots of the beam alignment test tool must be superimposed over each other and fall within the center circle b Check the radiation field 1 Acceptable falls within half a penny s distance from centerline 2 Unacceptable exceeds more than one penny NOTE lf the radiation field enters the halfpenny dead zone monitor the performance of the machine 4 Report unacceptable results to the appropriate authority 3 289 STP 8 91P15 SM TG Performance Measures GO 1 Gathered the equipment and materials 2 Performed the collimator quality control test Placed the cassette lengthwise on the table b J Q Set the source to image receptor distance SID to 40 inches 101 cm Centered the central ray to the cassette Set the conefield to 6 X 8 coverage Placed two pennies in each quadrant of the cassette Placed the ninth penny inside the light field on the cassette Centered the beam alignment test tool to the cassette Placed the lead letters markers indicating the room number and date Made the exp
25. PT TTT TTT ee 3 267 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C RADIOLOGY BRANCH SOP 3 268 STP 8 91P15 SM TG PREPARE DEPMEDS RADIOGRAPHIC UNIT CS 8952 FIELD DEPLOYABLE X RAY SYSTEM CONTINENTAL FOR MOVEMENT 081 823 0192 Conditions You are in a tactical environment and the unit commander has given the order to move You have the assistance of other soldiers if required You will need DEPMEDS Radiographic Unit CS 8952 Field Deployable X Ray System Continental and Continental Assembly Guide for CS 8952 Field Deployable System Standards Disassembled DEPMEDS Radiographic Unit CS 8952 Field Deployable X Ray System Continental Performance Steps 1 Remove image intensifier spot film device over table x ray tube and collimator 2 Store image intensifier spot film device over table x ray tube and collimator in containers provided 3 Remove table top by unscrewing bolts around the top of table 4 Remove table sub top 5 Remove fluoroscopy x ray tube and collimator a Using the allen wrenches provided in the tool box unbolt the fluoro tower using two personnel to remove it
26. 081 823 0114 081 823 0115 081 823 0116 081 823 0219 081 823 0220 CRITICAL TASKS Sust Tng Freq MAKE CALCULATIONS FOR mA AND TIME AN RELATIONSHIP MAKE CALCULATIONS FOR CHANGES IN AN SID MAKE EXPOSURE FACTOR AN COMPENSATION FOR PATIENT SIZE CALCULATE EXPOSURE FACTORS FOR AN DIFFERENT GRIDS DETERMINE EXPOSURE LIMITATION X RAY THE SKULL X RAY THE PARANASAL SINUSES X RAY THE FACIAL BONES X RAY THE MANDIBLE X RAY THE TEMPOROMANDIBULAR JOINTS X RAY THE ZYGOMATIC ARCHES X RAY THE NOSE X RAY THE HAND X RAY THE WRIST X RAY THE FOREARM X RAY THE ELBOW X RAY THE HUMERUS X RAY THE SHOULDER X RAY THE SCAPULA X RAY THE CLAVICLE X RAY THE ACROMIOCLAVICULAR JOINTS X RAY FINGER OR THUMB X RAY TRAUMA SHOULDER Sust Tng SL Subject Area 5 General Radiography Lower Extremities 6 General Radiography Trunk 7 General Radiography Spine 8 Contrast Media Studies Task Number Title Training Location 081 823 0117 081 823 0118 081 823 0181 081 823 0120 081 823 0121 081 823 0122 081 823 0123 081 823 0222 081 823 0223 081 823 0124 081 823 0125 081 823 0126 081 823 0127 081 823 0129 081 823 0216 081 823 0217 081 823 0221 081 823 0215 081 823 0130 081 823 0131 081 823 0132 081 823 0134 081 823 0218 081 823 0144 STP 8 91P15 SM TG CRITICAL TASKS Sust Tng Freq X RAY THE FOOT X RAY THE ANKLE X RAY THE CA
27. 10 9210 228 180 ue 210 228 180 LO 6220 228 180 3141 LYOHS ANY ASYL Y3SN 640524 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 Mood 1 91913 8 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 435 4 5916 WHOS JOS89901q 19821 9121990 9920 228 180 oe etre Drs 104 yun AydesBoipey 0002 9810 28 180 104 001 yun SAINAI 1610 28 180 20 MUD Jed PUN 0610 28 180 wasis 2568 50 SAINA 6810 28 180 001 ISPOW HUN 8810 28 180 104 12 2810 228 180 ewe tt Pt
28. 12 13 14 15 16 Performance Measures GO N O A 3 96 Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette the table lengthwise Positioned the overhead tube Positioned the humerus Immobilize the body part by placing sandbag or against hand Place the appropriate identification marker on the cassette Place the lead apron across the patient s lap Tell the patient STOP BREATHING AND DO NOT MOVE Make the exposure Tell the patient RELAX AND BREATHE NORMALLY and remove immobilization Process the film PT TTT f b Lateral view 10 11 12 13 14 15 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all STP 8 91P15 SM TG Immobilized the body part by placing a sandbag on or against the hand Placed the appropriate identification marker on the cassette Placed the lead apron across the patient s lap Gave proper pre post exposure instructions Made the exposure Processed the film
29. 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from patient as necessary 2 Ensure the patient s clothing is removed as required 3 Use a drape sheet or patient gown to cover the patient as needed c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use 1 2 of a 10 X 12 cassette for the AP dorsoplantar and oblique views and a 10 X 12 cassette for the lateral view 7 Place the cassette on the table lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film NOTE Angle the tube 10 degrees cephalic for the AP view Set the source to image receptor distance SID to 40 inches 101 c Center the tube to the portion of the film being used 3 115 STP 8 91P15 SM TG Performance Steps d Adjust the conefield to full field coverage 9 Position the foot a DP AP view 1 Place the patient supine or seated on the table 2 Flex the knee of the affected side to place the plantar surface of the foot in contact with the cassette 3 Place the foot parallel to the long axis of the cassette 4 Center the foot to the appropri
30. Checked the carotid pulse for about 5 seconds approximately 1 minute after starting CPR 8 Rechecked the carotid pulse every 3 to 5 minutes 9 Performed the transition to two rescuer CPR correctly if applicable 10 Changed positions during two rescuer CPR correctly if applicable 11 Continued CPR as stated task standard Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 21 STP 8 91P15 SM TG References Required Related None EMERGENCY CARE 3 22 STP 8 91P15 SM TG INITIATE TREATMENT FOR ANAPHYLACTIC SHOCK 081 833 0031 Conditions You will need needle syringe epinephrine 1 1000 solution stethoscope sphygmomanometer bag valve mask system and oxygen equipment Standards Initiated treatment for anaphylactic shock stabilized the casualty and minimized the effects of anaphylaxis without causing further injury to the casualty Performance Steps NOTE Anaphylactic reactions occur within minutes or even seconds after contact with the substance to which the casualty is allergic Reactions occur in the skin respiratory system and circulatory system 1 Check the casualty for signs and symptoms of anaphylactic shock a Skin
31. GO 6 performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 97 STP 8 91P15 SM TG X RAY THE SHOULDER 081 823 0113 Conditions You have a formal request for a radiologic examination of the shoulder You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from patient as necessary 2 Ensure the patient s clothing is removed as required 3 Use a drape sheet or patient gown to cover the patient as needed c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure t
32. PREPARE A MASS CASUALTY PLAN FOR RADIOLOGY SERVICE 081 823 0275 Conditions You must develop a mass casualty plan for your radiology section You will need personnel roster including other modality training department layout map medical facility mass casualty plan list of available imaging equipment current radiology SOP hospital layout map and phone and page directory Standards Developed a functional mass casualty plan document for your radiology section service or department Performance Steps 1 Identify the purpose of the mass casualty plan 2 Identify the scope of the plan a Applicable personnel Radiology sections modalities involved 3 Identify procedures to be followed concerning a Process for recalling off duty personnel b Utilization of fixed X ray units c Utilization and location of portable units d Coordination communication with triage area physicians emergency room trauma room and intensive care units concerning 1 Availability of fixed x ray units 2 Availability of portable X ray units 3 Availability of CT unit s 4 Availability of MRI unit s 5 Availability of special procedures services 6 Patient movement to from radiology service 7 Interpretation of examinations a Delivery of immediate verbal report wet read 0 Delivery of written report 8 Handling of films and reports needed for urgent patient care 4 Define coordinating instructions a Examination r
33. STP 8 91P15 SM TG Performance Steps 2 Block B Enter the address of the requesting unit 3 Blocks 4 6 Enter the NSN of the item requested 4 Block 7 Enter the unit of issue 5 Block 8 Enter the quantity requested Use all five positions Enter zeros 0 to the left of the quantity Blocks 9 10 Enter the unit DOD Activity Address Code DODAAC Block 11 Enter the Julian date Block 12 Enter the document serial number Block 13 Enter the demand code in using for recurring or for non recurring 10 Block 18 or card column 54 56 Enter the proper end item code EIC Use the EIC that identifies the major end item for which the request applies 11 Block 18b Enter the type of requirement code TRC if applicable 12 Block 20 Enter the priority designator 13 Block 21 Enter required delivery date RDD or leave blank 14 Block 22 Enter the proper advice code from appendix B or leave blank 15 16 17 wee DB YS a 6 7 8 9 Block L Enter the cost detail account number if required Block O Enter one or two words that describe the item requested Block Enter the type number date page number s of the authorization document publication and other applicable data b Record the DA Form 2765 1 in the appropriate document register c File one copy of the DA Form 2765 1 in the due in status file d Forward completed request to the supporting SSA SOS 5 Prepare DA Form 3161 as a r
34. Turned unit g 4 4 Checked temperature after 20 minutes Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 237 STP 8 91P15 SM TG PREPARE THE COMPUTED TOMOGRAPHY CT SCANNER FOR OPERATION 081 823 0187 Conditions You are in a tactical environment and the unit commander has given the order to set up The computed tomography CT scanner has been unloaded The assistance of other soldiers is available You will need the manufacturer s instructions if available Standards Assembled the computed tomography CT scanner in proper sequence Performance Steps 1 Level the gantry 2 Assemble the table to the gantry NOTE Align the head of the table to gantry and lock it into place at the floor connection point 3 Disconnect stabilizing straps from control panel and monitor 4 Assemble lead shield NOTE Pivot the shield around to form a single thickness straight wall Performance Measures GO 1 Leveled the gantry 2 Assembled the table to the gantry 3 Disconnected stabilizing straps from control panel and monitor 4 Assembled lead shield Bg Evaluation Guidance Score each soldier accor
35. and observed that ready lamp goes off and on after about a one second delay 11 Pressed the exposure switch all the way down to the X ray position and observed the X Ray lamp and audio tone operate Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None CUSWORTH RITA J RADIOLOGY BRANCH SOP 3 240 STP 8 91P15 SM TG PREPARE DEPMEDS RADIOGRAPHIC UNIT CS 8952 FIELD DEPLOYABLE X RAY SYSTEM CONTINENTAL FOR OPERATION 081 823 0189 Conditions You are in a tactical environment and the unit commander has given the order to set up The tactical shelter has been positioned leveled and expanded You have the assistance of other soldiers You will need DEPMEDS Radiographic Unit CS 8952 Field Deployable X Ray System Continental and Continental Assembly Guide for CS 8952 Field Deployable System Standards Assembled DEPMEDS Radiographic Unit CS 8952 Field Deployable X Ray System Continental properly Performance Steps 1 Detach all table accessories from table top a Detach foot support b Detach shoulder support c Detach hand grips NOTE Hand grips secure sub top barium shield to table top 2 Remove sub top NOTE Sub top is frag
36. 10 Did not cause further injury to the patient Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References 3 34 Required None Related BASIC NURSING STP 8 91P15 SM TG MANAGE AN UNCONSCIOUS CASUALTY 081 833 0048 Conditions You have an unconscious casualty in a field environment You are not in an NBC environment You will need blanket field jacket poncho Ringer s lactate and Field Medical Card Standards Managed and stabilized an unconscious casualty and arranged prompt evacuation Performance Steps 1 Establish unresponsiveness 2 Establish and maintain an open airway CAUTION Maintain C spine control Suspect C spine injury with trauma involving the head and neck motor vehicle accidents MVAs falls and diving accidents a Open the airway See task 081 831 0018 b Clear any upper airway obstruction See task 081 831 0019 c Insert an oropharyngeal airway if necessary to maintain the airway See task 081 833 0016 d Perform artificial respiration if breathing is absent See task 081 831 0048 3 Assess the casualty 4 Position the casualty a Place the casualty on his or her side or face down if the injury permits to prevent
37. 2 Clean the processor a Shut off the processor NOTE Put on the protective apron and goggles b Drain the developer and fixer tanks NOTE Dispose of the developer and fixer solutions according to the unit SOP c Remove the lid of the processor the overhead rollers developer rack and fixer rack d Remove and replace the developer recirculation filter e Clean thoroughly the following 1 Developer and fixer tanks 2 Overhead rollers 3 Developer and fixer racks 4 Interior 5 Exterior f Flush the tanks thoroughly with clean water g Mix the developer and fixer solutions according to manufacturer s instructions NOTE Ensure the appropriate solution is replaced in its respective tank h Replace the developer and fixer racks NOTE Add the proper amount of starter to the developer according to the manufacturer s instructions i Replace the overhead rollers j Replace the processor lid k Turn on the processor NOTE Run the processor for approximately 30 minutes NOTE Remove the protective mask and goggles 3 Check the following a Temperature of the fixer developer and wash b Replenishing rates c Water flow rate 3 226 STP 8 91P15 SM TG Performance Steps d Processing time NOTE The processing time is the time between the leading edge of the film entering the processor and the film exiting the dryer NOTE Process enough films through the processor to equalize the chemistry approximately 30
38. Central ray directed to level of T 7 3 4 inches inferior to the jugular notch b Dorsal decubitus chest view 1 Place the patient in a supine position with their arms over their head 2 Flex the knees slightly and ensure that the median plane is perpendicular to the table 3 Adjust the height of the film holder to center thorax to the film 4 Adjust the patient to center mid coronal plane and T 7 to the central ray NOTE Acromion processes about 2 3 inches below the upper film border 5 Central ray directed to level of T 7 3 4 inches inferior to the jugular notch 11 Immobilize the patient as necessary 12 Place the appropriate identification marker on the cassette NOTE For the lateral decubitus chest the film should be marked according to the side up For the dorsal decubitus chest the film should be marked side closest to film 13 Tell the patient TAKE IN A FULL BREATH BLOW IT OUT TAKE IN ANOTHER FULL BREATH AND HOLD IT 14 Make the exposure 15 Tell the patient RELAX AND BREATHE NORMALLY 16 Process the film Performance Measures GO Selected the required view s based on request Gathered the necessary material and supplies Prepared the patient Measured the body part entry exit site of the central Set the control panel Selected the proper size cassette Placed the cassette in an upright cassette holder lengthwise Positioned the
39. Do not elevate the patient s head 2 Do not restrain the patient s limbs during seizures 3 Prevent injury to tissue and bones by padding or removing objects on which the patient may injure himself or herself 4 Manage the patient after the convulsive state has ended 3 7 STP 8 91P15 SM TG Performance Steps a Place the patient on his or her side if necessary b Continue to maintain the patient s airway NOTE A patient who has just had a grand mal seizure will sometimes drool and will usually be drowsy so you must be prepared to suction if equipment is available c Administer supplemental oxygen if available via nonrebreather mask or bag valve mask as appropriate d If possible place the patient in a quiet reassuring atmosphere CAUTION Sudden loud noises may cause another seizure 5 Record the seizure activity Duration of the seizure Presence of cyanosis breathing difficulty or apnea Level of consciousness before during and after the seizure Whether preceded by aura ask the patient Muscles involved Type of motor activity Incontinence Eye movement Previous history of seizures head trauma and or drug or alcohol abuse 6 Evacuate the patient a Position the patient on his or her side b Arrange for the administration of oxygen or suction if available and necessary Evaluation Preparation Setup For training and evaluation have another soldier
40. Enter acquisition information 1 Radiographer ID Imager ID mAs kVp Imaging distance Review and if necessary change the Organ Code 2 3 4 5 6 7 Select the Plate ID box and scan the imaging plate bar codes 5 Demonstrate the use of the IP reader a Place cassettes in IP reader one at a time b Follow cassette insertion instructions for the particular IP reader model c Remove the reloaded cassette 3 323 STP 8 91P15 SM TG Performance Steps 6 Explain the MDIS diagnostic review work station a Roles of the LiteBox 1 Provides access to all images in the Picture Archiving Computer Systems 2 Provides high resolution display for image review and diagnosis 3 Allows simultaneous viewing of original image data throughout hospital 4 Provides image manipulation and processing capabilities 5 Provides film printing 6 Retrieves archived images by request 7 Access to IRIS for exam report processing b Explain workstation configuration 1 Type A amp B monitors are used for image review and diagnosis 2 Type C monitors are used for image review only c Explain and demonstrate LiteBox operation and features 1 Turning on the LiteBox 2 Opening the LiteBox application 3 Login window 4 Changing your password 5 Quitting the LiteBox application 6 Patient exam worklist a Selecting patient exam 0 Exam report window c Selecting relevant worklist
41. Finally the unit s training preparedness is reassessed and the training management cycle begins again This process ensures that the unit has identified what is important for the wartime mission that the training focus is applied to the necessary training and that training meets established objectives and standards Additionally the AMEDD is developing training products that will enhance medical prepared ness in the case of a Chemical Biological Radiological Nuclear and High Yield Explosive CBRNE event To assist commanders and leaders in training their units CBRNE related information is being included in AMEDD Mission Training Plans MTPs Even though most collective tasks within an MTP may directly affect or support a CBRNE event the ones that will most directly be impacted are clearly indicated with a statement in the CONDITION that reads THIS TASK MAY BE USED TO SUPPORT A CBRNE EVENT These collective tasks and any supporting individual tasks in this soldier s manual should be considered for training emphasis Also included in the MTP is a CBRNE Appendix The purpose of the appendix is to give a general overview of the Federal Response Plan the AMEDD support role and the command structure for those agencies and elements involved or participating ina CBRNE event It is understood that military resources temporarily support and augment but do not replace local state and federal civilian agencies having primary authority and resp
42. If power indicator illuminates proceed to next step 4 Turn power switch to ON position at the monitor 5 Turn power switch to ON position at the CPU 6 Allow software based initial Self Test to assess operational status NOTE Self Test should take less than 5 minutes from power initiation to complete In the event that it should not complete this function in the allotted time or identify system software problems notify qualified repair personnel immediately 7 Enter user name and password when prompted 8 Select appropriate application from file menu Performance Measures GO 1 Ensured based hardware was properly connected at CR work station NOTE lf cables appeared disconnected loose or frayed notified qualified computer technician for repair 2 Ensured all PC based hardware was connected to appropriate power source 3 Checked power supply indicator light for illumination at the Central Processing Unit a If power indicator did not illuminate checked for proper power source connection 3 224 STP 8 91P15 SM TG Performance Measures GO l NOTE power cord was disconnected soldier should reconnect to power source If damage was suspected notified qualified personnel for repair b If power indicator illuminated proceeded to next step 4 Turned power switch to ON position at the monitor 5 Turned power switch to ON position CPU
43. Jo SN 104 1 47813 4 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 90 o9 09 09 98 438 4 9918 OU ABY X 7210 28 180 94 2220 228 180 901 y 2220 228 180 ey X 2210 228 180 2210 228 180 1210 628 180 0210 28 180 1810 628 180 apy 8110 28 180 4 2110 28 180 Jepinoys 0220 28 180 10 19 6120 28 180 ABY X 9110 28 180 311 LYOHS ANY ASYL SNLVLS 6 3 01065 Y3SN Ol dO SdOSDq 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 133HS Mood 1 91913 5 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 435 4 5916 WHOS eulds sequin 8120 28 180 ae eine 4 ee ear meneame 12 0 629 180 SS EAR E
44. Newborn 30 50 2 Evaluate the respirations a Depth 1 Normal deep even movement of the chest 2 Shallow minimal rise and fall of the chest and abdomen 3 Deep the rib cage expands fully and the diaphragm descends to create a maximum capacity thm and pattern Healthy exhalations are twice as long as inhalations Irregular Hypoventilation slow and shallow respirations Hyperventilation sustained increased rate and depth of respiration Sigh deep inhalation followed by a slow audible exhalation Apnea temporary absence of breathing Tachypnea increased respiration rate usually 24 or more breaths per minute lity Normal effortless automatic regular rate even depth noiseless and free of discomfort 2 Dyspnea difficult or labored breathing 3 Wheezing or whistling sound 4 Rattling or bubbling b lt go x xa 3 Check for the physical characteristics of abnormal respirations a Appearance the casualty may appear restless anxious pale ashen or cyanotic b Position the casualty may alter his or her position by leaning forward or may be unable to lie flat c Cough 1 Acute comes on suddenly 2 Chronic has existed for a long time 3 Dry coughs without sputum 3 49 STP 8 91P15 SM TG Performance Steps 4 Productive coughs which expel sputum a Normal sputum clear semiliquid mucus which may appear watery frothy or thick 0 Abnormal sputum
45. Using the tool palette Image formats g Using Cine Stack control e f g h Resizing image by dragging i Displaying images from multiple exams j File menu k Edit menu I Display menu m Image menu n Draw menu 7 Discussed image quality control procedures 8 Directed new personnel to practice using the LiteBox 9 Supervised and guided new personnel as they practiced Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all STP 8 91P15 SM TG GO performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 325 STP 8 91P15 SM TG References None 3 326 STP 8 91P15 SM TG APPENDIX A FIELD EXPEDIENT SQUAD BOOK A 1 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 116 4 5916 WHOS eeuen 228 180 00 8 180 00 68 80 14 18240 9 00 68 80 Sag on nin 81 00 8 80
46. Y or N to answer deployment prompts if priority 01 03 was entered Complete the Request for Issue Higher Level Supply Data screen if the priority was 01 03 m Complete the bottom portion of the Request for Issue screen as needed and if priority is other than 01 03 n Process the request 3 Complete a request when no catalog data is available a Select Y to add a catalog record when NIIN MPN or MCN is not found on catalog or FED LOG 0 Complete the mandatory entries on the Add a Catalog screen 1 2 Federal supply class FSC CAGE 3 NOMENCLATURE 4 UI 5 Accounting requirement code ARC 6 Supply categories of materiel code SCMC 7 Unit price U PRICE c Process the new catalog record d Enter the SHRN e Enter the quantity f Enter the component list number if applicable g Enter the priority if the item is expendable non Class IX or non SSSC item h Select Y or N to answer deployment prompts if priority 01 03 was entered i Complete the Request for Issue Higher Level Supply Data screen if the priority is 01 03 j Complete the Item Identification Data screen with as much information as possible k Process the request Print a hard copy of the request Select Y or N for additional copies of the request n Return to the NIIN entry screen Post transaction to the document register Disposition instructions IAW local SOP 11 Prep
47. You are in a tactical environment and the unit commander has issued an order to move You have the assistance of other soldiers You will need manufacturer s instructions if available Standards Disassembled computed tomography CT scanner Performance Steps 1 Disassemble the lead shield a Fold outer shield back b Secure it to inner shield with Velcro straps 2 Connect stabilizing strips to the control panel and monitor 3 Disassemble the gantry from the table a Unlock table from gantry at floor level foot lever b Secure table to floor with eye bolts and tie down straps Performance Measures GO 1 Disassembled the lead shield 2 Connected stabilizing strips to the control panel and monitor 3 Disassembled the gantry from the table g 4 Secured table to floor Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None CUSWORTH RITA J RADIOLOGY BRANCH SOP 3 276 STP 8 91P15 SM TG PREPARE ACR 2000 COMPUTED RADIOGRAPHY UNIT FOR MOVEMENT 081 823 0196 Conditions You are in a tactical environment and the unit commander has ordered the unit to move You have the assistance of other soldiers if required You wi
48. aspiration of vomitus b Maintain good body alignment by using padding for head and limb support Use a folded or rolled blanket field jacket or poncho c In extended care situations turn the casualty from side to side every hour NOTE Protect the casualty against extremes of heat or cold 5 Observe the casualty a Check for drainage of blood or cerebrospinal fluid CSF from the ears and nose WARNING Do not attempt to control cerebrospinal bloody drainage with a dressing The dressing may cause increased pressure on the brain and collection of fluids between the brain and skull b Take the vital signs NOTE Check the vital signs every 15 to 20 minutes and record the data on the Field Medical Card Assess the casualty s level of consciousness using the AVPU scale 1 A alert The casualty responds spontaneously to stimuli and is able to answer questions in a clear manner 2 V verbal The casualty does not respond spontaneously but is responsive to verbal stimuli 3 P pain The casualty does not respond spontaneously or to verbal stimuli but is responsive to painful stimuli 4 U unresponsive The casualty is unresponsive to any stimuli NOTE Even if the casualty is unresponsive assume the casualty can hear you and explain the procedures d Assess the casualty s pupils 1 Observe the size of each pupil 3 35 STP 8 91P15 SM TG Performance Steps NOTE A variation of pupil size may indicate a brain injury
49. c Adjust the legs so that they are together and straight or nearly straight d Place one hand on the back of the casualty s head and neck e Grasp the casualty under the arm with the free hand f Pull steadily and evenly toward yourself keeping the head and neck in line with the torso g Roll the casualty as a single unit h Place the casualty s arms at his or her sides 2 Establish the airway using the head tilt chin lift or jaw thrust method a Head tilt chin lift method CAUTION Do not use this method if a spinal or neck injury is suspected NOTE Remove any foreign material or vomitus seen in the mouth as quickly as possible 1 Kneel at the level of the casualty s shoulders 2 Place one hand on the casualty s forehead and apply firm backward pressure with the palm of the hand to tilt the head back 3 Place the fingertips of the other hand under the boney part of the casualty s lower jaw bringing the chin forward CAUTIONS 1 Do not use the thumb to lift the lower jaw 2 Do not press deeply into the soft tissue under the chin with the fingers 3 Do not completely close the casualty s mouth b Jaw thrust CAUTION Use this method if a spinal or neck injury is suspected 1 Kneel at the top of the casualty s head 2 Rest the elbows on the surface on which the casualty is lying 3 Place one hand on each side of the casualty s lower jaw at the angle of the jaw below the ears 4 Stabilize the casualty s head with your
50. with the patient s arms down by their side 4 Center central ray 2 inferior to the level of the ASIS e Lateral decubitus views bilateral 1 Place the patient laterally recumbent on the table 2 Elevate the patient by placing radiolucent material under the patient 3 Adjust the coronal plane perpendicular to the table 4 3 4 5 c Ob 1 2 3 Center iliac crest to the center of the cassette 3 192 STP 8 91P15 SM TG Performance Steps 13 14 15 16 Instruct the patient DO NOT BREATHE OR MOVE Make the exposure Tell the patient RELAX AND BREATHE NORMALLY Develop the exposed film with the patient s identification Performance Measures 1 2 3 4 Selected the required view s based the request Gathered the necessary materials and supplies Attached any required accessories to the table Prepared the contrast medium NOTE Ensured the appropriate contrast medium was used and verified the expiration date 5 1 11 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Prepared the equipment for fluoroscopy 6 Prepared the patient 7 Notified the radiologist the patient is ready for fluoro 8 9 0 Assisted the radiologist as directed Prepared the equipment for follow up radiographs Positioned the patient for the follow up radio
51. 823 0114 X RAY 5 Sahu 3 101 081 823 0115 X RAY THE 3 104 081 823 0116 X RAY THE ACROMIOCLAVICULAR 3 106 081 823 0219 X RAY FINGER OR 3 109 081 823 0220 X RAY TRAUMA SHOULDE Riessaicscicccdcctescnacssnessostansoassanscecdennssesseansecadeaistectes 3 112 Subject Area 5 General Radiography Lower Extremities 081 823 0117 X RAY THE FOOT 3 115 081 823 0118 X RAY THE ANKLE 3 118 081 823 0181 X RAY THE CALCANEUS 2 22 3 121 081 823 0120 X RAY THE 3 124 081 823 0121 X RAY THE KNEE 3 127 081 823 0122 X RAY THE FEMUR 3 130 081 823 0123 X RAY THE 3 133 081 823 0222 3 136 081 823 0229 X RAY 3 139 Subject Area 6 General Radiography Trunk 081 823 0124 X RAY THE 3 142 081 8230125 X
52. 91P15 SM TG PERFORM SOFT TISSUE X RAY STUDY 081 823 0229 Conditions You have a request for a radiologic examination of soft tissue study c spine You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sandbags letter markers lead shielding calipers and positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers d Calipers e Sandbags 3 Prepare the patient a Bring the patient into the X ray room b Ensure foreign objects are removed from the patient as necessary 1 Glasses 2 Earrings 3 Necklaces or ID tags c Explain the procedure 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel NOTE Generally different from standard C spine technique by 10 15 kVp 6 Select the proper size cassette NOTE Use 10 x 12 cassette 7 Place the cassette lengthwise in the wall bucky 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the sourc
53. Angle the tube 15 degrees cephalic 2 AP coccyx Angle the tube 10 degrees caudad b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette 3 177 STP 8 91P15 SM TG Performance Steps d Restrict the cone field to 1 8 X 8 for the sacrum views 2 6 X 6 for the coccyx views 9 Position the sacrum and coccyx a AP sacrum 1 Place the patient supine on the table 2 Adjust the median plane perpendicular to and over the centerline of the table 3 Place the legs in full extension 4 Central ray directed to a point midway between the greater trochanter and ASIS b AP coccyx 1 Place the patient supine on the table 2 Adjust the median plane perpendicular to and over the centerline of the table 3 Place the legs in full extension 4 Central ray directed to a point 2 superior to the greater trochanter c Lateral sacrum 1 Place the patient laterally recumbent with the knees flexed and arms at right angles to the body 2 Adjust the coronal plane perpendicular to and over the centerline of the table 3 Place radiolucent material under the lower dorsal region to bring the long axis of the spine parallel to the table 4 Central ray directed to a point 2 anterior to the posterior sacral surface at the level of the ASIS d Lateral coccyx 1 Place the patient laterally recumbent with the knees flexed and arms at right angles to the body 2 Adjust the coron
54. BRANCH SOP 3 205 STP 8 91P15 SM TG PERFORM UNENHANCED COMPUTED TOMOGRAPHY CT OF THE CHEST 081 823 0200 Conditions You have the requirement to perform a computed tomography procedure of the chest that does not require the use of contrast media The patient has been properly prepared and is able to tolerate the exam You will need a fully equipped and functioning computed tomography suite Standards Produced radiographs of diagnostic quality that properly demonstrated the body section requested The radiographs were correctly identified and free from artifacts Performance Steps 1 A 9 10 11 Performance Measures GO 1 Touched anatomical area corresponding to thorax on body icon on the 2 Touched PROCEED WITH NEW STUDY 3 4 Touch anatomical area corresponding to thorax on body icon on the Electroluminescent Touch Panel Touch PROCEED WITH NEW STUDY Press ENTER TEXT key on keyboard a Type patient information on display monitor b Press F1 Save Data Position patient for pilot scan Touch double edged box PROCEED TO PRE SCAN Touch double edged box READY FOR PILOT Press START button for Pilot After pilot image appears press F8 PLAN STUDY a Position red cursor for first slice and press F1 FIRST Use theta ring to angle cursor if necessary b Position red cursor for last slice and press F2 LAST c Press F8 SAVE PLAN Touch double edged bo
55. C 3 229 STP 8 91P15 SM TG MAINTAIN DARKROOM 081 823 0241 Conditions You are in a tactical environment and have a darkroom tent that needs to be maintained The assistance of other soldiers is available You will need cleaning supplies and masking tape Standards Cleaned and performed necessary corrective procedures on the darkroom to ensure that there were no light leaks or build up of dirt and dust Performance Steps 1 Ensure that the film bin is closed and then turn on the light 2 Wipe off all of the dirt and dust that has accumulated inside the darkroom with all purpose cleaner and a rag 3 Ensure that the film bin is free of dirt and dust NOTE It is important to keep the dirt and dust down to a minimum the darkroom Although it is impossible to keep all dirt and dust out a high state of cleanliness should be maintained to reduce artifacts and to ensure quality films are produced 4 Check the darkroom tent for light leaks NOTE lf any light leaks are found utilize masking tape either dark green or black and place tape over the areas where light is visible 5 Repair all light leaks in darkroom if any 6 Check the laces of the darkroom tent to ensure that none have come undone Check the snaps of the darkroom tent sleeves to ensure that none have come undone 7 8 Check for defective Velcro or zippers 9 Check for dry rotted canvas 0 10 Annotate any faults on a DA Form 2404 and turn it into bi
56. CT OF THE ABDOMEN AND PELVIS 081 823 0201 Conditions You are required to perform a computed tomography procedure of the abdomen and pelvis that does not require the use of contrast media The patient has been properly prepared and is able to tolerate the exam You will need a fully equipped and functioning computed tomography suite Standards Produced radiographs of diagnostic quality that properly demonstrate the body section requested The radiographs were correctly identified and free from artifacts Performance Steps 1 Touch anatomical area of the abdomen on the body icon on the ELTP Electroluminescent Touch Panel Touch the abdomen pel box 3 Touch PROCEED WITH NEW STUDY Oo N 10 11 12 Performance Measures GO 1 2 3 4 Press ENTER TEXT key keyboard a Type patient information on display monitor b Press F1 Save Data Position patient for pilot scan Touch double edged box PROCEED TO PRE SCAN Touch double edged box READY FOR PILOT Press START button for Pilot After pilot image appears press F8 PLAN STUDY a Position red cursor for first slice and press F1 FIRST Use theta ring to angle cursor if necessary b Position red cursor for last slice and press F2 LAST c Press F8 SAVE PLAN Touch double edged box MOVE COUCH READY FOR SCAN Press START after prompt on ELTP When plan is complete the boxes will return on the ELTP 86 To
57. CT IMAGES 081 823 0368 STP 8 91P15 SM TG Conditions You have the requirement to reprint a computed tomography procedure You will need a fully equipped and functioning computed tomography suite Standards Reprinted CT images of diagnostic quality that properly demonstrate the body section requested The images were correctly identified and free from artifacts Performance Steps 1 N oO A Place tape in tape drive After green light comes on press SHIFT PT DIR Press 1 CARTRG TAPE Press F1 READ TAPE Press F1 PROCEED to automatically print study Performance Measures a A Placed tape in tape drive After green light comes on pressed SHIFT PT DIR Pressed F1 CARTRG TAPE Pressed F1 READ TAPE Moved red line with arrow keys over selected study and pressed to SET MARK After all cases are marked pressed F1 PROCEED Pressed SHIFT PT DIR to exit or PREV PAGE Pressed F2 SEND Selected the study to be reprinted on the Patient Directory page by pressing F3 SET MARK Pressed F1 PROCEED to automatically print study Move red line with arrow keys over selected study and press F3 to SET MARK After all cases are marked press F1 PROCEED Press SHIFT PT DIR to exit or PREV PAGE Press F2 SEND Select the study to be reprinted on the Patient Directory page by pressing F3 SET MARK 3 213 STP 8 91P15 SM TG E
58. Drip rate c Date and time the IV infusion was initiated d Initials of the person initiating the IV 2 Secure the tape to the IV container c IV tubing 1 Wrap a strip of tape around the tubing leaving a tab 2 Print the date and time the tubing was put in place and the initials of the person initiating the IV NOTE Place disposable items in an appropriate receptacle and clean and store equipment IAW local SOP 17 Recheck the site for infiltration 18 Perform a patient care handwash 19 Record the procedure on the appropriate form Date and time the IV infusion was initiated and amount of IV solution initiated Drip rate and total volume to be infused Type and gauge of needle or cannula Location of the infusion site Patient s condition Name of the person initiating the IV 3 28 Performance Measures N A N A N Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Inspected the equipment Prepared the equipment Identified the patient and explained the procedure Selected the infusion site Prepared the infusion site Prepared to puncture the vein Punctured the vein Confirmed the puncture Advanced the needle or the catheter
59. FIELD OPERATIONS IN NBC ENVIRONMENT 081 823 0301 Conditions You have been given a order to prepare for field operations in an NBC environment You will need x ray film chemicals folders water and emergency generator Standards Prepared radiology section to function adequately during NBC operation Performance Steps 1 Stockpile necessary X ray supplies such as film chemicals and folders to anticipate continuous operations above normal workload NOTE These items should be maintained separately from normal operation supplies and switched out according to expiration date in order to maintain usefulness 2 Store additional water supplies if a contamination hazard exists Additional water supplies for the processor s should be stored and safeguarded until an alternate water supply can be established NOTE Water can be stored in 5 or 55 gallon drums 3 Ensure that emergency generators or backup power are in place in the event of a power outage 4 Ensure that supply storage areas are secured and access to these areas are limited to radiology personnel only Performance Measures GO 1 Stockpiled necessary X ray supplies a Film b Chemicals c Folders 2 Stored and safeguarded additional water for the processor s 3 Ensured emergency generators and backup power put in place 4 Secured storage area and limited to radiology personnel Evaluation Guidance Score each soldier accor
60. Flushed or ashen Burning or itching Edema swelling especially in the face tongue or airway Urticaria hives spreading over the body Marked swelling of the lips and cyanosis about the lips piratory Tightness or pain in the chest Sneezing and coughing b 5 Wheezing stridor or difficulty in breathing dyspnea Weak rapid pulse Falling blood pressure Hypotension Dizziness or fainting 5 Coma 2 Transport the casualty to the aid station WARNING Do not attempt to transport the casualty to an aid station unless the station can be reached within 4 minutes Otherwise start supportive treatment immediately and transport the casualty as soon as possible 3 Open the airway if necessary NOTE In cases of airway obstruction from severe glottic edema a cricothyroidotomy may be necessary See task 081 833 3006 4 Administer high concentration oxygen See task 081 833 0158 5 Administer epinephrine a Administer 0 5 ml of epinephrine 1 1000 solution subcutaneously SQ or intramuscularly IM NOTE Annotate the time of injection on the Field Medical Card FMC b Additional epinephrine may be required as anaphylaxis progresses Additional incremental doses may be administered every 5 to 15 minutes IAW local SOP 3 23 STP 8 91P15 SM TG Performance Steps 6 Initiate an IV See task 081 833 0033 NOTE lf the anaphylaxis is due to an insect bite or st
61. Identify the standards for each performance of specific procedures and functions applicable to the radiology service including a Operation hours and locations 1 All shifts 2 All modalities Exams available and performed by each modality including routine procedures and views and step by step preparation and procedures for these examinations 1 Radiography a Fixed unit radiography b Portable unit radiography 2 Fluoroscopy a Fixed fluoroscopy 0 Portable unit fluoroscopy Special procedures angiography Computerized tomography Mammography Sonography Magnetic resonance imaging Nuclear medicine adiation protection and dosimetry afety 1 Radiation protection safety a Proper use of gonadal shielding and protective garments 0 Annual training c Protection of embryo fetus 2 Hazardous material safety 3 Safety of electrically and nonelectrically powered equipment used in treatment diagnosis and monitoring of patients to ensure proper performance 4 Written procedures dealing with restrictions in operating techniques are required to ensure safe utilization of x ray equipment e Quality assurance plan risk management f Infection control g Training programs 1 In service training 2 Student technologist training programs 3 On the job modality training program h Quality control QC program procedures 1 Film or image quality control 2 Reject repeat analysis evaluation
62. In a very small percentage of people unequal pupil size is normal 2 Shine a light into each eye to observe the pupillary reaction to light NOTE The pupils should constrict promptly when exposed to bright light Failure of the pupils to constrict may indicate brain injury e Check movement of the extremities NOTE Record which movements are spontaneous and which are stimulus related f Observe for seizure activity 6 Obtain the casualty s history if possible a Events immediately preceding current condition b Recent illness or infection c History of epilepsy diabetes or other medical conditions d Prior periods of unconsciousness e Drug or alcohol abuse evacuate any medications with the casualty 7 Initiate an IV of Ringer s lactate and run it slowly to keep the vein open TKO See task 081 833 0033 8 Administer supplemental oxygen without pressure if available 9 Record the treatment on the Field Medical Card 10 Evacuate the casualty NOTE unconscious casualty should have an artificial airway inserted prior to evacuation and must be constantly monitored during evacuation Performance Measures GO Established unresponsiveness Established and maintained an open airway Assessed the casualty Positioned the casualty Observed the casualty Obtained the casualty s history Initiated an IV Administered oxygen if available Recorded the treatment
63. Measures a A 7 8 9 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Gathered the necessary materials and supplies Measured the body part at the entry exit site Set the control panel Positioned the mannequin for a lateral lumbar spine Taped the metal objects keys coins and pens to the three 8 x 10 cassettes Placed the cassettes at the specified distances a 15 inches away b 30 inches away c 6 feet away Placed all cassettes upright Made the exposure Developed all film Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 284 STP 8 91P15 SM TG FORMULATE TECHNIQUE CHARTS FOR RADIOGRAPHIC UNITS 081 823 0267 Conditions You receive a new radiographic unit for which you need to formulate a technique chart You must create the technique chart by taking into consideration specific methods and factors You will need a writing implement and stationery to record your techniques Standards Properly formulated the technique chart and demonstrated acceptable technical factors for the various radiologic exams Performance Steps 1 Determine the method for selecting technique factors a Body habitus meth
64. Place the median plane perpendicular to and over the centerline of the table 2 Adjust the OML to form a 37 degree angle with the cassette 3 Center the acanthion to the cassette c Lateral view 1 Place the medial plane parallel to the table 2 Adjust the interpupillary line perpendicular to the cassette 3 Adjust the infraorbitomeatal line IOML perpendicular to the front edge of the cassette 4 Center the external canthus of the eye to the center of the cassette Place the appropriate identification marker on the cassette Tell the patient DO NOT BREATHE AND DO NOT MOVE Make the exposure Tell the patient BREATHE NORMALLY AND RELAX Develop the exposed cassette s with the patient s identification Performance Measures N A 10 12 13 14 3 66 Selected the required view s based request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size of cassette Placed the cassette in the bucky lengthwise for all views Positioned the overhead tube Positioned the sinuses a Caldwell view b Water s view c Lateral view Placed the appropriate identification marker on the cassette Placed the lead apron across the patient s lap Gave the patient the pre post exposure instructions Made the
65. RAY THE CHES 3 144 081 823 0126 3 147 081 823 0127 X RAY 3 150 081 823 0129 X RAY THE ABDOMEN 200 2 2000001022000000000 0000 000000000000000441 3 153 081 823 0216 X RAY DECUBITUS 3 156 081 823 0217 X RAY DECUBITUS GHEST 3 159 081 823 0221 25 3 162 Subject Area 7 General Radiography Spine 081 823 0215 X RAY TRAUMA CERVICAL 3 165 081 823 0130 X RAY THE CERVICAL 0 3 168 081 823 0131 X RAY THE THORACIC 5 3 171 081 823 0132 X RAY THE LUMBAR 3 174 081 823 0134 X RAY THE SACRUM AND OR 3 177 081 823 0218 X RAY TRAUMA LUMBAR 3 180 Subject Area 8 Contrast Media Studies 081 823 0144 ASSIST PHYSICIAN WITH ESOPHAGRAM BARIUM SWALLOW 3 183 081 823 0145 ASSIST PHYSICIAN WITH UPPER G I
66. Radiographs which were not of diagnostic quality were repeated with the deficiencies corrected Performance Steps 1 Check for artifacts within the area of consideration Check for adequate contrast to demonstrate the requested anatomy Check for adequate density to demonstrate the requested anatomy Check for demonstration of all of the requested anatomy on the radiograph Check for the correct letter marker Check for motion Check for the correct patient identification Check for correct positioning Check for correct alignment N A PD Check for correct collimation Performance Measures GO 1 Checked for artifacts within the area of consideration Checked for adequate contrast to demonstrate the requested anatomy Checked for adequate density to demonstrate the requested anatomy N Checked for demonstration of all of the requested anatomy on the radiograph Checked for the correct letter marker Checked for motion Checked for the correct patient identification Checked for correct positioning Checked for correct alignment 3 279 STP 8 91P15 SM TG Performance Measures GO 86 10 Checked for correct collimation Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the sol
67. Remove the stand frame assembly from reusable container Remove the pipe assembly lower section with gear box assembly from the reusable container Insert lower pipe assembly into slots on the base of the stand frame assembly a Slide lower assembly back until it stops b Rotate the two side locking devices up and lock into place Remove pipe assembly upper section from the reusable container a Insert upper section to lower section b Turn the locking devise on top of upper section Crank gear box assembly up to a comfortable working height Remove cross arm assembly from side of stand frame assembly a Insert cross arm into gear box assembly with handle to the rear of machine b Push the locking lever down and slide the cross arm through the gear box Lift control assembly out of reusable container a Slide control assembly into the receiving slots at rear of frame assembly b Turn locking pins to lock in place Lift x ray generator assembly from the reusable container a Slide generator assembly into cross arm b Secure with attached locking pin Attach line cord to control assembly LINE IN connector Attach exposure switch cable to control assembly HAND SWITCH connector and connect one end of the interconnect cable to the control assembly LINE OUT connector and the remaining end to the x ray generator assembly connector Removed the stand frame assembly from reusable container
68. SMV 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the control panel 6 Select the proper size cassette NOTE Use a 10 X 12 cassette for all views 7 Place the cassette in the bucky lengthwise for the PA and the Chamberlain Towne CT and crosswise for the lateral view 8 Position the overhead tube a Set the tube angle perpendicular to the film 1 Angle the tube 15 degrees caudad for the PA view 2 Angle the tube 30 degrees caudad for the CT view 3 Perpendicular for the lateral view b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the cone fields to full field coverage 9 Position the skull NOTE Because of the extreme mobility of the head on the back of the neck all positions of the skull require a two way head alignment TWHA for exact positioning of the skull 3 62 Performance Steps 10 11 12 13 14 15 view TWHA 1 Place the patient prone the table 2 3 4 Project the nasion to the center of the cassette b CT view TWHA 1 Place the patient supine on the table 2 3 4 Adjust the OML perpendicular to the cassette 2 DV YS c Lateral view bilateral TWHA 1 Place the patient semiprone on the table 2 Place the median plane parallel to the table 3 Adjust the interpupillary line
69. Select the proper view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Letter markers Sandbags Calipers Radiolucent sponges Lead shielding Tape Grid 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Provide the patient with a gown if necessary c Explain the procedure if applicable 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size film cassette NOTE Use a 10 x 12 cassette for all the views 7 Place the cassette or grid on the table or bucky according to the desired position a Lengthwise bucky for the AP view b LW grid for the axiolateral hip 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Position the trauma hip 3 162 Performance Steps a AP hip STP 8 91P15 SM TG Place patient in a supine position arms at side or across chest 1 2 Shield gonads without obscuring
70. Sustainment BASELINE REQUIRED RECOMMENDED PROFIS 081 MD0057 AMEDD Computer Literacy Correspondence Sustainment Emergency Medical Training EMT X TDA and TOE 081 MD0058 AMEDD Computer Literacy II Basic Life Support BLS X TDA and TOE 081 MD0062 Intro to Quality Assurance Correspondence Sustainment 081 MD0064 Intro to Radiography Correspondence Sustainment ARRT X 081 MD0066 Health Care Ethics Correspondence Sustainment Computer Tomography Training X X 081 MD0067 Health Care Ethics II Correspondence Sustainment 6H F18 322 F18 Medical X Ray Survey Techniques 2 wks AHS FSHTX X 081 MD0520 Quality Care Patient Relations Correspondence Sustainment 5 Radiology Annual Seminar 1 AHS FSHTX Sustainment 081 MD0532 CPR Correspondence Sustainment 313 F1 Radiology NCO Management Course 1 wk 3 days AHS FSHTX Just in Time 081 MD0902 Basic Electricity Correspondence Sustainment Leadershi EG 8 Instructor Courses P 081 MD0903 Basic Electrical Circuits Correspondence Sustainment 5K F3 520 F3 Instructor Training Course 2 weeks AHS Just in time 5K 081 MD0950 Fundamentals of X Ray Physics Correspondence Sustainment 5K F6 520 F6 Small Group Leader Course 5 Days AHS Just in time 081 MD0952 Principles of Radiographic Exposure Correspondence Sustainment Recruiter 6 wks USAREC Just in time 081 MD0954 X Ray Film Processing Correspondence Sustainment Drill Sgt School 9 wks Multiple Sites Just in Time SQI X 081 00956 Anatomy for X Ray Specialist Correspond
71. Validate maintenance request if items are in maintenance 8 Conduct a sensitive item inventory a Sensitive items and Control Cryptographic Items will be inventoried quarterly 0 Sensitive types of ammunition weapons and other hazardous items will be inventoried monthly c The responsible officer must notify hand subhand receipt holders when the items are to be inventoried either monthly or quarterly d The PBO inventories sensitive items not listed on hand receipts e Inventory sensitive items as follows 1 For weapon and ammunition use the procedures underlined in weapons and ammunition inventories 2 Count each sensitive item for which you have responsibility 3 Make a visual check of condition of the items 4 Check end items for completeness 5 Check the serial number on the item with the serial number recorded 6 Report damaged equipment to unit maintenance personnel for repair 7 Hand subhand receipt holders report the results of the inventory to the responsible officer 9 Conduct a weapons and ammunition inventory a Inventory procedures when responsibility is transferred are as follows 1 Both incoming and outgoing custodians must conduct a physical count of the weapons ammunition and keys 2 Record the results of the weapons and ammunition inventory on DA Form 2062 Hand Receipt 3 Record the results of key inventory control on DA Form 5513 R Key Control Register 4 The person receiv
72. Verify that the printer is online when message prompt Ensure printer is Online is displayed then press any key d Select Y or N to the message prompt Commander s Report Should Be Run Before Sending Transactions To Source of Supply Do You Wish To Continue 1 Selecting returns you to the Send Transactions screen where you can then return to the Request Processes Menu to run the Commander s Reports 2 Selecting Y allows you to continue the process Label a diskette Insert the diskette into A drive Format the diskette Select the diskette volume label Select Y or N to format another disk j Process the transactions Print the Send Supply Transactions Report Continue performing the send transactions via floppy diskette process for all direct support units DSU m Review the Send Supply Transactions Report n File the Send Supply Transactions Report in the unit files Forward the diskette to the SOS 2 Send transactions via communications a Select the Send Trans Via Communications 0 Verify that the printer is online gt 0 7 c Process the transactions d Review the Send Supply Transactions Report e File the Send Supply Transactions Report in the unit files g Select Send Transactions for All Units on File Previous Transactions option 4 1 Send transactions via floppy disk a Select Send Trans Via F
73. You have a requirement to perform a CT examination of the spine You will need the Picker PQS Field CT Scanner and examination request SF 519 B Standards Performed computed tomography examination of the spine without error Performance Steps 1 Touch anatomical area of the spine on the body icon on the ELTP Electroluminescent Touch Panel Touch the lumbar box 3 Touch PROCEED WITH NEW STUDY N Press ENTER TEXT key on keyboard a Type patient information on display monitor b Press F1 Save Data Position patient for pilot scan Touch double edged box PROCEED TO PRE SCAN Touch double edged box READY FOR PILOT Press START button for Pilot After pilot image appears press F8 PLAN STUDY a Position red cursor for first slice and press F1 FIRST Use theta ring to angle cursor if necessary b Position red cursor for last slice and press F2 LAST c Press F8 SAVE PLAN scanning through each disc space use theta ring for tilt and repeat steps 9a and 90 for each disc Touch double edged box MOVE COUCH READY FOR SCAN Press the START button after prompt on ELTP After first scan is complete press STOP button Press F1 CURSOR OPS a Press F3 RULER Place ruler on superior edge of spinal cord Change ruler length to 16 cm using window width wheel Press F6 AREA ID Touch SCAN REPROCESSS OPTIONS Touch REPROCESS SCANS Touch number on ELTP that corresp
74. a AP view KUB 1 Place the patient supine on the table 2 Position the medium plane perpendicular to and over the centerline of the table Extend the patient s legs and place a support under the knees R Center the iliac crests to the cassette lique RPO LPO view Place the patient supine on the table Adjust the coronal plane to form a 30 degree angle to the table Center the trunk to the cassette R Center the iliac crests to the cassette c Post void view 1 Place the patient supine on the table 2 Position the medium plane perpendicular to and over the centerline of the table 3 2 3 4 1 2 3 4 3 Extend the patient s legs and place a support under the knees 4 R Center the iliac crests to the cassette 10 Tell the patient BLOW YOUR BREATH OUT AND HOLD IT DO NOT BREATHE OR MOVE 11 Make the exposure 12 Tell the patient RELAX AND BREATHE NORMALLY 13 Repeat steps 9 through 12 to take additional views as required 14 Forward the exposed cassette s with patient identification for processing 15 Deliver all the radiographs to the radiologist prior to releasing the patient 16 Release the patient when instructed to do so by the radiologist Performance Measures GO 1 Selected the required view s based on the request 2 Gathered the necessary materials and supplies CAUTION Ensured the anaphylactic shock tray was available at all t
75. a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required views s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Gauze or tape c Lead apron d Letter markers e Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use 1 2 of a 10 X 12 cassette for the AP and oblique views and an 8 X 10 cassette for the lateral view 7 Place the cassette on the table according to the desired position a Crosswise for the AP and oblique views b Lengthwise for the lateral view 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor dista
76. abdomen 3 156 STP 8 91P15 SM TG Performance Steps a Lateral decubitus abdomen view NOTE Place a cardiac board or radiolucent pad under patient 1 Place the patient in a lateral recumbent position with their back firmly against the film holder NOTE Patient should be on his her side for at least 5 minutes before the exposure to allow possible free air to rise and abnormal fluids to accumulate 2 Arms should be raised up near the head 3 Flex the knees slightly and ensure that the coronal plane is parallel to the film with no body rotation 4 Adjust the patient so that the center of film and central ray are about 1 to 2 inches above the level of the iliac crest NOTE Top of film should be at the level of the axilla armpit 5 Adjust the patient to center midsagittal plane to center of film and ensure that the up side of the abdomen is clearly included on the film 6 Central ray directed to center of film at 1 to 2 inches above level of iliac crest b Dorsal decubitus abdomen view 1 Place the patient in a supine position with their arms over their head 2 Flex the knees slightly and ensure that the median plane is perpendicular to the table NOTE Ensure that both ASISs are the same distance from the tabletop to check for rotation of the pelvis 3 Adjust the patient so that the center of film and central ray are about 1 to 2 inches above the level of the iliac crest 4 Adjust the height of the film holder to align m
77. and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Tape Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary 3 Use a drape sheet to cover the patient as necessary c Explain the procedure if applicable d Assist the patient onto the X ray table NOTE Stand the patient in front of the upright film holder for the upright abdomen view 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size film cassette NOTE Use a 14 X 17 cassette for both views 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inc
78. are in a field hospital environment with a digital fluoroscopic unit C arm You will need the operator s manual if available Standards Operated the digital fluoroscopic unit IAW the operator s manual Performance Steps 1 Turn the console on a Flip the circuit breaker to the on position b Push the MAINS button on the power console 2 Set up the console for fluoroscopy a Push the AUTOTIMER button on the power console b Push the SPOT FILM button on the power console c Select the appropriate density according to the patient s size by pushing the corresponding DENSITY button on the power console d Push the RESET AUTOTIMER button on the power e Select the mA level by pushing the 200 LARGE SPOT 3 Select the appropriate fluoro time NOTE Fluoro time can be set anywhere from 0 5 minutes 4 Place the table bucky at one end of the table NOTE Bucky should be at the opposite end of the area of interest 5 Rotate the conventional X ray tube away from the table and to the opposite side of the fluoro 6 Pull the fluoro tower out by releasing the stop lock button and pulling towards you 7 Select the proper film format on the fluoro tower console NOTE Film format options are from 1 X 1 to9 X 1 8 Adjust the digital fluoro monitor so that you are able to view the digital image properly 9 Push the PREPARE button on the fluoro tower console to make exposure 10 Place film in fluoro tower bucky and
79. assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sandbags letter markers lead shielding calipers and positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrate the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers d Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is dressed properly 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required 3 Provide the patient with a gown c Explain the procedure to the patient 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size film cassette s NOTE Use an 10 x 12 cassette for both views 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm NOTE For the lateral view use an SID of 72 inches to reduce magnification of
80. carriage Pressed the top release foot beam on the front of the table to move the top to the rear to mate the tube arm to the vertical column Attached the transverse tube arm to the vertical carriage with four bolts Removed the counterweight support pin from the back of the tube column Lifted the tube head assembly vertically out of the tube collimator transport fixture Removed elastic strap holding bucky to the foot end of table Placed the top back on the tube collimator transport fixture and stored it for the next time the shelter is to be transported Applied power to the system by pressing the power ON switch on the control panel performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 245 STP 8 91P15 SM TG References Required Related None CUSWORTH RITA J RADIOLOGY BRANCH SOP 3 246 STP 8 91P15 SM TG PREPARE DEPMEDS RADIOGRAPHIC UNIT MODEL 1200 FOR OPERATION 081 823 0191 Conditions You are in a tactical environment and the unit commander has given the order to setup You have the assistance of other soldiers if required You will need DEPMEDS Portable Radiographic Unit IDDC Model 1200 and Operation and Maintenance Manual for Model 1200 Portable X Ray System Standards Assembled DEPMEDS Portable Radiographic Unit IDDC Model 1200 Performance Steps 1 2 Performance Measures GO 1 2 3
81. closely maintain an open airway and check for other injuries If the casualty s condition permits place him or her in the recovery position See task 081 831 0018 Evaluation Preparation Setup For training and evaluation a CPR mannequin must be used Position the mannequin on its back To test step 3 you may specify to the soldier whether to use the mouth to mouth or mouth to nose method or you may create a scenario in which the casualty s condition dictates which method is to be used You may determine how much of the task is tested by telling the soldier whether the airway is clear or a pulse is found as the soldier proceeds through the task However you should ensure that the soldier is routed through the task far enough to continue rescue breathing after checking the carotid pulse Brief soldier Tell the soldier to perform rescue breathing Performance Measures GO 1 Opened the airway 2 Ventilated the casualty using the mouth to mouth mouth to nose mouth to mask BVM or FROPVD method as appropriate Repositioned the head to ensure an open airway and repeated ventilation attempt if necessary 4 Cleared an airway obstruction if necessary 5 Checked the carotid pulse for 5 to 10 seconds 6 Continued rescue breathing 3 17 STP 8 91P15 SM TG Performance Measures GO 86 7 Completed necessary steps order Evaluation Guidance Score each s
82. d Using the scroll bar e Using key work query Selecting archived patient exam Moving around exam list playing i images Image viewing mode Diagnostic view Stack view Selecting viewing mode Using the tool palette Image formats Using Cine Stack control i j e f g lt gt 2 7 Discuss image quality control procedures 8 Direct new personnel to practice using the LiteBox 9 Supervise and guide new personnel as they practice 3 324 Performance Measures 1 Showed and discussed imaging plates IPs Showed and discussed imaging plate holders cassettes Demonstrated use of IP holders Demonstrated the use of the exam terminal computer a Using the mouse selected work list exams for today b Entered last four digits of the patient ID number SSN c Double clicked on the patient current examination d Entered acquisition information 5 Demonstrated the use of the IP reader 6 Explained the MDIS diagnostic review work station a Roles of the LiteBox b Work station configuration c LiteBox operation and features 1 Turning on the LiteBox 2 Opening the LiteBox application 3 Login window 4 Changing your password 5 Quitting the LiteBox application 6 Patient exam work list 7 Displaying images a Image viewing mode 0 Diagnostic view c Stack view d Selecting viewing mode e
83. entry training in skill level 1 tasks for an individual newly arrived in a unit but limited specifically to tasks associated with the mission organization and equipment of the unit to which the individual is assigned It may be conducted by the unit using training materials supplied by the school by troop schools or by inservice or Glossary 3 STP 8 91P15 SM TG contract mobile training teams In all cases this training is supported by the school proponent IOML infraorbitomeatal line IP imaging plate IV intravenous JTA Joint Table of Allowances KED Kendrick Extrication Device KUB kidney ureters and bladder KVO keep the vein open kVp kilovoltage peak LAO left anterior oblique logistics assistance officer depends on use LPM liters per minute LPO left posterior oblique mA milliamperage mAs milliamperage second s MDIS medical diagnostic imaging support Merger training Training that prepares noncommissioned officers to supervise one or more different military occupational specialties at lower skill levels when they advance to a higher level in their career management field Glossary 4 STP 8 91P15 SM TG METL mission essential task list Mission essential task list A compilation of collective mission essential tasks which must be successfully performed if an organization is to accomplish its wartime mission s ml milliliter mm Hg millimeters of mercury MOS military occup
84. environment location equipment dispersion and similar factors Therefore the MTP should be used as a guide for conducting unit training and not a rigid standard The MTP consists of two parts Each part is designed to assist the commander in preparing a unit training plan which satisfies integration cross training training up and sustainment training requirements for soldiers in this MOS Part One of the MTP shows the relationship of an MOS skill level between duty position and critical tasks These critical tasks are grouped by task commonality into subject areas Section lists subject area numbers and titles used throughout the MTP These subject areas are used to define the training requirements for each duty position within an MOS Section identifies the total training requirement for each duty position within an MOS and provides a recommendation for cross training and train up merger training e Duty Position column This column lists the duty positions of the MOS by skill level which have different training requirements Subject Area column This column lists by numerical key see Section the subject areas a soldier must be proficient in to perform in that duty position Cross Train column This column lists the recommended duty position for which soldiers should be cross trained Train up Merger column This column lists the corresponding duty position for the next higher skill level or MOSC the soldier wi
85. examination of the patella You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Gauze or tape c Lead apron d Letter markers e Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary 3 Use a sheet to cover the patient as needed c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size of cassette NOTE Use an 8 X 10 cassette 7 Place the cassette lengthwise on the tabletop 8 Position the overhead tube a Set the tube angle perpendicular to the apex of the patella b Set the source to image receptor distance SID
86. excess equipment 5 Prepare required adjustment document s 6 Process adjustment documents 7 Adjust all hand receipts property listings or component listings as required 8 Prepare a memorandum with results of inventory between outgoing and incoming commander if required 9 Provide a copy of memorandum of inventory results to higher headquarters if required 10 Place the inventory documents in the Property Record Inspection and Inventory Reports File 710 2d 11 Place copies of all adjustment documents in property book and supporting documents File 710 2a 12 File the inventory results IAW AR 25 400 2 appendix B b Perform the required post inventory actions for specific inventories as follows 1 Perform post inventory actions for a receipt and issue of property inventory Report discrepancies in the receipt and accounting of Communications Security COMSEC equipment as a violation of physical security per TB 380 415 or TB 380 40 22 as applicable 2 Perform post inventory actions for a change of hand receipt holder inventory a Report damaged equipment to unit maintenance personnel for corrective action 0 Report any discrepancies found during the inventory to the accountable officer 3 Perform post inventory actions for a change of responsible officer in the United States Army Reserve USAR 3 314 STP 8 91P15 SM TG Performance Steps 4 Perform post inventory actions for a tool room inventory
87. exposure 3 200 STP 8 91P15 SM TG Performance Steps NOTE This will allow him her to hold the patient s leg and foot completely still 12 Make the exposure 13 Develop the exposed film with the patient identification 14 Return the radiographs to the operating room CAUTION Make sure your surgical mask is on before reentering the operating room Performance Measures GO Selected the required views based on request Gathered the necessary material and supplies Put on the proper surgical garments Set the technical factors Selected the proper size cassette Placed the appropriate letter marker on cassette Placed the cassette in a sterile plastic cassette cover Informed the nurse cassette placement Positioned the X ray tube N A Put on their lead shielding Made exposure 12 Processed the exposed film with the patient identification FT TTT ITT TT ttt 13 Returned the film to the operating room Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 201 STP 8
88. exposure Developed the exposed radiographs with the patient s identification STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Related Required None BONTRAGER KENNETH L 3 67 STP 8 91P15 SM TG X RAY THE FACIAL BONES 081 823 0138 Conditions You have a request for an X ray examination of the facial bones You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required views s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Letter markers d Calipers 3 Prepare the patient a Bring the patient into the x ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary c Explain the procedure if applic
89. have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sandbags lead shielding letter markers and positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Belt c Lead shielding d Letter markers e Calipers f Radiolucent sponges 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is dressed properly 1 Ensure the patient s jewelry is removed as necessary 2 Ensure the patient is dressed in a gown if necessary c Explain the procedure to the patient 4 Place the lead shielding across the patient s lap 5 Measure the body part through the entry exit site of the central ray 6 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 7 Select the proper size cassette NOTE Use 1 2 of a 8 x 10 cassette crosswise 8 Place the cassette on the tabletop 9 Position the overhead tube a Set the tube angle according to the desired position 1 For the plantodorsal Axial projection the tube will be angled 40 degrees toward the heel 2 For the late
90. image receptor distance SID to 40 inches 101 cm c Center the tube to the portion of the film being used d Adjust the conefield to full field coverage NOTE Full field coverage being 1 2 of a 14 x 17 cassette 10 Position the forearm NOTE Place the AP right left forearm on the corresponding side of the cassette This will prevent the upper arm from overlapping onto the exposed or unexposed area of the cassette when in the lateral position 3 89 STP 8 91P15 SM TG Performance Steps a AP View 1 Patient seated at the end of table with hand and arm fully extended NOTE The palm should be facing upward or supinated 2 Drop the shoulder to place the entire limb on the same plane 3 Have patient lean laterally as necessary to place entire wrist forearm and elbow in as near a true lateral position as possible NOTE Styloid processes and epicondyles will be equal distance from their respective film borders NOTE Ensure that the distal radius and ulnas are directly superimposed 6 Central ray is perpendicular to the film directed to mid forearm 11 Immobilize the body part by placing a sandbag on or against the hand 12 13 4 Central ray is perpendicular to the film directed to mid forearm b Lateral view 1 Patient seated at the end of the table with the elbow flexed 90 degrees 2 Drop shoulder to place the entire upper limb on the same horizontal plane 3 Align and center forearm to
91. inspect equipment for defects expiration date and contamination a IV fluid of choice check doctor s orders as appropriate Discard containers that have cracks scratches leaks sedimentation condensation or fluid which is not crystal clear and colorless b IV injection set 1 Spike drip chamber tubing and needle adapter Discard them if there are cracks or holes or if any discoloration is present 2 Tubing clamp Ensure that the clamp releases and catches 3 Needle or catheter over needle Discard them if they are flawed with barbs or nicks NOTE Place the stand to the side of the patient and close to the IV site 3 Prepare the equipment a Clamp the tubing 6 to 8 inches below the drip chamber b Remove the protective covers from the spike and from the outlet of the IV container CAUTION Do not touch the spike or the outlet of the IV container c Insert the spike into the container 1 If using a bag push the spike firmly into the container s outlet tube 2 If using a bottle push the spike firmly through the container s diaphragm CAUTION If no vacuum release sound is heard when puncturing bottled solution discard the solution Bagged solution makes no vacuum release sound d Hang the container at least 2 feet above the level of the patient s heart if possible NOTE An IV bag container be placed under the patient s body if there is way to hang it e Squeeze the drip chamber until it is h
92. it correctly References Required Related None FM 4 25 11 GURLEY AND CALLAWAY 3 3 STP 8 91P15 SM TG MAINTAIN RADIOLOGY EMERGENCY EQUIPMENT TRAY CART 081 823 0316 Conditions You must maintain an emergency equipment tray cart in the radiology section Standards The radiology emergency cart was maintained to standard Performance Steps 1 Locate the emergency equipment tray cart in the radiology section 2 Ensure the location of the cart makes it easily accessible 3 Check all contents to ensure they are current NOTE Cart should have a checklist with all required contents 4 Check all items that have an expiration date If expired replace item NOTE To replace expired medications the cart must be turned into Pharmacy Department 5 Initial and date the inspection work sheet Performance Measures GO Located the emergency equipment tray cart the radiology section Ensured the location was accessible Checked all contents to ensure they were current 2 3 4 Checked all items that had expiration dates and replaced them if needed 5 Initialed and dated the inspection work sheet Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and
93. manual is as follows e Task Title The task title identifies the action to be performed e Task Number A 10 digit number identifies each task or skill Include this task number along with task title in any correspondence relating to the task Conditions The task conditions identify all the equipment tools references job aids and supporting personnel that the soldier needs to perform the task in wartime This section identifies any environmental conditions that can alter task performance such as visibility temperature and wind This section also identifies any specific cues or events that trigger task performance e Standards The task standards describe how well and to what level you must perform a task under wartime conditions Standards are typically described in terms of accuracy completeness and or speed e Performance Steps This section includes a detailed outline of information on how to perform the task e Evaluation Preparation when used This subsection indicates necessary modifications to task performance in order to train and evaluate a task that cannot be trained to the wartime standard under wartime conditions It may also include special training and evaluation preparation instructions to accommodate these modifications and any instruction that should be given to the soldier before evaluation e Performance Measures This evaluation guide identifies the specific actions that the soldier must do to successfully com
94. message prompt Ensure printer is Online is displayed then press any key d Select Y or N to the message prompt Commander s Report Should Be Run Before Sending Transactions To Source of Supply Do You Wish To Continue 1 Selecting N returns you to the Send Transactions screen where you can then return to the Request Processes Menu to run the Commander s Reports 2 Selecting Y allows you to continue the process Label a diskette Insert diskette into A drive Verify that the printer is on a f 9 h Format the diskette Select the diskette volume label 3 305 STP 8 91P15 SM TG Performance Steps i Select or N to format another disk j Process the transactions k Review the Send Supply Transactions Report File the Send Supply Transactions Report in unit file m Forward the diskette to the SOS 2 Send previous transactions via communications a Select Previous Transactions option 2 0 Select the Send Trans Via Communications option 2 c Verify that the printer is on d Process the transactions e Print the Send Supply Transactions Report f File the Send Supply Transactions Report in unit files g Return to the Send Supply Transactions screen f Select Send Current Transactions for All Units on File option 3 1 Send transactions via floppy diskette a Select Send Current Trans Via Floppy Diskette 0 Select the drive
95. moving the head and neck as one unit NOTE lf the cervical collar or improvised collar does not fit flush with the spine board place roll in the hollow space between the neck and board The roll should only be large enough to fill the gap not to exert pressure on the neck f Secure the casualty s head and head supports to the board with straps cravats WARNING Ensure that the cravats or head straps are firmly in place before the assistant releases stabilization 1 Apply head supports 2 Use two rolled towels blankets sandbags or similar material 3 Place one close to each side of the head 4 Using a cravat like material across the forehead make the supports and head one unit by tying to the board g Secure the casualty to the short spine board 1 Place the buckle of the first strap in the casualty s lap 2 Pass the other end of the strap through the lower hole in the board up the back of the board through the top hole under the armpit over the shoulder and across the back of the board at the neck 3 Buckle the second strap to the first strap and place the buckle on the side of the board at the neck 4 Pass the other end over the shoulder under the armpit through the top hole in the board down the back of the board through the lower hole and across the lap Secure it by buckling it to the first strap h the casualty s hands together and place them in his or her lap NOTE When positioning a c
96. must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 266 Subject Area 15 Movement PREPARE THE DARKROOM TENT FOR MOVEMENT 081 823 0163 STP 8 91P15 SM TG Conditions You are in a tactical environment and the commander has given the order to move You have the assistance of other soldiers Standards Prepared the darkroom tent for movement without damage Performance Steps 1 N A D Disconnect and pack the darkroom fan Disconnect and pack the four outlet power cord Remove the transfer cabinet Remove any remaining equipment from the tent Secure all of the tent openings Unsnap the sleeves from the uprights Remove and disassemble the uprights Unlace the tent from the top framework Disassemble the top framework Fold the tent Pack the tent and poles Performance Measures N A N Disconnected and packed the darkroom fan Disconnected and packed the four outlet power cord Removed the transfer cabinet Removed any remaining equipment from the tent Secured all of the tent openings Unsnapped the sleeves from the uprights Removed and disassembled the uprights Unlaced the tent from the top framework Disassembled the top framework Folded the tent Packed the tent and poles
97. nonexpendable register and post to property records 2 Send the original and first copy to approving authority within five working days after the adjustments are posted to property records d The approving authority for ARs is determined by the total value of gains and losses 1 When IARs are two thousand five hundred dollars 2 500 or less the approving authority is the commander who appointed the PBO 2 When IARs are over 2 500 but less than 10 000 the approving authority is the commander who appointed the PBO is the grade of 0 5 or above or assigned to a position authorized grade 0 5 or above 3 When an IAR is ten thousand 10 000 or more the approving authority is the commander who appointed the PBO is the grade of 0 6 or above or assigned to a position authorized grade 0 6 or above 4 Adjustments gains and losses for the fiscal year that excess 2 1 2 percent of the total value of the stockage allowance must be an approving authority in the grade 0 6 or above or assigned to a position authorized grade 0 6 or above 5 Compute the dollar value of the stockage allowance as of the last day of the first month of the fiscal year STP 8 91P15 SM TG Performance Steps e Final disposition of IARs depends upon action taken by the approving authority 1 When all items listed on IAR are approved the original copy will be returned to the PBO for filing 2 When one or more items listed on the IAR are disapproved
98. not available use tape or sandbags to hold cassette in place 4 Horizontal central ray centered to vertebral column 5 Center the cassette 1 inch above the iliac crest 6 Collimate long and narrow field to region of the spine 11 Place the appropriate identification marker on the cassette NOTE Letter marker based on side of body closest to the cassette 12 Tell the patient TAKE INA DEEP BREATH BLOW IT OUT AND HOLD IT OUT 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the exposed film with the patient s identification Performance Measures GO Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part entry exit site of the central Set the control panel Selected the proper size cassette Placed the cassette into the film holder lengthwise Positioned the overhead tube Placed a lead apron across the patient s lap N A PD Positioned for trauma lumbar spine a AP view b Cross table lateral view 11 Placed the proper letter marker on the cassette 12 Gave the proper pre post exposure instructions 13 Made the exposure 14 Developed the exposed film with the patient s identification 3 181 STP 8 91P15 SM TG Evaluation Guidance Score each s
99. overhead tube eg N A Placed the lead shielding around the patient s waist 3 160 STP 8 91P15 SM TG Performance Measures GO 10 Positioned the decubitus chest Lateral decubitus chest view b Dorsal decubitus chest view 11 Immobilized the patient as necessary 12 Placed the appropriate identification marker on the cassette 13 Gave the proper pre post exposure instructions 14 Made the exposure 15 Processed the film Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 161 STP 8 91P15 SM TG X RAY TRAUMA HIP 081 823 0221 Conditions You have a request for a radiologic examination of trauma hip You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes in various sizes sandbags lead aprons letter markers and numerous positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1
100. pass all Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette in the bucky crosswise Positioned the overhead tube Positioned the clavicle for the AP view Placed the appropriate identification marker on the cassette Secured the lead apron around the patient s waist Gave the patient the pre post exposure instructions Made the exposure Developed the film with patient s identification on it PT TTT TTT performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 105 STP 8 91P15 SM TG X RAY THE ACROMIOCLAVICULAR JOINTS 081 823 0116 Conditions You have a request for a radiologic examination of the acromioclavicular joints You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sandbags lead shielding letter markers and various size positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Se
101. patient DO NOT BREATHE OR MOVE 13 Make the exposure 14 Tell the patient BREATHE NORMALLY AND RELAX 15 Develop the exposed cassette s with the patient identification for processing 16 Return the patient to the waiting area Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size of cassette N O oO A Placed the cassette the bucky lengthwise for the view crosswise for the lateral view 8 Positioned the overhead tube 9 Positioned the mandible 10 Placed the lead apron across the patient s lap 11 Gave the patient the pre post exposure instructions 12 Made the exposure 13 Developed exposed cassette s 3 72 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Related Required None BONTRAGER KENNETH L 3 73 STP 8 91P15 SM TG X RAY THE TEMPOROMANDIBULAR JOINTS 081 823 0141 Condition
102. patient comfort b Lateral view 1 Place the patient in a lateral recumbent position with the knees flexes for support 2 Place the patient s arms at right angles to the body 3 Align the mid coronal plane to the midline of the table cassette 4 Place acromion processes 2 below the upper film border c RAO view 1 Place the patient in the prone position 2 Rotate the 35 40 degrees to the left NOTE The patient s right side should be against the table 3 Place the right arm down left arm flexed at the elbow and by the patients head NOTE Flex the patient s knees for support 4 Align the mid thorax to the center of table cassette with the acromion processes 2 below the upper film border 15 Administer the contrast medium a Instruct the patient FILL YOUR MOUTH WITH CONTRAST MEDIUM BUT DO NOT SWALLOW IT b Start the rotor c Tell the patient START DRINKING THE CONTRAST MEDIUM NOTE While swallowing the patient will momentarily stop breathing suspended respiration 16 Make the exposure 17 Tell the patient STOP DRINKING AND RELAX 18 Develop the exposed film with the patient s identification Performance Measures GO 1 Gathered the necessary materials and supplies 2 Attached any required accessories to the table B 3 Prepared the contrast medium 3 184 N A 12 13 14 Evaluation Guidance S
103. portable x ray operators h Floor supervising 1 Number of personnel needed Process for examination distribution Process for determining priority care Process for coordinating patient delivery and retrieval Process for reporting equipment problems a D 2 3 4 5 ray exposure rooms 1 Number of technologists needed 2 Types of equipment available a Head x ray rooms 0 Trauma x ray rooms c Routine x ray rooms d Fluoroscopy rooms Patient flow coordination 3 3 321 STP 8 91P15 SM TG Performance Measures GO 6 Established a process for determining sleep and work time schedules if the mass casualty situation continues for an undetermined extended time period Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 322 STP 8 91P15 SM TG TRAIN PERSONNEL IN COMPUTED RADIOGRAPHY 081 823 0319 Conditions You are a staff NCO radiographer in a diagnostic section of radiology service equipped with medical diagnostic imaging support MDIS systems computed radiography equipment You have received new personnel and need to train them on computed radiography e
104. request Process for determining exam protocol Process for exam production accountability Process for exam review reading Process for films check out 2 a SS DS SS wa 1 2 3 4 5 6 3 320 STP 8 91P15 SM TG Performance Measures GO 215 b Portables ER OR 1 Number of technologists needed 2 Process for review of examination request Process for exam production accountability Process for exam review reading Process for films check out delivery Process for communication c Film quality control 1 Number of technologists needed 2 Process for repeat notification 3 Process for film matching and sorting 4 Process for exam review reading 5 1 2 3 4 5 6 Process for films check out delivery kroom and film processors Number of technologists needed Process for cassette handling a Exposed 0 Unexposed 3 Process for processor trouble shooting 4 Primary and alternated processors e Film file room 1 Number of personnel needed 2 Process for report distribution 3 Process form film sign out in Reception area 1 Number of personnel needed 2 Process for logging examination requests 3 Process for dissemination of requests to exposure rooms g Telephonic communications 1 Number of personnel needed 2 Process for transferring emergency calls 3 Process for communicating with other imaging areas 4 Process for communicating with
105. show what was done wrong and how to do it correctly References None 3 256 STP 8 91P15 SM TG OPERATE DEPMEDS RADIOGRAPHIC UNITS 081 823 0303 Conditions You are required to perform a radiology procedure The patient has been properly prepared and is able to tolerate the exam You will need a fully equipped x ray room and functioning radiographic unit Standards Produced radiographs of diagnostic quality that properly demonstrated the body section requested The radiographs were correctly identified and free from artifacts Performance Steps 1 Prepare patient for requested diagnostic procedure NOTE Follow SOP for correctness in patient preparation and attire 2 Position part to be imaged NOTE Follow SOP for correct routine for each anatomical region 3 Set technical factors a Measure body part using correct radiograph calipers b Set proper mAs using provided technique chart c Set proper kVp using provided technique chart d Select appropriate cassette size 4 Expose film 5 Develop film NOTE event computed radiography is in use image plates will be used in place of film Performance Measures GO 86 1 Prepared patient for requested diagnostic procedure NOTE Followed SOP for correctness in patient preparation and attire 2 Positioned part to be imaged NOTE Followed SOP for correct routine for each anatomical region 3 Set technical factors a Measured body p
106. soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Prepared to perform the handwash Wet the hands wrists and forearms Washed the hands wrists and forearms Rinsed the hands wrists and forearms Dried the hands wrists and forearms necessary Removed wristwatch and jewelry if applicable Rolled shirt sleeves to above the elbows if applicable Covered the hands wrists and forearms with soap Used a towel to turn off the running water if applicable Reinspected the fingernails and cleaned them and rewashed the hands if GO PTT TTT Tt e performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References 3 6 Required None Related BTLS FOR PARAMEDICS EMERGENCY CARE STP 8 91P15 SM TG MANAGE A CONVULSIVE AND OR SEIZING PATIENT 081 831 0035 Conditions You have already taken the appropriate body substance isolation precautions Standards Completed all steps to manage a convulsive and or seizing patient without allowing or causing unnecessary injury to the patient Performance Steps 1 Identify the type of convulsions and or seizures based upon the following characteristic signs and symptoms a Petit mal 1 Brief loss of concentration or awareness without loss of motor tone 2 Found chiefly in childr
107. sufficiently to allow 15 column rotation Install over table x ray tube and collimator NOTE Do not reinstall table sub top and top until calibration is complete 16 17 18 Install table sub top Install table top Install over table x ray tube and collimator Performance Measures 15 16 17 18 Detached all table accessories from table top Removed sub top Removed table top Installed spot film device image intensifier fluoroscopy x ray tube collimator Released spot film carriage Released table Released grid cabinet Secured locks in counterweight pulleys Released spring loaded pin from ceiling bracket Did not remove from tube stand Released the hook and pile Velcro strips on the overhead tube arm Unlatched spring loaded pin that secures the bottom of the tube stand to the rail Unlatched the spring loaded pin that secures the tube arm Moved bolt on back of tube arm from Shipping Position center hole to Operational Position upper hole Unscrewed the lock handle on the tube stand base Released tension sufficiently to allow column rotation Installed over table x ray tube and collimator Installed table sub top Installed table top Installed over table x ray tube and collimator 3 242 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the eva
108. supplies in the following situations 1 Non NSN single line item 2 NSN single line item when the NSN is not listed on the FED LOG 3 Modification work order MWO and modification kits 4 Classified items Select the Request for Issue menu driver option to request items from automated and non automated supply sources 3 295 STP 8 91P15 SM TG Performance Steps f Select the Request for Issue file driver option to request items to replenish shortages of components of end items determined in the component list processes 3 Process DA Form 581 Request for Issue and Turn in of Ammunition IAW DA Pam 710 2 1 and the local SOP a Prepare DA Form 581 1 Issue block Enter X 2 Turn in block Leave blank 3 Document Number block Enter unit document number from the expendable register 4 Page block Enter total number of DA Form 581 and 581 1 with this document number Send To block Enter the name and address of the supporting ASP Request From block Enter the name address and UIC of using unit Date Material Required block Enter the appointment date and time at ASP Allocation Period block Enter the allocation period as indicated in the using unit s forecast 9 DODAAC block Enter the using unit s DODAAC 10 Requested By block Enter the name of the authorized requester as indicated on the 1687 11 Block 13b Date Enter the Julian date 12 Block 13c Signature Enter the signature of the
109. technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 14 x 17 cassette for all views 7 Place the cassette in the holder lengthwise for the AP and lateral views 8 Position the overhead tube a Set the tube angle 1 For the AP view the tube angle will be vertical perpendicular 2 For the lateral view the tube angle will be horizontal perpendicular b Set the source to image distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to long and narrow fields to the region of the spine 9 Place a lead apron across the patient s lap without obscuring the area of interest 10 Position for trauma lumbar spine NOTE With assistance from other personnel slide the patient on the back board onto the table Use extreme caution not to cause further injury a AP view 1 Patient in a supine position on the back board 2 Align the midsagittal plane to midline of the table 3 180 STP 8 91P15 SM TG Performance Steps 3 Place arms at their sides 4 Center central ray at the level of the iliac crest b Cross table lateral lumbar spine 1 Patient supine with arms up and across their chest as not to obscure lumbar region 2 Medial plane parallel to the cassette 3 Move the patient to edge of table so vertical cassette is next to the patient and can be placed below the level of the tabletop NOTE moving grid is
110. the fluoro tower console to expose the film Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C 3 253 STP 8 91P15 SM TG OPERATE FIXED RADIOGRAPHIC FLUOROSCOPIC UNIT 081 823 0254 Conditions You are in a field hospital environment with a fixed radiographic fluoroscopic unit Continental You will need the operator s manual if available Standards Operated the fixed radiographic fluorscopic unit IAW the operator s manual Performance Steps 1 Turn the console on a Flip the circuit breaker to the on position b Push the MAINS button on the power console 2 Set up the console for fluoroscopy a Push the AUTOTIMER button on the power console b Push the SPOT FILM button on the power console c Select the appropriate density according to the patient s size by pushing the corresponding DENSITY button on the power console Push the RESET AUTOTIMER button on the power console to reset the autotimer to zero e Select the mA level by pushing the 200 LARGE SPOT button on the power console 3 Select the appropriate fluoro time NOTE Fluoro time can be set anywhere from 0 5 minutes 4 Place the table bu
111. the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Sandbags c Lead shielding d Letter markers e Calipers 3 Prepare the patient a Bring the patient into the room b Ensure the patient is dressed properly NOTE Have the patient remove all items from around their neck and well as any removable dental work c Explain the procedure to the patient 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Use the proper size cassette a Use an 8 x 10 for the AP and open mouth views b Use a 10 x 12 for the lateral view 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the cassette NOTE Angle the tube 15 degrees cephalic for the AP view b Set the source to image receptor SID to 40 inches 101 cm NOTE For the lateral view set the SID at 72 inches 182 cm c Center the tube to the cassette d Adjust the conefield to full field coverage NOTE Use 6 x 6 conefield for the open mouth view 9 Place the lead shielding around the patient s lap 10 Position for the cervical spine a AP view 1 Place the patient supi
112. the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Since only the toes are being demonstrated use 1 2 of an 8 X 10 for the DP view and the other half for the lateral 7 Place the cassette on the table crosswise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101cm c Center the tube to the portion of the film being used d Adjust the conefield to area of concern 9 Position the toes a AP view 3 136 Performance Steps 10 11 12 13 14 15 16 1 Place the patient supine or seated on the table 2 Flex the knee of the affected side to place the plantar surface of the foot in contact with the cassette STP 8 91P15 SM TG 3 Center the toes of interest to the appropriate half of the cassette 4 Central ray directed to the middle portion of the toes to be examined b Lateral view 1 Place the patient laterally recumbent Position the foot and leg to form a 90 degree angle Immobilize the body part as required Place the appropriate letter marker on the cassette Place the lead apron across the patients lap Tell the patient DO NOT MOVE Make the exposure Tell the patient RELAX and remove immobilization Process the film with the patient s identification Performance Measures ON 10 Selected
113. the approving authority will circle the item s number s and indicate the investigative procedure AR 15 6 or AR 735 5 desired 3 When an AR 15 6 investigation is desired the original copy is returned to the PBO for filing and the approving authority initiates the investigation 4 When a report of survey is desired the original copy is returned to the PBO with instruction to initiate a report of survey within 5 working days 5 Assign DA Form 1574 Report of Proceedings or DA Form 4697 Report of Survey the same document number as was assigned to IAR 6 Prepare a memorandum for the PBO s signature when the inventory is completed f File the inventory results IAW AR 25 800 2 Appendix B 1 Place the inventory documents in the Property Record Inspection and Inventory Report File 710 2d 2 Place copies of all adjustment documents in the Property Book and Supporting Documents File 710 2a Performance Measures GO 1 Prepare for inventory 2 Conduct a physical inventory B 3 Conduct post inventory procedures Evaluation Guidance Score the soldier a GO if steps are done correctly Score the soldier a NO GO if any step is failed If the soldier fails any step show what was done wrong and how to do it correctly References Required Related AR 190 11 None AR 25 400 2 AR 710 2 AR 735 5 DA PAM 25 30 DA PAM 710 2 1 3 317 STP 8 91P15 SM TG Skill Level 3 Subject Area 18 Admin SL3
114. the assistance of additional personnel if required You will need a properly equipped fluoroscopic room with correct contrast medium and various sizes of film cassettes Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiographs were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Lead apron Lead gloves Letter markers Contrast medium Anaphylactic shock tray 3 Attach any required accessories to the table 4 Prepare the contrast medium 5 Prepare the equipment for fluoroscopy 6 Prepare the patient a Bring the patient into the x ray room b Ensure the patient is properly dressed 1 Ensure that foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary NOTE Gown the patient as necessary c Explain the procedure if applicable d Assist the patient onto the X ray table 7 Assist the radiologist as directed 8 Prepare the equipment for follow up radiographs a Measure the body part through the entry exit site of the central ray b Set the control panel 1 Consult the technique chart 2 Set the appropriate mAs and kVp on the control panel c Select proper size film cassette NOTE Use a 10 X 12 cassette lengthwise for
115. the casualty was stable 9 Recorded the procedure on the appropriate form 10 Evacuated the casualty and provided supportive measures en route Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 24 STP 8 91P15 SM TG INITIATE AN INTRAVENOUS INFUSION 081 833 0033 Conditions You have performed a patient care handwash You will need IV injection set IV solution needle or catheter over needle constricting band antiseptic sponges 2 x 2 gauze sponges tape IV stand or substitute armboard and gloves Standards Initiated an intravenous infusion without causing further injury or unnecessary discomfort to the patient Did not violate aseptic technique Performance Steps 1 Identify the patient and explain the procedure Ask the patient s name Check the identification band against the patient s chart as appropriate Explain the reason for IV therapy Explain the procedure and caution the patient against manipulating the equipment Ask about any known allergies to such things as betadine or medication Reassure the patient that this is a common procedure 2 Select and
116. the cleaned cassettes on their sides and allowed 20 30 minutes for drying 5 Once the screens were dry and free from particles and dirt reloaded the cassettes a darkroom 6 Cleaned the outside of the cassettes with a cloth and cleaning solution 7 Allowed the outsides of the cassettes to dry before using them for a 3 232 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C 3 233 STP 8 91P15 SM TG Subject Area 13 Field Set Up PREPARE THE DARKROOM TENT FOR FIELD OPERATION 081 823 0154 Conditions You are in a tactical environment and the unit commander has given the order to setup The assistance of other soldiers is available You have a darkroom tent accessories and the field cassette transfer cabinet Standards Unpacked and assembled the darkroom tent without damage Upon completion light should not enter the darkroom tent Performance Steps 1 Ensure all components are on hand a The canvas case containing the tent covering frame stakes and ropes b The metal case containing the exhaust fan the four outlet receptacle cord the fa
117. the long axis of the unused portion of the film 4 Rotate hand and wrist into a true lateral position thumb up 5 Position and support hand to prevent motion Place the appropriate letter marker on the cassette Tell the patient DO NOT MOVE 14 Make the exposure 15 16 Tell the patient RELAX Develop the film with the patient s identification Performance Measures N O A Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Placed the lead apron across the patient s lap Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette on the table lengthwise 9 10 Positioned the overhead tube Positioned the forearm NOTE To Include both joints used a larger cassette and positioned the styloids and epicondyles equidistant from the respective film borders 3 90 a AP view b Lateral view FT TTT TIT STP 8 91P15 SM TG Performance Measures GO 11 Placed the appropriate identification marker on the cassette 11 Immobilized the body part by placing sandbag on or against the hand 12 Gave the patient the pre post exposure instructions 13 Made the exposure B 14 Developed the film with the patient s identification Evaluation Guidance Score each
118. the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette on the table crosswise Properly positioned the overhead tube Positioned the toes a AP view b Lateral view Immobilized the body part as required Placed the appropriate identification marker on the cassette 12 13 Placed the lead apron across the patients lap Gave the proper pre post exposure instructions 2 3 4 Center the toes of interest to the appropriate half of cassette 5 Central ray directed to the middle portion of toes to be examined Place the plantar surface of the foot perpendicular to the cassette 3 137 STP 8 91P15 SM TG Performance Measures GO 14 Made the exposure 15 Processed the film with the patient s identification Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 138 STP 8 91P15 SM TG X RAY THE PATELLA 081 823 0223 Conditions You have a request for an X ray
119. the soldier must pass all Displayed the patient record with the correct Exam ID on the Film Digitizer work station Ordered an exam to create the Exam ID if necessary Verified that the Exam ID correctly matches the film to be digitized Loaded the film into the digitizer Clicked OK to begin digitizing Removed the film from the output tray performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 222 STP 8 91P15 SM TG TRANSMIT IMAGES USING TELERADIOLOGY SOFTWARE AND HARDWARE 081 823 0324 Conditions You are a radiographer with appropriate sending privileges Standards Sent diagnostic quality computerized image via phone or LAN line IAW DIN PACS and department SOP Performance Steps 1 Select the on line exam to be sent from the primary work list window Select Display Exam from the Images menu Select desired images to be sent from the Format pop up menu Select Send Exam from the Option menu Select destination from the Destination pop up menu Select Send oa A 1 Selected the on line exam to sent from the primary work list window Selected Display Exam from the Images menu Selected desired images to be sent from Format pop up menu Selected Send Exam from the Option menu Selected destination from the Desti
120. the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette Restrict the cone field to 10 17 lengthwise 9 Position the thoracic spine 3 171 STP 8 91P15 SM TG Performance Steps a AP view 1 Place the patient supine with the median plane perpendicular to and over the centerline of the table 2 Flex the knees with the soles of the feet flat on the table NOTE This will reduce dorsal kyphosis 3 Central ray directed to a point 3 to 4 inches below the jugular manubrial notch b Lateral view 1 Place the patient laterally recumbent with the knees flexed and arms at right angles to the body 2 Adjust the coronal plane perpendicular to and over the centerline of the table 3 Place radiolucent material under the lower dorsal region to bring the long axis of the spine parallel to the table 4 Central ray directed to a point 3 to 4 inches below the jugular manubrial notch 10 Place the appropriate identification marker on the cassette 11 Place the lead apron across the patient s lap 12 Tell the patient STOP BREATHING AND DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Process the film Performance Measures GO Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the cen
121. to 40 inches 101 cm c Center the tube to the cassette d Collimate on all sides to the area of the patella 9 Position the patella NOTE This acute flexion of the knee should NOT be attempted until fracture of patella has been ruled out by other projections a Tangential Axial projection sunrise 3 139 STP 8 91P15 SM TG Performance Steps 10 11 12 13 14 15 16 1 Place the patient in the prone position the table and slowly flex knee to a minimum of 90 degrees 2 Central ray angle central ray 15 to 20 degrees from long axis of lower leg Immobilize the body part as required Place the appropriate letter marker on the cassette Place the lead apron across the entire pelvic area Tell the patient DO NOT MOVE Make the exposure Tell the patient RELAX and remove immobilization Develop the exposed cassette s with patient identification for processing Performance Measures GO N oO A N Evaluation Guidance Score each soldier according to the performance measures the Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size of cassette Placed the cassette lengthwise on the tabletop Positioned the overhead tube P
122. to SM standards and have them continue to practice until they can perform to SM standards Record results in the leader book 1 6 STP 8 91P15 SM TG 1 9 Training Support This manual includes the following information which provides additional training support information e Appendix A DA Form 5165 R Field Expedient Squad Book This appendix provides an overprinted copy of DA Form 5165 R for the tasks in this MOS The NCO trainer can use this form to set up the leader book described in FM 25 101 appendix B The use of this form may help preclude writing the soldier tasks associated with the unit s mission essential task list and can become a part of the leader book Glossary The glossary which follows the last appendix is a single comprehensive list of acronyms abbreviations definitions and letter symbols e References This section contains two lists of references required and related which support training of all tasks in this SM Required references are listed in the conditions statement and are required for the soldier to do the task Related references are materials which provide more detailed information and a more thorough explanation of task performance 1 7 STP 8 91P15 SM TG CHAPTER 2 Trainer s Guide 2 1 General The MOS Training Plan MTP identifies the essential components of a unit training plan for individual training Units have different training needs and requirements based on differences in
123. to request supplies IAW AR 71 32 and AR 710 2 a Identify the authorization document b 1 11 Other publications 1 Modification table of organizational equipment MTOE Table of distribution and allowances TDA 3 Joint table of allowances JTA 4 Common table of allowances CTA 5 HQDA memorandum 6 Army regulation AR 7 Supply bulletin SB 8 Supply catalog component listing SC CL 9 Technical manual TM 0 Government supply activity catalog GSA 2 Check required item against the authorization document and verify authorization and quantity 2 Select correct request form or method a b Select DA Form 581 Request for Issue and Turn in of Ammunition to order ammunition and explosives Select DA Form 2765 1 Request for Issue and Turn in to request expendable durable and non expendable single line items with national serial number NSN listed on FED LOG Select DA Form 3161 Request for Issue and Turn in to request the following types of supplies 1 Ten or more line items of supplies normally provided by a self service supply center SSSC when SSSCs are not available 2 Five or more line items of packaged Class III items 3 Expendable medical items within a medical facility 4 Five or more line items of supplies normally ordered on a recurring basis Select DD Form 1348 6 DOD Single Line Item Requisition System Document to request
124. top of unit ensure unit is level Connect the power cord to a grounded power source Connect drainage outlets to hazardous material containers Remove roller racks Set the thermostat to 68 degrees F Fill the back tank labeled with a white dot with water to the level marked on the inside of tank Insert roller rack slowly Measure the water temperature Turn the heating or cooling system on as required Mix the developing chemical according to manufacturer s guidelines and fill first tank labeled with a red dot to the level marked on the inside of tank Insert roller rack slowly Mix the fixing chemical according to manufacturer s guidelines and fill middle tank labeled with a blue dot to the level marked on the inside of tank Insert roller rack slowly Insert dryer roller Place dryer cover over dryer rollers Place lid on top of processor Turn unit on Check the developer temperature after 20 minutes 86 Set processor on the selected site and ensured it was level 3 236 STP 8 91P15 SM TG Performance Measures GO Connected the power cord to a grounded power source Connected drainage outlets to hazardous material containers Removed roller racks E Set the thermostat to 68 degrees F Filled the water tank Filled developer tank Filled fixer tank Inserted rollers and replaced cover N A PD
125. view 8 Position the overhead tube a Set the tube angle perpendicular to the film NOTE Angle the tube 25 degrees cephalic for the lateral view b Set the source to image receptor distance SID to 40 inches 101cm c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Position the mandible NOTE Because of the extreme mobility of the head on the neck all positions of the skull require a two way head alignment TWHA for exact positioning of the skull PA view TWHA 1 Place the patient prone with the nose and forehead in contact with the table 2 Place the median plane perpendicular to and over the centerline of the table 3 71 STP 8 91P15 SM TG Performance Steps 3 Adjust the orbitomeatal line OML perpendicular to the cassette 4 Center the junction of the lips to the film b Lateral bilateral view TWHA 1 Place the patient semiprone with the head turned and the side of the face down in contact with the table 2 Adjust the elevated shoulder down and out of the conefield 3 Tilt the median plane of the skull 15 degrees vertex down to the tabletop 4 Adjust the inferior border of the chin parallel with the lower edge of the cassette 5 Project the midpoint of the inferior margin of the mandibular body of the side up to the cassette 10 Place the appropriate identification marker on the cassette 11 Place the lead apron across the patient s lap 12 Tell the
126. 0 66 Medical Record Administration and Health Care Documentation 3 May 1999 AR 710 2 Inventory Management Supply Policy Below the Wholesale Level 31 October 1997 AR 735 5 Policies and Procedures for Property Accountability 20 June 2002 Department of Army Forms DA FORM 2062 Hand Receipt Annex Number DA FORM 3161 Request for Issue or Turn In Department of Army Pamphlets DA PAM 25 30 Consolidated Index of Army Publications and Blank Forms 1 October 2002 DA PAM 611 21 Military Occupational Classification and Structure 31 March 1999 DA PAM 710 2 1 Using Unit Supply System Manual Procedures 31 December 1997 Other Product Types 10 CFR 20 Standards for Protection Against Radiation JCAHO MANUAL JCAHO Accreditation Manual for Hospitals SF 519 B Radiologic Consultation Request Report References 1 STP 8 91P15 SM TG Related Publications Related publications are sources of additional information They are not required in order to perform the tasks in this manual Department of Army Forms DA FORM 1574 Report of Proceedings by Investigating Officer Board of Officers DA FORM 2028 Recommended Changes to Publications and Blank Forms DA FORM 2404 Equipment Inspection and Maintenance Worksheet DA FORM 2765 1 Request for Issue or Turn In DA FORM 444 Inventory Adjustment Report IAR DA FORM 4697 Department of the Army Report of Survey DA FORM 5164 R Hands On Evaluation DA FORM 5165 R Field Expedient Squad Book DA FORM 5513 R Key Control Registe
127. 0048 PERFORM RESCUE 3 15 081 831 0046 ADMINISTER EXTERNAL CHEST 55 5 3 19 081 833 0031 INITIATE TREATMENT FOR ANAPHYLACTIC 5 3 23 081 833 0033 INITIATE AN INTRAVENOUS 3 25 081 833 0034 MANAGE A PATIENT WITH AN INTRAVENOUS INFUSION 3 30 081 833 0048 MANAGE AN UNCONSCIOUS 3 35 081 833 0076 APPLY RESTRAINING DEVICES 3 38 081 833 0092 TRANSPORT A CASUALTY WITH A SUSPECTED SPINAL Wace a eect ect seach 3 41 081 831 0011 MEASURE A PATIENT PULSE 3 46 081 831 0010 MEASURE A PATIENT S RESPIRATIONS 3 49 081 831 0012 MEASURE A PATIENT S BLOOD 3 51 081 831 0013 MEASURE A PATIENT S 2 3 54 Subject Area 2 Basic X Ray Skills 081 823 0101 MAKE CALCULATIONS FOR mA AND TIME RELATIONGSHIP 3 57 081 823 0102 MAKE CALCULATIONS FOR CHANGES IN 50 3 58 081 823 0104 MAKE EXPOSURE FACTOR COMPENSATION FOR PATIENT a esse SD ania
128. 1 081 833 0033 081 833 0034 081 833 0048 081 833 0076 081 833 0092 081 831 0011 081 831 0010 081 831 0012 081 831 0013 MOS TRAINING PLAN 91P15 CRITICAL TASKS Training Sust Sust Tng SL Location Tng Freq Skill Level 1 HANDLE PATIENT USING PROPER BODY MECHANICS ASSESS PATIENT CONDITION BEFORE X RAY MAINTAIN RADIOLOGY EMERGENCY EQUIPMENT TRAY CART PERFORM A PATIENT CARE HANDWASH MANAGE A CONVULSIVE AND OR SEIZING PATIENT OPEN THE AIRWAY CLEAR AN UPPER AIRWAY OBSTRUCTION PERFORM RESCUE BREATHING ADMINISTER EXTERNAL CHEST COMPRESSIONS INITIATE TREATMENT FOR ANAPHYLACTIC SHOCK INITIATE AN INTRAVENOUS INFUSION MANAGE A PATIENT WITH AN INTRAVENOUS INFUSION MANAGE AN UNCONSCIOUS CASUALTY APPLY RESTRAINING DEVICES TO PATIENTS TRANSPORT A CASUALTY WITH A SUSPECTED SPINAL INJURY MEASURE A PATIENT S PULSE MEASURE A PATIENT S RESPIRATIONS MEASURE A PATIENT S BLOOD PRESSURE MEASURE A PATIENT S TEMPERATURE 2 5 STP 8 91P15 SM TG Subject Area 2 Basic X Ray Skills 3 General Radiography Head 4 General Radiography Upper Extremities 2 6 Task Number Title Training Location 081 823 0101 081 823 0102 081 823 0104 081 823 0105 081 823 0106 081 823 0135 081 823 0136 081 823 0138 081 823 0140 081 823 0141 081 823 0142 081 823 0143 081 823 0108 081 823 0109 081 823 0110 081 823 0111 081 823 0112 081 823 0113
129. 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Lead gloves d Letter markers e Contrast medium f Cups g Straw 3 Attach any required accessories to the table 4 Prepare the contrast medium CAUTION Ensure the appropriate contrast medium is being used and verify the expiration date 5 Prepare the equipment for fluoroscopy 6 Prepare the patient a Bring the patient into the room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Give the patient a gown if necessary c Explain the procedure if applicable d Assist the patient onto the X ray table 7 Assist the radiologist as directed 8 Prepare the equipment for the follow up radiographs a Measure the body part through the entry exit site of the central ray b Set the control panel 1 Consult the technique chart 2 Set the appropriate mAs and kVp on the control panel c Use a 14 x 17 inch cassette for all the views d Place the cassette in the bucky lengthwise e Place the letter marker on the film f Position the overhead tube 1 Set the tube angle 3 186 STP 8 91P15 SM TG Performance Steps 2 Set the source to image distance SID 3 Center the tube to the film 4 Adjust the conefield to full film coverage
130. 15 SM TG Performance Steps 1 Set the tube angle vertical perpendicular 2 Set the source to image distance SID to 40 inches 101 cm 3 Center the tube to the film 4 Adjust the conefield to full film coverage g Position the patient for follow up radiographs of the KUB 1 Align midsagittal plane to midline of the film 2 Arms down by their side legs extended with support under the knees 3 Ensure the body is not rotated NOTE Take the radiograph at the time intervals indicated by the radiologist 9 Tell the patient BLOW OUT YOUR BREATH AND HOLD IT OUT DO NOT BREATHE OR MOVE 10 Make the exposure 11 Tell the patient RELAX AND BREATHE NORMALLY 12 Develop the exposed film with the patient s identification Performance Measures Selected the required view s based request Gathered the necessary materials and supplies Attached any required accessories to the X ray table Prepared the contrast medium Prepared the equipment for fluoroscopy Prepared the patient Assisted the radiologist as directed Prepared the equipment for follow up radiographs Positioned the patient for follow up radiographs of the AP KUB N A PD 4 Gave the patient the pre post exposure instructions Made exposure 12 Developed the exposed film with the patient s identification Evaluation Guidance Score each soldier according to t
131. 2 Ensure the patient s clothing is removed as required 3 Use a drape sheet or patient gown to cover the patient as needed c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use 10 X 12 cassette for both views 7 Position the cassette a Place the cassette crosswise in the bucky for the AP neutral rotation view trauma b Place the cassette in the bucky lengthwise for the scapular Y lateral view 8 Position the overhead tube a Set the tube angle perpendicular to the film Set the source to image receptor distance SID to 40 inches 101 Adjust the conefield to full field coverage 9 Position the trauma shoulder 3 112 STP 8 91P15 SM TG Performance Steps a AP neutral rotation 1 Place the patient supine or erect with the coracoid process over the centerline of the table NOTE Erect is usually more comfortable for a trauma patient 2 Rotate the coronal plane 10 to 15 degrees toward the affected side 3 Ensure that you do not rotate the arm for this view let the arm hang in its natural position and perform the exam 4 Place the acromion process 2 below the upper edge of the cassette b Scapular Y lateral view 1 Stand the pati
132. 2 YS DB a YS a 3 4 5 6 7 8 5 3 292 STP 8 91P15 SM TG Performance Steps 3 Protective devices 4 Radiologist peer review 5 Radiographic equipment QC testing 6 Film processor QC testing 7 maximize the quality of diagnostic information i File room procedures j Examination report distribution procedures k Referral procedures Hazardous material management m New personnel orientation and safety education n Other 9 Identify the names of those licensed or authorized to request imaging services 10 Identify any references used in the development of the SOP document Other QC procedures designed to minimize patient personnel or public risk and 11 Obtain the approval and endorsing signature of the Chief Radiologist Director of Radiology or senior authority for the radiology service or department NOTE The last page of this document must display the signature of the approving authority NOTE The standing operating procedures document must be reviewed and updated annually and as needed Performance Measures N O A 10 Obtained the approval and endorsing signature of the Chief Identified the purpose of the SOP Identified the applicability of the SOP Identified the personnel responsibilities Identified with whom the authority for radiological services rests Identified the interrelationships external relationships for the service
133. 2 feet of one end of the sheet under one side of the mattress at the patient s chest level 3 Bring the other end of the sheet over the patient s chest keeping the sheet over the arms Tuck the free end of the sheet snugly under the other side of the mattress 4 If further restriction is necessary apply sheets the same manner at the level of the patient s abdomen legs knees and ankles NOTE Use this method of restraint only for limiting movement It is a secure method of restraining a violent patient 4 Apply field expedient restraints NOTE Field expedient restraints should not be used for long periods of time and should be replaced with regular restraining devices as soon as possible a Mixed equipment Restraints may be improvised from such items as rifle slings web belts bandoleers or cravats 1 Restrain the patient s arms and legs tight enough to restrict movement but not so tight as to restrict circulation 2 Lay the patient on the ground b Double litters 1 Place the patient on his or her stomach on a litter Turn the head to the side 2 Place the patient s hands alongside the thighs and secure them to the litter with wrist restraints 3 Place the other litter carrying side down on top of the patient 4 Bind the litters together with two or more litter straps 5 Place the litter strap buckles in a location inaccessible to the patient 3 39 STP 8 91P15 SM TG Performance Steps 5 Check
134. 3 0188 PERFORM PRE OPERATIONAL CHECK ON DEPMEDS PORTABLE RADIOGRAPHIC UNIT MODEL 1200 081 823 0189 PREPARE DEPMEDS RADIOGRAPHIC UNIT CS 8952 FIELD DEPLOYABLE X RAY SYSTEM CONTINENTAL FOR ORERA TION ee are 081 823 0190 PREPARE DEPMEDS RADIOGRAPHIC UNIT PICKER CLINIX VP4 FOR OPERATION 081 823 0191 PREPARE DEPMEDS RADIOGRAPHIC UNIT MODEL 1200 FOR OPERATION 081 823 0301 PREPARE FOR OPERATIONS IN NBC ENVIRONMENT 081 823 0185 081 823 0251 081 823 0254 081 823 0255 081 823 0303 081 823 0304 081 823 0325 081 823 0326 081 823 0327 081 823 0253 081 823 0163 081 823 0192 081 823 0193 081 823 0194 081 823 0197 081 823 0198 081 823 0196 081 823 0107 081 823 0265 081 823 0266 081 823 0267 081 823 0270 081 823 0167 081 823 0274 STP 8 91P15 SM TG PREPARE ACR 2000 COMPUTED RADIOGRAPHY UNIT FOR OPERATION cx taste 3 250 Subject Area 14 Field Operation OPERATE DIGITAL FLUOROSCOPIC 3 252 OPERATE FIXED RADIOGRAPHIC FLUOROSCOPIC 3 254 OPERATE DRY LASER PROCESSOR 3 256 OPERATE DEPMEDS RADIOGRAPHIC 3 257 OPERATE FIELD SCANNER
135. 3 59 081 823 0105 CALCULATE EXPOSURE FACTORS FOR DIFFERENT GRIDG 3 60 081 823 0106 DETERMINE EXPOSURE 3 61 Subject Area 3 General Radiography Head 081 823 0135 X RAY THE deat 3 62 081 823 0136 X RAY THE PARANASAL 5 3 65 081 823 0138 X RAY THE FACIAL 024 2 2 2 1 12 00000 00000110 0000000000000421 3 68 081 823 0140 X RAY 3 71 081 823 0141 X RAY THE TEMPOROMANDIBULAR 3 74 081 823 0142 X RAY THE ZYGOMATIC 8 1 00200 000 441010001645 3 77 081 823 0143 X RAY THE NOSE sesccccccssessntestsseeectendauctssatacunedsnaveatedanssnnsdeasonaeddussanbsanseeteddadenns 3 80 Subject Area 4 General Radiography Upper Extremities 081 823 0108 X RAY THE HAND 3 83 081 823 0109 X RAY THE 3 86 081 823 0110 X RAY 3 89 081 823 0111 X RAY THE ELBOW 3 92 STP 8 91P15 SM TG 081 823 0112 X RAY THE 2 3 95 081 823 0113 X RAY THE SHOULDER 3 98 081
136. 33 0033 Clamp the IV tubing shut Remove the used container from the IV hanger Remove the spike from the used container Insert the IV spike into a new IV container CAUTION The old tubing is still connected to the catheter or needle Use care to maintain sterility To prevent backflow of blood keep the spike and tubing elevated g Hang the new container h Adjust the infusion rate i Label the solution container and prepare a timing label j Record the amount of solution received from the previous container and the time type and amount of new solution 5 Change the dressing NOTE Change the dressing every 24 hours or IAW local SOP a Perform a patient care handwash b Remove the tape and the old dressing without dislodging the catheter needle NOTE Tubing should remain taped in place to reduce the chance of accidental dislodgement of the catheter or needle c Clean the area around the infusion site IAW local SOP d Examine the site for infiltration Cover the infusion site with sterile gauze and secure with tape or dress IAW local SOP f Secure the dressing to the site without encircling the wrist or arm g Label the dressing 6 Replace the solution container and tubing NOTE Change the tubing every 48 hours or IAW local SOP Time the tubing change to coincide with the time the solution container will be changed a Perform a patient care handwash b Spike the new tubing into
137. 823 0125 Conditions You have a request for a radiologic examination of the chest You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes lead aprons sandbags letter markers and positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers d Calipers e Gowns f Positioning sponges 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure all foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as necessary NOTE All clothing from the waist up should be removed and the patient will wear a gown c Explain the procedure 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 14 x 17 cassette for all views 7 Place the cassette in the upright cassette holder lengthwise NOTE For the decubitus view a moving or stationary grid m
138. 9 Project code Block 20 Priority designator Block 21 RDD Block 22 Advice code b Prepare a modification request 1 Use the latest status document if received a Block 1 Enter AM_ the correct series DIC 0 Delete a previously submitted code by circling the empty block using colored pencil or ink 2 Remake the supply request from the document register if no status has been received a Block 1 card column 1 3 Enter AM_ the correct series DIC from appendix H 3 4 5 6 7 8 b Enter the new data in the appropriate blocks c Include the project code RDD and advice code if one or more of the codes were entered on the original request d Circle the entries using colored pencil or ink c Record the request modifier in the document register 1 Draw line through the old priority and enter the new if changed Have the request authenticated if required 2 Column n Enter AM_ the correct series DIC and the Julian date of the action d Send the request modifier to the SSA SOS e Post transaction to the document register f Disposition instructions IAW local SOP 10 Prepare a request for issue menu driver IAW ULLS S4 EM para 4 2 1 p 4 4 4 16 a Sign on to ULLS S4 b Select the Supply Menu from the S4 Main Menu screen c Select the Request Processes Menu d Select the Request for Issue Menu Driver option 1 Complete a system catalog request a Enter the national item ident
139. A SUSPECTED SPINAL INJURY 081 833 0092 Conditions All other more serious injuries or conditions have been treated Three or four soldiers are available for assistance You will need straps cravats towels long and short spine boards safety pins and materials to improvise a cervical collar and head supports Standards Completed all the steps necessary to immobilize and transport a casualty with a suspected spine injury without causing additional injury to the casualty Performance Steps 1 Check for the signs and symptoms of a spinal injury WARNING you suspect that the casualty has a spinal injury treat him or her as though he she does have a spinal injury a Spinal deformity presence indicates a severe spinal injury but its absence does not rule one out b Tenderness and or pain in the spinal region 1 Detect it by palpation or ask the casualty 2 The presence of any pain is sufficient cause to suspect the presence of a spinal injury c Lacerations and or contusions in the spinal region indicate severe trauma and usually accompany a spinal injury NOTE The absence of lacerations and or contusions does not rule out a spinal injury d Weakness loss of sensation and or paralysis 1 A neck level cervical spine injury may cause numbness or paralysis in all four extremities 2 A waist level spinal injury may cause numbness or paralysis below the waist 3 Ask the casualty to try to move the fingers and t
140. A rectal thermometer has a red tip and may be labeled Rectal d Axillary temperatures are taken with oral thermometers 3 Explain the procedure and position the patient a Take a tympanic temperature with the patient s head turned toward side so that the ear canal is easily viewed b Take an oral temperature with the patient seated or lying face up c Take a rectal temperature with the patient lying on either side with the top knee flexed d Take an axillary temperature with the patient lying face up with the armpit exposed 4 Measure the temperature a Shake the thermometer down to below 94 F b Place the thermometer at the proper site 1 If you are taking an oral temperature place the thermometer the heat pocket under the tongue and tell the patient to close his or her lips and not to bite down 2 If you are taking a rectal temperature an adult insert the thermometer 1 to 2 inches into his or her rectum 3 54 STP 8 91P15 SM TG Performance Steps CAUTION Lubricate the tip prior to insertion Hold the thermometer in place 3 If you are taking a tympanic temperature pull the ear pinna back up and out insert the speculum into the ear canal snugly to make a seal pointing toward the nose 4 If you are taking an axillary temperature pat the armpit dry and then place the bulb end in the center with the glass tip protruding to the front of the patient s body Place the arm across his or her chest c Leave
141. AP axial projection 3 Place the tube horizontal perpendicular for the decubitus b Set the source to image distance SID to 40 c Center the tube to the film d Adjust the conefield to full field coverage 12 Position the patient for the follow up radiographs a AP or PA view 1 Place the patient supine on the table for the AP view or prone for the PA view 2 Position the midsagittal plane to the midline of the table 3 No body rotation 4 Place the iliac crest to the center of the film b Lateral rectum 1 Place the patient laterally recumbent on the table 2 Flex and superimpose knees arms up in front of head Ensure no rotation superimpose the shoulders and hips Adjust the coronal plane perpendicular to and over the centerline of the table Center the central ray to a point 2 below the ASIS to the cassette lique view RPO LPO Place the patient supine on the table Rotate the coronal plane right or left to form a 45 degree angle to the cassette Flex elevated side elbow and place in front of the head Place opposite arm down by the patient s side 4 Align midsagittal plane along long axis of table with right and left abdominal margins equal distance from centerline of table 5 Center iliac crest to the center of the cassette d AP axial projection 1 Place patient supine on the table 2 Adjust the midsagittal plane perpendicular and over the midline of the table 3 Flex the knees slightly
142. Bring the patient into the X ray room b Ensure all foreign objects are removed from the patient as necessary 1 Glasses 2 Dentures 3 Hair pins or clips c Explain the procedure d Assist the patient onto the table 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the proper mAs and kVp on the control panel 6 Place the lead shielding across the patient s lap 7 Select the appropriate size cassette NOTE Use 1 2 of an 8 x 10 for the lateral views Use an 8 x 10 for the Water s view 8 Place the cassette on the table crosswise for the lateral views and lengthwise for the Water s view 9 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the portion of the film being used 10 Position the nose NOTE Because of extreme mobility of the head and neck all positions require two way head alignment TWHA for exact positioning of all skull work a Water s view 3 80 STP 8 91P15 SM TG Performance Steps 1 Place the patient in the prone position 2 Extend neck resting chin against the top 3 Adjust head until mentomeatal line is perpendicular to the film 4 OML will form a 37 degree angle to the tabletop 5 Position the midsagittal plane perpendicular to the midline of the tabletop NOTE En
143. Center the tube to the portion of the cassette being used 3 83 STP 8 91P15 SM TG Performance Steps d Adjust the conefield to full field coverage 10 Position the hand a PA view 1 Center the hand to the appropriate half of the cassette 2 Place the palmar surface of the hand flat against the cassette 3 Separate the fingers equally 4 Center the head of the third metacarpal to the appropriate half of the cassette NOTE The oblique view of the thumb is obtained in this view b Oblique view 1 Center the hand to the appropriate half of the cassette 2 Adjust the metacarpal plane to form a 45 degree angle to the cassette 3 Flex the fingers slightly and separate them to avoid superimposition of the anatomy being demonstrated 4 Center the head of the third metacarpal to the appropriate half of the cassette NOTE The lateral view of the thumb is obtained in this view c Lateral view 1 Center the hand to the cassette 2 Place the hand perpendicular to the cassette with the ulnar surface on the cassette 3 Extend and place fingers in a fanned position 4 Place a radiolucent block under the thumb to maintain the thumb in a PA position 5 Center the head of the second metacarpal to the center of the cassette NOTE The lateral view will identify anterior and posterior displacement in cases of fractures 2 2 YS wa 11 Immobilize the body part by placing a sandbag over the forearm 12 Place the lead apron
144. Connected the tubing to the catheter or needle hub Released the constricting band Unclamped the IV tubing and adjusted the flow rate TKO Checked the site for infiltration Secured the site Readjusted the flow rate Prepared and placed the appropriate labels Rechecked the site for infiltration Performed a patient care handwash Recorded the procedure on the appropriate form Did not violate aseptic technique 21 Did not cause further injury to the patient STP 8 91P15 SM TG PTT TTT ITT Prt ttt performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BASIC NURSING 3 29 STP 8 91P15 SM TG MANAGE A PATIENT WITH AN INTRAVENOUS INFUSION 081 833 0034 Conditions You will need dressings antiseptic swabs sterile gauze IV tubing IV solution tape antimicrobial ointment and exam gloves Standards Properly managed a patient with an IV infusion accurately documented the IV therapy properly assessed for the complications of IV therapy and initiated appropriate interventions when necessary Did not violate aseptic technique and did not cause further injury to the patient Performance Steps 1 Assess for signs and symptoms of IV therapy complications a Infiltration is an accumulation of fluids in the tissue surrounding an IV needle site It is caused by penetration of the vei
145. Disconnected all peripheral devices keyboard mouse etc from the back of the computer processing unit Disconnected the monitor s power cord from the power strip 3 277 STP 8 91P15 SM TG Performance Measures GO 7 Disconnected the monitor s serial cable from computer processing unit 8 Disconnected the ACR s DAC cable from the computer processing unit 9 Disconnected the 5 power cord from the power strip 10 Disconnected the power strip from the uninterrupted power supply 11 Disconnected the uninterrupted power supply form the source 12 Packed the components in the proper storage cases ensuring that all cables and manuals are stored inside Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 278 STP 8 91P15 SM TG Subject Area 16 Quality Control EVALUATE DEVELOPED RADIOGRAPH 081 823 0107 Conditions You have a request for a radiologic examination and a developed radiograph for which you need to evaluate You will need an X ray illuminator box or other suitable light source Standards Radiographs which were of diagnostic quality were sent to the radiologist for interpretation
146. E DEPMEDS RADIOGRAPHIC UNIT CS 8952 FIELD DEPLOYABLE X RAY SYSTEM CONTINENTAL FOR OPERATION PREPARE DEPMEDS RADIOGRAPHIC UNIT PICKER CLINIX VP4 FOR OPERATION PREPARE DEPMEDS RADIOGRAPHIC UNIT IDDC MODEL 1200 FOR OPERATION PREPARE FOR FIELD OPERATIONS IN NBC ENVIRONMENT PREPARE ACR 2000 COMPUTED RADIOGRAPHY UNIT FOR OPERATION OPERATE DIGITAL FLUOROSCOPIC UNIT OPERATE FIXED RADIOGRAPHIC FLUOROSCOPIC UNIT 2 9 STP 8 91P15 SM TG CRITICAL TASKS Subject Task Number Title Training Sust Sust Area Location Tng Tng SL Freq 15 Field Movement 16 Quality Control 2 10 081 823 0255 081 823 0303 081 823 0304 081 823 0325 081 823 0326 081 823 0327 081 823 0253 081 823 0163 081 823 0192 081 823 0193 081 823 0194 081 823 0197 081 823 0198 081 823 0196 081 823 0107 081 823 0265 081 823 0266 081 823 0267 081 823 0270 OPERATE A DRY LASER PROCESSOR OPERATE DEPMEDS RADIOGRAPHIC UNITS OPERATE FIELD CT SCANNER OPERATE CR EXAMINATION TERMINAL OPERATE CR ACQUISITION WORKSTATION OPERATE CR PLATE READER OPERATE ACR 2000 COMPUTED RADIOGRAPHY UNIT PREPARE THE DARKROOM TENT FOR MOVEMENT PREPARE DEPMEDS RADIOGRAPHIC UNIT CS 8952 FIELD DEPLOYABLE X RAY SYSTEM CONTINENTAL FOR MOVEMENT PREPARE DEPMEDS RADIOGRAPHIC UNIT PICKER CLINIX VP4 FOR MOVEMENT PREPARE DEPMEDS PORTABLE RADIOGRAPHIC UNIT MODEL 1200 FOR MOVEMENT PREPARE THE FIELD X RAY P
147. E NORMALLY AND RELAX Develop the exposed cassette s with patient identification for processing Return the patient to the waiting area Gave the patient the pre post exposure instructions Made the exposure PT TTT TTT TT tt tt Developed exposed cassette s Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 78 STP 8 91P15 SM TG References Required Related None BONTRAGER KENNETH L 3 79 STP 8 91P15 SM TG X RAY THE NOSE 081 823 0143 Conditions You received a request for a radiologic examination of the nose You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes letter markers lead shielding sandbags calipers and positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrate the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassette b Lead shielding c Letter markers d Calipers e Positioning sponges 3 Prepare the patient a
148. ERATING PROCEDURE DOCUMENT FOR A RADIOLOGY 3 291 101 92 1111 REQUEST SUPPLIES AND EQUIPMENT 3 295 101 92Y 1110 INVENTORY SUPPLIES AND EQUIPMENT 3 310 081 823 0275 081 823 0319 Skill Level 3 Subject Area 18 Admin SL3 PREPARE A MASS CASUALTY PLAN FOR RADIOLOGY isc cence ced 3 318 TRAIN PERSONNEL COMPUTED 3 323 STP 8 91P15 SM TG Appendix A Field Expedient Squad 22 2 A 1 eee ee ee eee ee eee eee Glossary 1 PRU RTI E EE rua aed vate References 1 vi STP 8 91P15 SM TG PREFACE This publication is for skill level 1 2 3 4 and 5 soldiers holding military occupational specialty MOS 91P and for trainers and first line supervisors It contains standardized training objectives in the form of task summaries to train and evaluate soldiers on critical tasks that support unit missions during wartime Trainers and first line supervisors should ensure soldiers holding MOS SL 91 1 2 3 4 5 have access to this publication This STP is available for download from the Reimer Digital Library RDL This manual applies to both Active and Reserve Component soldiers The proponent of this pub
149. For training and evaluation have another soldier act as the casualty You will need three or four soldiers to act as the assistants The soldier being tested is to act as the team leader and direct the actions of the assistants The casualty may be placed in a vehicle or other scenario depending on available resources and the technique you are testing Tell the casualty not to assist the soldiers in any way Brief soldier To test step 1 tell the soldier to state the signs and symptoms of a spinal injury Tell the soldier that the casualty has a suspected spinal injury Then tell the soldier to position the casualty on a spine board and to direct the actions of the assistants Performance Measures GO 1 Checked for signs and symptoms of a spinal injury Secured the casualty a short spine board KED if appropriate Placed the casualty the long spine board Secured the casualty on the long spine board Recorded the treatment the Medical Evacuated the casualty tis N O Did not cause further injury to the casualty Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related N
150. Form 581 Request for Issue and of Ammunition IAW DA Pam 710 2 1 and the local SOP 4 Prepare DA Form 2765 1 as a request for issue IAW DA Pam 710 2 1 5 Prepare DA Form 3161 as a request for issue IAW DA Pam 710 2 1 6 Prepare DD Form 1348 6 as request issue for non NSN item IAW DA Pam 710 2 1 7 Prepare DD Form 1348 6 as request for issue for an NSN item IAW DA Pam 710 2 1 8 Process request for follow up IAW DA Pam 710 2 1 9 Process a modification request for a previously ordered item IAW DA Pam 710 2 1 10 Prepare request for issue menu driver IAW 5 54 4 2 1 4 4 4 16 11 Prepare a request for issue file driver IAW ULLS S4 4 3 4 17 4 19 12 Prepare a request for modification DCR update IAW ULLS S4 EM para 4 6 4 27 4 30 13 Prepare a request for follow up IAW ULLS S4 EM para 4 7 4 31 4 32 14 Prepare request for issue post post IAW 1115 54 EM 44 4 20 4 24 15 Produce Want List Reports IAW ULLS S4 EM para 4 5 p 4 25 4 26 16 Produce the Commander s Reports IAW 0115 54 para 4 10 4 47 17 Send request transactions to the SOS IAW ULLS S4 4 11 4 49 4 68 Evaluation Guidance Score the soldier a GO if all steps are done correctly Score the soldier a N
151. GO If the soldier fails any step show what was done wrong and how to do it correctly 3 287 STP 8 91P15 SM TG References Required Related None BUSHONG STEWART C 3 288 STP 8 91P15 SM TG Skill Level 2 Subject Area 17 Admin SL2 PERFORM COLLIMATOR QUALITY CONTROL TEST 081 823 0167 Conditions The collimator does not open to set field size You will need a properly equipped X ray room 9 pennies or collimator test tools and beam alignment test tool Standards Identified any unacceptable radiation fields of the collimator Performance Steps 1 Gather the necessary materials and supplies a One 10 x 12 cassette b Nine pennies NOTE Commercially made collimator test tools can be used in place of the pennies c Lead letter markers d Beam alignment test tool 2 Perform the collimator quality control test a Place the cassette lengthwise on the table b Set the source to image distance SID to 40 inches 101 cm c Center the central ray to the cassette d Set the conefield to 6 X 8 coverage e Place two pennies in each quadrant of the cassette 1 Place one penny inside the light field of each quadrant 2 Place the second penny in contact with the first penny in each quadrant but outside of the light field f Place the ninth penny inside the light field of the cassette NOTE The placement should indicate the anode and front side of the tube This is important to correct adjustments if necessary
152. Gave the pre post exposure instructions Made the exposure Selected the required view s based on the request Gathered the necessary material and supplies Measured the body part at the entry exit site of the central ray Placed the appropriate letter marker on the cassette Placed the lead shielding around the patient s waist Developed the exposed radiograph with the patient s identification FT TTT ITT Itt performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 203 STP 8 91P15 SM TG Subject Area 10 Computerized Tomography CT PERFORM UNENHANCED COMPUTED TOMOGRAPHY CT OF THE HEAD 081 823 0199 Conditions You have a requirement to perform a computed tomography procedure of the head that does not require the use of contrast media The patient has been properly prepared and is able to tolerate the exam You will need a fully equipped and functioning computed tomography suite Standards Produced radiographs of diagnostic quality that properly demonstrated the body section requested The radiographs were correctly identified and free from artifacts Performance Steps 1 N 10 11 12 13 Performance Measures GO 1 2 3 Touch HEAD on the body icon on the ELTP Electroluminescent Touch Panel Touch box for desir
153. I 2000 Icon located on the Windows desktop 2 Enter new patient information a Left click the New Patient Icon b Fill the appropriate patient information NOTE The last name and patient ID must be filled in to create a patient s record c Click Save to create patient record NOTE Patient record appears in patient database with blue active scan line 3 Scan a plate a Place plate in the feed tray of the reader with the gray side towards you and white side towards the CR reader NOTE Make sure the series is highlighted for the correct patient and patient ID number in the patient database window b Left click Scan button on Image window toolbar c Verify the patient s ID and accession number are correct d Select the body part and position for the image to be scanned e Hit Enter or left click Scan NOTE The plate is scanned in about 50 seconds and a thumbnail image will appear f Click on the Lock symbol to commit the image to the patient NOTE Once you do this you cannot change and commit the image to a different patient 4 Review the image s a Select the patient study or series with the image s you wish to view with the left mouse button b Click on the Display Image button c A viewer will open with the image d Use the tools to manipulate the image 5 Send a Patient Series Study NOTE Once you have scanned all plates for a particular patient you are ready to send the images to the Zip drive a Select
154. LCANEUS X RAY THE LEG X RAY THE KNEE X RAY THE FEMUR X RAY THE HIP X RAY THE TOES X RAY THE PATELLA X RAY THE PELVIS X RAY THE CHEST X RAY THE RIBS X RAY THE STERNUM X RAY THE ABDOMEN X RAY DECUBITUS ABDOMEN X RAY DECUBITUS CHEST X RAY TRAUMA HIP X RAY TRAUMA CERVICAL SPINE X RAY THE CERVICAL SPINE X RAY THE THORACIC SPINE X RAY THE LUMBAR SPINE X RAY THE SACRUM AND OR COCCYX X RAY TRAUMA LUMBAR SPINE ASSIST PHYSICIAN WITH ESOPHAGRAM BARIUM SWALLOW Sust Tng SL 2 7 STP 8 91P15 SM TG Subject Area 9 Other Procedures 10 ized Tomography CT 11 Radiography CR 2 8 Task Number 081 823 0145 081 823 0146 081 823 0147 081 823 0149 081 823 0238 081 823 0228 081 823 0229 081 823 0199 081 823 0200 081 823 0201 081 823 0202 081 823 0368 081 823 0379 081 823 0174 081 823 0175 081 823 0176 081 823 0177 081 823 0178 081 823 0203 CRITICAL TASKS Sust Tng SL Sust Tng Training Location ASSIST PHYSICIAN WITH UPPER G I EXAM ASSIST PHYSICIAN WITH SMALL BOWEL SERIES ASSIST PHYSICIAN WITH BARIUM ENEMA EXAM ASSIST PHYSICIAN WITH INTRAVENOUS PYELOGRAM ASSIST PHYSICIAN WITH CYSTOGRAM PERFORM X RAY STUDY DURING GENERAL SURGICAL PROCEDURE PERFORM SOFT TISSUE X RAY STUDY PERFORM UNENHANCED COMPUTED TOMOGRAPHY CT OF THE HEAD PERFORM UNENHANCED COMPUTED TOMOGRAPHY CT OF THE CHEST PE
155. Measures GO Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central Set the control panel Selected the proper size cassette Placed the cassette on the table according to the desired position Positioned the overhead tube Positioned the ankle N A Immobilized the body as required Placed the appropriate identification marker on the cassette FT TTT ITT Tt tt Placed the lead apron across the patient s lap 3 119 STP 8 91P15 SM TG Performance Measures GO 13 Gave the patient the pre post exposure instructions 14 Made the exposure 86 15 Developed the exposed cassette s with patient identification for processing Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 120 STP 8 91P15 SM TG X RAY THE CALCANEUS 081 823 0181 Conditions You have a formal request for a radiologic examination of the calcaneus You
156. O GO if any step is failed If the soldier fails any step show what was done wrong and how to do it correctly 3 308 STP 8 91P15 SM TG References Required Related None AR 25 400 2 DA PAM 710 2 1 3 309 STP 8 91P15 SM TG INVENTORY SUPPLIES AND EQUIPMENT 101 92Y 1110 Conditions Assigned as the unit supply specialist in a field or garrison environment given the requirement to inventory supplies and equipment Given property records blank forms for DA Form 2062 Hand Receipt DA Form 3161 Request for Issue or Turn in location of equipment hand receipts property listings of equipment to be inventoried appropriate publications AR 25 400 2 The Modern Army Recordkeeping System MARKS AR 190 11 Physical Security of Arms Ammunition and Explosives AR 735 5 Polices and Procedures for Property Accountability AR 710 2 Supply Policy Below the Wholesale Level DA Pam 25 30 Consolidated Index Army Publications and Forms DA Pam 710 2 1 Using Unit Supply System Manual Procedures Unit Level Logistics System ULLS S4 a computer with CD ROM and a forms program Standards Conduct inventories without losing supply accountability IAW the appropriate publications Performance Steps 1 Prepare for inventory IAW DA Pam 710 2 1 a Determine the type of inventory required b Check with the next higher headquarters for any special instructions c Verify inventory by using DA Pam 25 30 to determine the publications required fo
157. ON Keep the needle at the same angle to prevent through and through penetration of the vein walls NOTE You may position the needle directly above the vein or slightly to one side of the vein a Draw the skin below the cleaned area downward to hold the skin taut over the site of venipuncture b Position the needle point bevel up parallel to the vein and about 1 2 inch below the site of venipuncture c Hold the needle at a 20 to 30 degree angle and insert it through the skin d Decrease the angle of the needle until it is almost parallel to the skin surface and direct it toward the vein e Move the needle forward about 1 2 inch into the vein 8 Confirm the puncture NOTE A faint give will be felt as the needle enters the lumen of the vein a Check for blood in the flash chamber If successful proceed to step 9 b If the venipuncture is unsuccessful pull the needle back slightly not above the skin surface and attempt to pierce the vein again c If the venipuncture is still unsuccessful release the constricting band and tell the patient to open and relax his or her clinched fist 1 Place a sponge lightly over the site and quickly withdraw the needle 2 Immediately apply pressure to the site d Notify your supervisor before attempting a venipuncture at another site 9 Advance the needle or the catheter a Grasp the hub and advance the needle into the vein up to the hub b If using the catheter over needle grasp the hub an
158. P 8 91P15 SM TG Placed the appropriate letter marker on the cassette Gave the patient the pre post exposure instructions Made the exposure Developed the exposed film GO performance measures to be scored GO the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 123 STP 8 91P15 SM TG X RAY THE LEG 081 823 0120 Conditions You have a request for a radiologic examination of the leg You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sandbags lead shielding letter markers and various sized positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Sandbags c Lead shielding d Letter markers e Positioning sponges f Bed sheet 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is dressed properly 1 Provide the patient a gown 2 Ensure all foreign objects are removed from the patient as necessary 3 Ensure the patient s clothing is removed as required 4 Use a sheet to cov
159. P15 SM TG PREPARE THE FIELD X RAY PROCESSOR FOR MOVEMENT 081 823 0197 Conditions You are in a tactical environment and the unit commander has issued an order to move You have the assistance of other soldiers You will need manufacturer s instructions if available Standards Disassembled the field X ray processor Performance Steps 1 Turn the unit off 2 Disconnect the power cord from the power source 3 Drain the wash water developer and fixer from the tanks a Wash water can be poured into gray water sump b Developer and fixer must be separated into two different hazardous materials containers and disposed of through the unit POL clerk 4 Rinse the tanks 5 Do not pack until completely dry Performance Measures GO Turned the unit off 2 Disconnected the power cord from the power source 3 Drained the wash water developer and fixer from the tanks 4 Rinsed the tanks 5 Be Packed unit once dried Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None RADIOLOGY BRANCH SOP 3 275 STP 8 91P15 SM TG PREPARE THE COMPUTED TOMOGRAPHY CT SCANNER FOR MOVEMENT 081 823 0198 Conditions
160. Place the appropriate letter marker on the cassette 12 Place the lead apron across the patient s lap 13 Tell the patient DO NOT MOVE 14 Make the exposure 15 Tell the patient RELAX and remove immobilization 16 Process the film with the patient s identification Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central Set the control panel Selected the proper size cassette Bg N O A Placed the cassette in the bucky according to the required view a Lengthwise 10 X 12 for the AP b Crosswise 14 X 17 for the frog leg view 8 Positioned the overhead tube 9 Positioned the hip b Frog leg view 3 134 10 11 12 13 14 15 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Immobilized the body part as required STP 8 91P15 SM TG Placed the appropriate identification marker on the cassette Placed the lead apron across the patient s lap Gave the proper pre post exposure instructions Made the exposure Processed the film GO 86 performan
161. Position yourself at the casualty s head 2 Open the airway see task 081 831 0018 a Head tilt chin lift when no trauma is suspected b Jaw thrust when trauma is suspected 3 Ventilate the casualty using the mouth to mouth mouth to nose mouth to mask bag valve mask or flow restricted oxygen powered ventilation device FROPVD demand valve aS appropriate a Mouth to mouth method 1 Maintain the chin lift while pinching the nostrils closed using the thumb and index fingers of the hand on the casualty s forehead 2 Take deep breath and make an airtight seal around the casualty s mouth with your mouth 3 Blow one full breath 1 5 to 2 seconds into the casualty s mouth watching for the chest to rise and fall and listening and feeling for air to escape during exhalation 4 If the chest rises and air escapes a Give a second full breath 0 Go to step 6 5 If the chest does not rise or air does not escape go to step 4 b Mouth to nose method NOTE The mouth to nose method is recommended when you cannot open the casualty s mouth there are jaw or mouth injuries or you cannot maintain a tight seal around the casualty s mouth 1 Maintain the head tilt with the hand on the forehead while using the other hand to lift the casualty s jaw and close the mouth 2 Take a deep breath and make an airtight seal around the casualty s nose with your mouth 3 Blow one full breath 1 5 to 2 seconds into the casual
162. RFORM UNENHANCED COMPUTED TOMOGRAPHY CT OF THE ABDOMEN AND PELVIS PERFORM COMPUTED TOMOGRAPHY CT EXAMINATION OF THE SPINE REPRINT CT IMAGES PRINT CT IMAGES PROCESS AN IMAGING PLATE MANIPULATE COMPUTERIZED IMAGE FOR INTERPRETATION PRINT A COMPUTERIZED IMAGE DISPLAY IMAGES FROM DIGITAL ARCHIVES ACQUIRE IMAGES USING COMPUTED RADIOGRAPHY PICTURE ARCHIVAL AND COMMUNICATION SYSTEM CR PACS ARCHIVE IMAGES TO OPTICAL DISK SYSTEM Subject Area 12 Film Processing 13 Field Set Up 14 Field Operation Task Number 081 823 0321 081 823 0324 081 823 0328 081 823 0170 081 823 0179 081 823 0241 081 823 0242 081 823 0154 081 823 0186 081 823 0187 081 823 0188 081 823 0189 081 823 0190 081 823 0191 081 823 0301 081 823 0185 081 823 0251 081 823 0254 STP 8 91P15 SM TG CRITICAL TASKS Training Location DIGITIZE CONVENTIONAL RADIOGRAPHIC IMAGES TRANSMIT IMAGES USING TELERADIOLOGY SOFTWARE AND HARDWARE INITIATE CR APPLICATIONS SOFTWARE AND HARDWARE MAINTAIN THE AUTOMATIC FILM PROCESSOR PROCESS FILM USING AN AUTOMATIC FILM PROCESSOR MAINTAIN DARKROOM MAINTAIN INTENSIFYING SCREENS AND CASSETTES PREPARE THE DARKROOM TENT FOR FIELD OPERATION PREPARE THE FIELD X RAY PROCESSOR FOR OPERATION PREPARE THE COMPUTED TOMOGRAPHY CT SCANNER FOR OPERATION PERFORM PRE OPERATIONAL CHECK ON DEPMEDS PORTABLE RADIOGRAPHIC UNIT IDDC MODEL 1200 PREPAR
163. ROCESSOR FOR MOVEMENT PREPARE THE COMPUTED TOMOGRAPHY CT SCANNER FOR MOVEMENT PREPARE ACR 2000 COMPUTED RADIOGRAPHY UNIT FOR MOVEMENT EVALUATE DEVELOPED RADIOGRAPH PERFORM SCREEN FILM CONTACT TEST TEST FOR SECONDARY SCATTER RADIATION FORMULATE TECHNIQUE CHARTS FOR RADIOGRAPHIC UNITS MAINTAIN TECHNIQUE CHARTS FOR RADIOGRAPHIC UNITS STP 8 91P15 SM TG CRITICAL TASKS Subject Task Number Title Training Sust Sust Area Location Tng Tng SL Freq 17 Admin SL2 081 823 0167 081 823 0274 101 92Y 1111 101 92Y 1110 Skill Level 2 PERFORM COLLIMATOR QUALITY CONTROL TEST DEVELOP A STANDING OPERATING PROCEDURE DOCUMENT FOR A RADIOLOGY SECTION REQUEST SUPPLIES AND EQUIPMENT INVENTORY SUPPLIES AND EQUIPMENT 18 Admin 513 081 823 0275 081 823 0319 Skill Level 3 PREPARE A MASS CASUALTY PLAN FOR RADIOLOGY SERVICE TRAIN PERSONNEL IN COMPUTED RADIOGRAPHY STP 8 91P15 SM TG CHAPTER 3 MOS Skill Level Tasks Skill Level 1 Subject Area 1 General Medical HANDLE PATIENT USING PROPER BODY MECHANICS 081 823 0306 Conditions You have a patient with a request for a radiologic examination and must use proper body mechanics while assisting the patient Standards Properly handled and moved the patient without causing further injury to the patient or the technologist Performance Steps 1 Determine what examination you will be performing based on the request 2 Assess the pati
164. STP 8 91P15 SM TG EMERGENCY CARE O Keefe Editor Brady Emergency Care 8th Edition Prentice Hall 1 July 1997 GURLEY AND CALLAWAY Introduction to Radiologic Technology 3rd Edition Multi Media Publishing Inc 1 January 1993 MOSS ALBERT A Computed Tomography of the Body RADIOLOGY BRANCH SOP Radiology Branch Standing Operating Procedures SOP Technical Bulletins TB MED 521 Occupational Environmental Health Management and Control of Diagnostic Therapeutic and Medical Research X Ray Systems amp Facilities 26 February 2002 References 3 STP 8 91P15 SM TG 26 February 2003 By Order of the Secretary of the Army ERIC 5 General United States Army Chief of Staff Official 5 Administrative Assistant to the Secretary of the Army 0304401 DISTRIBUTION Active Army Army National Guard and US Army Reserve Not to be distributed Electronic Means Only 080640 000
165. STP 8 91P15 SM TG SOLDIER S MANUAL AND TRAINER S GUIDE MOS 91P RADIOLOGY SPECIALIST SKILL LEVELS 1 2 3 4 5 FEBRUARY 2003 HEADQUARTERS DEPARTMENT OF THE ARMY DISTRIBUTION RESTRICTION Approved for public release distribution is unlimited STP 8 91P15 SM TG SOLDIER TRAINING PUBLICATION HEADQUARTERS No 8 91P15 SM TG DEPARTMENT OF THE ARMY Washington DC 26 February 2003 SOLDIER S MANUAL SKILL LEVELS 1 2 3 4 5 AND TRAINER S GUIDE MOS 91P RADIOLOGY SPECIALIST TABLE OF CONTENTS PAGE Table GOATS i aaa cs asa eee eee vii Chapter 1 1 1 Ve General 1 1 152 Focused Training 1 1 1 3 Relationship of Soldier Training Publications STPs to Focused ern mney Perr mene enya 1 1 Task Summaries 2 1 2 1 5 Soldier s Responsibilities cts 1 3 1 6 NCO Self Development and the Soldier s 1 3 1 7 Trainer s Responsibilities 1 3 1 8 Training Tips for the Trainer
166. Steps 1 Find optimum kVp chart from radiology section 2 Select AVERAGE range patient on whom you already have a request for the views you are about to do a Make an exposure using the suggested kVp and mAs from the existing technique chart b Make adjustments to the mAs to achieve an ideal technique 3 Secure the section radiologist s approval of the ideal technique 4 Make intermediate changes to the ideal technique if requested by the radiologist 5 Calculate the correction factor CF NOTE Divide the new mAs by the old mAs to get the CF 6 Check CF on several body parts 7 Convert existing techniques on chart to new techniques that are applicable to the section by multiplying the CF by each mAs Performance Measures GO 1 Found optimum kVp chart from radiology section 2 Selected AVERAGE range patient on whom a request for the views to be done already existed Secured the section radiologist s approval of the ideal technique Calculated the correction factor Checked the on several body parts Converted existing techniques on chart to new techniques that applicable to the section by multiplying the CF by each mAs Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored
167. T PICKER CLINIX VP4 FOR MOVEMENT 081 823 0193 Conditions You are in a tactical environment and the unit commander has given the order to move You have the assistance of other soldiers if required You will need DEPMEDS Radiographic Unit Picker CLINIX VP4 and Picker System Operator s Guide Standards Disassembled DEPMEDS Radiographic Unit Picker CLINIX VP4 Performance Steps 1 N O A 10 20 21 Move the column to the head of the table Move the table top all the way toward the foot end right Place the foam pad on the head end of the table top Place the tube collimator transport fixture on the foam pad Rotate the tube collimator assembly so that the collimator is aimed toward the foot end Lower the tube collimator assembly into the transport Remove the counterweight support pin and bracket from the back of the vertical column Insert the long end of the counterweight through the hole in the back of the vertical column and into the counterweight carriage inside the column Remove four screws and lock washers securing the tube arm to the vertical carriage and push the tube arm into its fully retracted position Move the table top forward away from the column Place the cover on the tube collimator transport fixture 12 13 14 15 16 17 Place one plastic spacer ring over each corner post and insert a clip in the top of each post Position the vertical carri
168. TP 8 91P15 SM TG References Required Related None BONTRAGER KENNETH L 3 70 STP 8 91P15 SM TG X RAY THE MANDIBLE 081 823 0140 Conditions You have a request for an X ray examination of the mandible You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Letter markers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary c Explain the procedure if applicable d Assist the patient onto the table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use an 8 X 10 cassette for all views 7 Place the cassette in the bucky lengthwise for the PA view and crosswise for the lateral
169. WYN 5 42107105 435 Ol 30 6 640524 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 1 47813 10 STP 8 91P15 SM TG 11410560 SI 28 40 NOILIGS 98 435 4 5916 WHOS ul 6120 228 180 clack fees ee 10 7220 228 180 Mesilla 85 104 0220 228 180 10 4 2920 228 130 nee cite ae E 1 _____ ___ __ ____________________ 90 os on ovon oson 90 oson oson o9 90 09 09 Tae SNLVLS 6 3 01065 Y3SN OL 30 OL SdOSDq 5 Aouebe y 76 066 YY 998 10 SIY Jo SN 104 133HS Mood 1 91913 11 STP 8 91P15 SM TG GLOSSARY ACCP The Army Correspondence Course Program AML acanthiomeatal line AP anterior posterior Arm
170. a Checked the type of film holders and screens and determined the speeds b Determined grid ratios for all grids used c Determined the tube limits and capabilities as well as the rectification of the machine d Determined the patient thickness and made adjustments accordingly e Adjusted technique accordingly when adjusting conefields 3 285 STP 8 91P15 SM TG Performance Measures GO 3 Recorded any adjustments to the original technique and annotated on a piece of stationery 4 Recorded what factors resulted in a change in technique 5 Posted technique chart near the control panel for use all future exams 6 Made the necessary corrections as needed Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all NO GO performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 286 STP 8 91P15 SM TG MAINTAIN TECHNIQUE CHARTS FOR RADIOGRAPHIC UNITS 081 823 0270 Conditions You have an existing optimum technique chart and must maintain the technique chart so it is applicable to section and safety requirements You will need a pencil and paper to record your new technical factors Standards Properly maintained the technique chart using correction factors and met section safety requirements Performance
171. a new solution container and hang it from the IV pole c Prime the tubing and clamp it d Clamp the old tubing shut e Connect the new tubing to the needle hub WARNING Wear gloves for self protection against transmission of contaminants whenever handling body fluids 1 Loosen the tape on the old tubing without dislodging the catheter and needle 2 Place a sterile gauze pad under the catheter or needle hub to provide a small sterile field for the needle hub 3 Grasp the new tubing between the fingers of one hand 3 32 STP 8 91P15 SM TG Performance Steps 4 Grasp the catheter or needle hub with a sterile gauze pad between the thumb and index finger and carefully disconnect the old adapter 5 Press the fingers over the catheter or needle tip to help prevent dislodgement and backflow of blood 6 Remove the protective cap from the new tubing adapter and quickly connect it to the catheter or needle hub CAUTION Do not remove the protective cap with your teeth 7 Remove the pressure over the catheter or needle tip 8 Remove the gauze pad from under the needle hub and clean the site if necessary 9 Secure the tubing to the arm and reinforce the dressing as necessary 10 Adjust the infusion rate 7 Discontinue the infusion Perform a patient care handwash Put on exam gloves Clamp the IV tubing Remove the tape and dressing without dislodging the needle and catheter Place a sterile gauze pad over the injecti
172. able d Assist the patient onto the table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use an 8 X 10 cassette for all views 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the portion of the film being used d Adjust the conefield to full field coverage 9 Position the facial bones NOTE Because pf the extreme mobility of the head on the neck all positions of the skull require a two way head alignment TWHA for exact positioning of the skull a Water s view TWHA 1 Place the patient prone with the chin on the table 2 Place the median plane perpendicular to and over the centerline of the table 3 Adjust the orbitomeatal line OML to form a 37 degree angle with the cassette 3 68 Performance Steps 10 11 12 13 14 15 16 4 Center the acanthion to the cassette b Lateral view TWHA STP 8 91P15 SM TG 1 Place the patient semiprone with the side of the injury nearest the table Place the median Plane parallel to the table Adjust the interpupillary line to the cassette 2 3 4 Adjust the infraorbitomeatal line IOML parallel to t
173. across the patient s lap 13 Place the appropriate letter marker on the cassette 14 Tell the patient DO NOT MOVE 15 Make the exposure 16 Tell the patient RELAX and remove the immobilization 17 Develop the exposed film with patient identification Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Placed the lead apron across the patient s lap Measured the body part through the entry exit site of the central ray Set the control panel I ee N O A Selected the proper size cassette 3 84 8 9 10 11 12 13 13 14 15 16 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Placed the cassette on the table according to the desired position Positioned the lead mask over the unused portion of the cassette as needed Positioned the overhead tube Positioned the hand a PA view b Oblique view c Lateral view Immobilized the body part by placing a sandbag over the forearm Placed the appropriate letter marker on the cassette Placed the lead apron across the patient s lap Gave the proper pre post exposure instructions Made the exposure Developed the ex
174. act as a patient Brief soldier Tell the soldier to manage the patient Performance Measures GO 1 Identified the type of convulsions and or seizures Maintained the airway of a patient exhibiting tonic clonic movement Placed the patient on his or her side if possible Prevented injury to tissue and bones by padding or removing objects on which the patient may injure himself or herself Managed the patient after the convulsive state ended Recorded the seizure activity Evacuated the patient N Did not cause further injury to the patient Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 8 References Required None Related EMERGENCY CARE STP 8 91P15 SM TG 3 9 STP 8 91P15 SM TG OPEN THE AIRWAY 081 831 0018 Conditions You are evaluating a casualty who is not breathing You are not in an NBC environment Standards Completed all of the steps required to open the casualty s airway without causing unnecessary injury Performance Steps 1 Roll the casualty onto his or her back if necessary a Kneel beside the casualty b Raise the near arm and straighten it out above the head
175. age lock so that the notch is over the set screw Secure the vertical carriage lock in place using two screws and two lock washers Loosen the hole cover at the rear of the table and remove cable slack Position the column all the way to the right on its travel foot end Position the column support bracket to the base plate and secure in place using four screws and four lock washers Position the column hold down support bracket to the base plate and secure in place using four screws and four lock washers Lower the column hinge bracket and secure it to the column base using four screws and four lock washers Remove four screws that secure the column to the column base While making sure that the cables do not come between the vertical column and the support brackets lay the column down on the support brackets 3 271 STP 8 91P15 SM TG Performance Steps 22 23 24 25 26 27 28 29 Performance Measures GO 1 Position the column hold down bracket in place using two screws and two lock washers Secure the column hold down bracket in place using two screws and two lock washers Lift the tube collimator transport fixture off of the table and set it on the base plate near the table base Secure the fixture to the base plate using four screws and four lock washers Move the table top to the middle position At the rear of the bucky hook bucky restraint cord to the guide rail At the front of the bucky
176. al plane perpendicular to and over the centerline of the table 3 Place radiolucent material under the lower dorsal region to bring the long axis of the spine parallel to the table 4 Central ray directed to a point 2 posterior to the coronal plane and 3 below the ASIS 10 Place the appropriate identification marker on the cassette 2 DS wo 11 Place the lead apron across the patient s lap 12 Tell the patient STOP BREATHING AND DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Process the film Performance Measures GO 1 Selected the required view s based on the request 2 Gathered the necessary materials and supplies 3 Prepared the patient Be 4 Measured the body part through entry exit site of the central ray 3 178 N 10 11 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Set the control panel Selected the proper size cassette Placed the cassette in the bucky lengthwise Positioned the overhead tube a Angled the tube 15 degrees cephalic for the AP sacrum view b Angled the tube 10 degrees caudad for the AP coccyx view Positioned the sacrum and coccyx a AP view b Lateral view Placed the appropriate identificatio
177. alf full of the IV fluid f Prime the tubing NOTE Ensure that all air is expelled from the tubing 1 Hold the tubing above the level of the bottom of the container 2 Loosen the protective cover from the needle adapter to allow the air to escape 3 Release the clamp on the tubing 3 25 STP 8 91P15 SM TG Performance Steps 4 Gradually lower the tubing until the solution reaches the end of the needle adapter 5 Clamp the tubing 6 Retighten the needle adapter s protective cover 7 Loop the tubing over the IV stand or holder g Cut several pieces of tape and hang them in a readily accessible place 4 Select the infusion site a Put on gloves for body substance isolation b Choose the most distal and accessible vein of an uninjured arm or hand c Avoid sites over joints d Avoid veins in infected injured or irritated areas e Use the nondominant hand or arm whenever possible CAUTION Do not use an arm that may require an operative procedure f Select a vein large enough to accommodate the size of needle catheter to be used 5 Prepare the infusion site a Apply the constricting band NOTE When applying the constricting band use soft walled latex tubing about 18 inches in length 1 Place the tubing around the limb about 2 inches above the site of venipuncture Hold one end so that it is longer than the other and form a loop with the longer end 2 Pass the looped end under the shorter end of the con
178. all views d Position the overhead tube 1 Set the tube angle a 10 15 degrees caudad for AP projection 0 Vertical perpendicular for oblique positions 2 Set the source to image receptor distance SID to 40 inches 101 cm 3 Center the tube to the cassette 4 Adjust the conefield to full field coverage 3 197 STP 8 91P15 SM TG Performance Steps 9 Position the bladder a AP view 1 Place the patient supine with median plane perpendicular to and over the centerline of the table 2 Extend the patient s legs and place support under the knees 3 Center 2 inches 5 cm superior to the symphysis pubis NOTE Angle the tube 10 15 degrees caudad to project symphysis pubis inferior to bladder b Oblique views NOTE Both LPO and RPO positions need to be done 1 Rotate the patient s coronal plane to 45 60 degrees 2 Partially flex downside leg for stabilization 3 Patients trunk to center of table 4 Center 2 inches 5 cm superior to the symphysis pubis and 2 inches 5 cm medial to ASIS 10 Place appropriate identification marker on the cassette 11 Tell the patient DO NOT BREATHE OR MOVE 12 Make the exposure 13 Tell the patient BREATHE NORMALLY AND RELAX 14 Develop the exposed cassette s with patient identification for processing 15 Return patient to waiting area Performance Measures GO Selected the required view s based on the request Gathered the necessary mater
179. als and supplies a Appropriate cassettes b Lead shielding c Letter markers d Positioning sponges e Sheet 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required 3 Use a sheet to cover the patient as needed c Explain the procedure to the patient d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use an 8 x 10 cassette for each view 7 Place the cassette in the bucky lengthwise for the AP and lateral views 8 Position the overhead tube a Set the tube angle perpendicular to the film NOTE Angle the tube 5 10 degrees cephalic for the lateral view b Set the source to image receptor distance SID to 40 inches 101 cm c Center the central ray to the cassette d Adjust the conefield to full film coverage 9 Position the knee a AP view 1 Place the patient supine with both legs fully extended on the table NOTE There should be no rotation of the pelvis 3 127 STP 8 91P15 SM TG Performance Steps 2 Align and center the long axis of the leg and knee to the midline of the cassette 3 Rotate the
180. aluations of tasks critical to the unit s mission Use the information in the MTP as a guide to determine how often to train the soldier on each task to ensure that soldiers sustain proficiency Record the results The leader book referred to in FM 25 101 appendix is used to record task performance and gives the leader total flexibility on the method of recording training The trainer may use DA Forms 5164 R Hands On Evaluation and 5165 R Field Expedient Squad Book as part of the leader book The forms are optional and locally reproducible STP 21 24 SMCT contains a copy of the forms and instructions for their use e Retrain and evaluate Work with each soldier until he or she can perform the task to specific SM standards 1 8 Training Tips for the Trainer Prepare yourself e Get training guidance from your chain of command on when to train which soldiers to train availability of resources and a training site Get the training objective task conditions and standards from the task summary in this manual e Ensure you can do the task Review the task summary and the references in the reference section Practice doing the task or if necessary have someone train you on the task e Choose a training method e Prepare a training outline consisting of informal notes on what you want to cover during your training session e Practice your training presentation 1 5 STP 8 91P15 SM TG Prepare the resources O
181. an X ray unit of higher capacity must be used Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 61 STP 8 91P15 SM TG Subject Area 3 General Radiography Head X RAY THE SKULL 081 823 0135 Conditions You have a request for an X ray examination of the skull You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Letter markers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary c Explain the procedure if applicable Assist the patient onto the X ray table except for the submentovertex view
182. and index fingers of the hand nearest the casualty s legs locate the lower margin of the casualty s rib cage on the side nearest you 3 Move the fingers up the rib cage to the notch where the ribs meet the sternum in the center of the lower part of the chest 4 With the middle finger on this notch place the index finger next to it on the lower end of the sternum 5 Place the heel of the other hand on the lower half of the sternum next to the index finger of the first hand 6 Remove the first hand from the notch and place it on top of the hand on the sternum so that the hands are parallel to each other NOTE You may either extend or interlace your fingers but keep the fingers off the casualty s chest 7 Lock your elbows into position straighten your arms and position your shoulders directly over your hands 8 Press straight down depressing the sternum 1 5 to 2 inches and then release the pressure completely without lifting the hands from the chest 9 Repeat the chest thrust up to five times NOTE Make each thrust a separate distinct movement given with the intent of relieving the obstruction 2 Perform a finger sweep a Open the mouth by grasping both the tongue and lower jaw with your thumb and fingers and lifting 0 Insert the index finger of your other hand down along the inside of the cheek and deeply into the throat to the base of the tongue c Use a hooking motion to attempt to dislodge the foreign body and m
183. aneuver it into the mouth for removal CAUTION Do not force the object deeper into the airway 3 13 STP 8 91P15 SM TG Performance Steps 3 Attempt to ventilate If the airway is still not clear repeat the sequence of thrusts finger sweep and attempt to ventilate until the airway is cleared or you are relieved by qualified personnel 2 When the object is dislodged check for breathing Perform rescue breathing if necessary see task 081 831 0048 or continue to evaluate the casualty for other injuries Evaluation Preparation NOTE Only the procedure for clearing an airway obstruction in a conscious casualty will be evaluated The procedure for an unconscious casualty can be evaluated as a part of task 081 831 0048 Setup You will need another soldier to play the part of the casualty Brief soldier Describe the symptoms of a casualty with good air exchange poor air exchange or a complete airway obstruction Ask the soldier what should be done and score step 1 based on the answer Then tell the soldier to clear an upper airway obstruction Tell the soldier to demonstrate how to position the casualty where to stand and how to position his or her hands for the thrusts The soldier must tell you how they should be done and how many thrusts should be performed Ensure that the soldier understands that he or she must not actually perform the thrusts After completion of step 5 ask the soldier what must be done if the casualty beco
184. aph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required views based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers d Sterile plastic cassette covers 3 Put on the proper surgical garments a Surgical cap b Hospital scrubs c Surgical shoe covers d Surgical mask 4 Set the technical factors NOTE Set the mAs and then kVp 5 Select the proper cassette size NOTE A 10 x 12 is recommended with one image per cassette 6 Place the appropriate letter marker on the cassette 7 Place the cassette in the plastic cassette covering NOTE Have the nurse open the sterile plastic cassette cover for you 8 Inform the nurse on placement of the cassette under the patient NOTE The nurse is placing the cassette under the patient to maintain the sterile field The doctor will lift the patient s leg and foot 9 Position the X ray tube a Set the tube angle perpendicular to the film b Set the source to image distance SID to 40 inches c Center the tube to the cassette CAUTION This must be done without contaminating the sterile field 10 Put on your lead shielding CAUTION All O R personnel should have on their lead shielding Check to make sure 11 Inform the doctor when you are prepared to make the
185. are a request issue file driver IAW ULLS S4 EM para 4 3 p 4 17 4 19 a Select the Supply Menu from the S4 Main Menu screen b Select the Request Processes Menu c Select the Request for Issue File Driver option to generate want slips transactions 1 Select the Hand Receipt Shortages option a Enter the quantity for the item shown 3 301 STP 8 91P15 SM TG Performance Steps b Select Y or N to order the item 1 Select N to go to the next shortage without generating the request 2 Select Y to generate the request and go to the next shortage c Complete remaining shortages d Return to the Request for Issue Options Menu when no more shortages exist 2 Request component list shortages a Select the Component List Shortages option 0 Enter the quantity for the item shown Select Y or N to order the item 1 Select N to go to the next shortage without generating the request 2 Select Y to generate the request and go to the next shortage d Complete remaining shortages e Return to the Request for Issue Options menu when no more shortages exist 12 Prepare a request for modification document control register DCR update IAW ULLS S4 EM para 4 6 p 4 27 4 30 Select the Supply Menu from the S4 Main Menu screen Select the Request Processes Menu Select Request for Mod DCR Update option Enter the document number Select Y if the modification request is for a ne
186. art using correct radiograph calipers b Set proper mAs using provided technique chart c Set proper kVp using provided technique chart d Selected appropriate cassette size 4 Exposed film 5 Developed film gt NOTE computed radiography is in use image plates were used place of film Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 257 STP 8 91P15 SM TG References Required Related None CUSWORTH RITA J MOSS ALBERT A RADIOLOGY BRANCH SOP 3 258 STP 8 91P15 SM TG OPERATE FIELD CT SCANNER 081 823 0304 Conditions You must perform a computed tomography procedure that does not require the use of contrast media The patient has been properly prepared and is able to tolerate the exam You will need a fully equipped and functioning computed tomography suite Standards Produced radiographs of diagnostic quality that properly demonstrated the body section requested The radiographs were correctly identified and free from artifacts Performance Steps 1 Prepare scanner room a Clean and organized b Support items assembled c Operator console display console and computer activated 2 Position patient a Patient supine on table b Immobilize
187. ary resuscitation CR computed radiography Cross training The systematic training of a soldier on tasks related to another duty position within the same military occupational specialty or tasks related to a secondary military occupational specialty at the same skill level CSF cerebrospinal fluid CT computed tomography computerized tomography Chamberlain Towne depends on use CTA Common Table of Allowances Consolidated Training Activities depends on use DIC document identifier code DIN PACS Defense Imaging Network Picture Archiving and Communications Systems DODAAC Department of Defense Activity Address Code EIC equipment identification code Glossary 2 STP 8 91P15 SM TG ELTP electroluminescent touch panel EOP external occipital protuberance frequency fail Fahrenheit full failed FAD force activity designator finance and accounting document depends on use FFD focal film distance FMC field medical card FROPVD flow restricted oxygen powered ventilation device GSA General Services Administration gtts drops Hz hertz cycles per second IAR inventory adjustment report IAW in accordance with ID identification infantry division IM intramuscular Individual training Training which prepares the soldier to perform specified duties or tasks related to the assigned duty position or subsequent duty positions and skill levels Integration training The completion of initial
188. as necessary Placed the appropriate identification marker on the cassette Gave the proper pre post exposure instructions Made the exposure Processed the film performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 158 STP 8 91P15 SM TG X RAY DECUBITUS CHEST 081 823 0217 Conditions You have a formal request for a radiologic examination of the decubitus chest You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Tape Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure all foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as necessary NOTE All clothing from
189. asualty who is secured to a short spine board on a long spine board line up the hand grip holes of the short spine board with the holes of the long spine board if possible and secure the two boards together 3 Secure the casualty to a KED a Direct an assistant to immobilize the head and neck using manual stabilization 1 Place the hands on both sides of the casualty s skull with the palms over the ears 2 Support the jaw mandible with the fingers 3 Maintain manual stabilization until directed to release the stabilization b Position the immobilization device behind the patient c Secure the device to the patient s torso 1 Immobilize the torso from the top to the bottom strap 2 Apply the pelvic straps ensuring to pad the groin area d Secure the patient s head to the device 1 Pad behind the patient s head as necessary 2 Place one cravat across the chin angle towards the ear ensuring the cravat does not interfere with the airway Tie cravats to the side of the device 3 Place a cravat across the forehead angle towards the base of the head and tie it to the side of device e Evaluate and adjust the straps They must be tight enough so the device does not move excessively up down left or right but not so tight as to restrict the patient s breathing NOTE The pelvic straps must be released after being placed on a long spine board 3 42 STP 8 91P15 SM TG Performance Steps 4 Place
190. asured the body part through the entry exit site of the central ray Set the control panel Select the proper size film cassette Placed the cassette in the upright cassette holder lengthwise Positioned the overhead tube Positioned the chest a PA view b Lateral view c Decubitus view Immobilized the body part as required Placed the appropriate letter marker on the cassette Placed the lead shield around the patient s waist Gave the proper pre post exposure instructions Made the exposure Developed the exposed film with the patient s identification performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 146 STP 8 91P15 SM TG X RAY THE RIBS 081 823 0126 Conditions You have a formal request for an X ray examination of the ribs You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Letter mar
191. ate half of the cassette 5 Central ray directed to the base of the 3rd metatarsal blique view 1 Place the patient supine or seated with both legs fully extended on the table 2 Rotate the foot and leg of the affected side medially until the plantar surface of the affected foot forms a 30 degree angle with the cassette 3 Place the foot parallel to the long axis of the cassette 4 Center the foot to the appropriate half of the cassette 5 Central ray directed to the base of the 3rd metatarsal NOTE The leg of the affected side should exit the lateral edge of the cassette c Lateral view 1 Place the patient laterally recumbent 2 Place the plantar surface of the foot perpendicular to the cassette 3 Position the foot and leg to form a 90 degree angle 4 Center the foot with the plantar surface of the foot parallel to the long axis of the cassette 5 Central ray directed to the 1st medial cuneiform b O 10 Immobilize the body part as required a AP Place the knees against each other b Oblique Place a buttress between the knees c Lateral Place a sandbag under the knee of the affected side 11 Place the appropriate letter marker on the cassette 12 Place the lead apron across the patient s lap 13 Tell the patient DO NOT MOVE 14 Make the exposure 15 Tell the patient RELAX and remove immobilization 16 Develop the exposed film with the patient s identification Performance Meas
192. atient s identification Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Placed the cassette in the bucky lengthwise Positioned the overhead tube N O A Positioned the cervical spine a AP view b Open mouth view c Lateral view 9 Placed the appropriate identification marker on the cassette 10 Placed the lead apron across or around the patient s lap 3 169 STP 8 91P15 SM TG Performance Measures 11 Gave the proper pre post exposure instructions 12 Made the exposure 13 Developed the exposed film with the patient s identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all 8 performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None 3 170 Related BONTRAGER KENNETH STP 8 91P15 SM TG X RAY THE THORACIC SPINE 081 823 0131 Conditions You have a formal request for a radiologic examination of the thoracic spine You have the assistance of additional personnel if required Yo
193. ation if any was used 16 Processed the film with the patient s identification Performance Measures GO 1 Selected the required view s based on the request 2 Gathered the necessary materials and supplies STP 8 91P15 SM TG Performance Measures ON A 10 10 11 12 14 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Prepared the patient Placed the lead apron across the patient s lap Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Positioned the overhead tube Positioned the wrist a PA view b PA ulnar flexion view c Oblique view d Lateral view Placed the appropriate identification marker on the cassette Immobilized the body part by placing a sandbag over the forearm necessary Gave correct pre post exposure instructions Made the exposure Processed the film with the patient s identification Tid performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 88 STP 8 91P15 SM TG X RAY THE FOREARM 081 823 0110 Conditions You have a request for a radiologic examination of
194. ation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 57 STP 8 91P15 SM TG MAKE CALCULATIONS FOR CHANGES IN SID 081 823 0102 Conditions You have an exposure factor chart for a radiographic exposure and a different FFD for the exposure Standards Calculated the new mAs without error Performance Steps 1 Obtain the original mAs and FFD mAs from the factor chart 2 Calculate the new mAs 5 using the formula 5 mAs x FFD FFD NOTE Source to image receptor distance SID is synonymous with FFD Performance Measures GO 1 Obtained the original mAs and FFD from the factor chart 2 Calculated the new mAs mAsz using the formula mAs mAs 2 FFD 2 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 58 STP 8 91P15 SM TG MAKE EXPOSURE FACTOR COMPENSATION FOR PATIENT SIZE 081 823 0104 Conditions You have an exposure factor chart and calipers Standards Calculated the exposure factors w
195. ational specialty MOSC military occupational specialty code MTOE Modified Table of Organization and Equipment MVA motor vehicle accident MWO modification work order NBC nuclear biological and chemical NCO noncommissioned officer NIIN national item identification number NMCS not mission capable supply NSN national stock number O R operating room OCIE organizational clothing and individual equipment OML orbitomeatal line Glossary 5 STP 8 91P15 SM TG PA posterior anterior PBO property book officer PC personal computer POL petroleum oils and lubricants quality control RAO right anterior oblique RPO right posterior oblique Self development Self development is a planned progressive and sequential program followed by leaders to enhance and sustain their military competencies Self development consists of individual study research professional reading practice and self assessment SID source to image receptor distance SL squad leader skill level SM soldier s manual SMCT soldier s manual of common tasks SMV submentovertex SOP standing operating procedures SOS source of supply subcutaneous Glossary 6 STP 8 91P15 SM TG SSA supply support activity SSN social security number SSSC self service supply center Sustainment training The provision of training to maintain the minimum acceptable level of proficiency required to accomplis
196. authorized requester as indicated on the 1687 13 Approved By block Enter the name of the authorized approving authority IAW local SOP 14 Block 14b Date Enter the Julian date the request is approved 15 Block 14c Signature Enter signature of the authorized approving authority 16 block Enter the item number 17 18 19 5 6 7 8 DODIC block Enter the Department of Defense identification code DODIC Block 17 NSN Enter the NSN Nomenclature block Enter the nomenclature Enter the words LAST ITEM after the last entry 20 UI block Enter the unit of issue 21 Quantity Requested Turned in block Enter quantity requested 22 TEC block Enter the training event code TEC See appendix K of DA Pam 710 2 1 23 Action Code block Enter the appropriate code IAW DA Pam 710 2 1 24 Remarks block Enter the applicable statement IAW DA Pam 710 2 1 25 Related Document Serial Numbers block List all supporting DA Forms 581 and 581 1 b Record the DA Form 581 in the expendable document register c File one copy of DA Form 581 and or DA Form 581 1 continuation sheet if applicable in the suspense file d Forward required number of copies through the authentication officer to the ASP e Pick up ammunition 4 Prepare DA Form 2765 1 as a request for issue IAW DA Pam 710 2 1 a Prepare DA Form 2765 1 1 Block A Enter the name and address of the supply support activity SSA SOS 3 296
197. ay be used 8 Position the overhead tube a Set the tube angle perpendicular to the cassette b Set the source to image distance SID to 72 inches 182 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Place the lead shielding around the patient s waist 10 Position the chest a PA view 1 Patient standing feet spread slightly weight equally distributed on both feet 3 144 STP 8 91P15 SM TG Performance Steps 2 Chin raised resting against film holder 3 Hands on hips palms out and elbows partially flexed 4 Shoulders rotated forward against film holder NOTE This allows scapulae to move laterally clearing the lung fields NOTE This depresses the shoulders downward to move clavicles below the apices 5 Align midsagittal plane midline of the film holder NOTE Insure no rotation of thorax 6 Central ray perpendicular to the film and centered to the midsagittal plane at the level of T 7 NOTE Acromion process should be 3 inches below the upper film border b Lateral view 1 Patient erect with their left side against the film 2 Weight evenly disturbed on both feet 3 Arms raised above their head with chin up 4 Center the patient to film by checking anterior and posterior aspects of the thorax NOTE There should be no rotation of the thorax 5 Central ray perpendicular and centered at level of T 7 NOTE Acromion processes 3 inches below the upper film bo
198. b Store fluoroscopy x ray tube and collimator in containers provided 6 Install table supports a Move X ray tower to foot end of table b Using locking pin attached lock into place 7 Secure counterweight pulleys 8 Secure spot film carriage 9 Reinstall table top 10 Secure sub top and accessories Performance Measures GO 1 Removed image intensifier spot film device over table x ray tube and collimator 2 Stored image intensifier spot film device over table x ray tube and collimator containers provided Removed table top Removed table sub top Removed fluoroscopy x ray tube and collimator oa Stored fluoroscopy x ray tube and collimator in containers provided 3 269 STP 8 91P15 SM TG Performance Measures 7 Installed table supports 8 Secured counterweight pulleys 9 Secured spot film carriage 10 Reinstalled table top 11 Secured sub top and accessories Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None 3 270 Related CUSWORTH RITA J RADIOLOGY BRANCH SOP STP 8 91P15 SM TG PREPARE DEPMEDS RADIOGRAPHIC UNI
199. b hand receipt 1 Check all items to ensure the descriptions on the hand subhand are correct 2 Count all items 3 Verify serial numbers 4 Report differences to the person making the issue 5 Sign the hand subhand receipt after action in 1 through 4 above have been completed 2 Conduct a change of hand receipt holder inventory a Schedule a minimum of thirty days to conduct the joint inventory 0 Check with next higher commander supervisor for any special instructions c Review the Hand or Subhand Receipts and Annexes d Review the Hand Receipt to find the type of items to be inventoried e Notify the subhand receipt holders of when where and how the inventory will be conducted f Verify that the current publications are available for use during the inventory g Check all items to verify the description on unit hand receipt is correct Make a visual check of the condition of the property i Count all items listed on the hand receipt j Check end items to ensure all component items are on hand k Verify the serial number on the item with that recorded on the hand receipt Validate maintenance request if items are in maintenance If a hand receipt holder dies or departs the unit without transferring property the Unit Commander Supervisor will appoint a person to act on their behalf so that a joint inventory can be conducted 3 Conduct a Change of Responsible Officer in the United States Army Reserv
200. be se registered for the exam 5 Registered imaging plate information using plate barcode and scanner 6 Inserted the cassette into the plate reader 7 Removed freshly loaded cassette Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 216 STP 8 91P15 SM TG MANIPULATE COMPUTERIZED IMAGE FOR INTERPRETATION 081 823 0175 Conditions You have a DIN PACS computed radiography system and appropriate privileges to manipulate images Standards Manipulated the computerized image for interpretation IAW DIN PACS and department SOP Performance Steps 1 Select the on line exam from work list window Select Display Exam from the Images menu Highlight appropriate image Rotate and flip image orientation if necessary Adjust window level values Verify image Performance Measures oa Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Selected the on line exam from the work list window Selected Display Exam from the Images menu Highlighted appropriate image
201. bilities 2 NCOIC responsibilities 3 Assistant NCOIC responsibilities 4 Supply clerk responsibilities 5 Secretary responsibilities 6 Responsibilities of each position b Use general terms c List a subparagraph for each function and sub function d Create a separate annex to address each segment within the radiology section 4 Identify with whom the authority for radiological services rests Usually the chief radiologist or director of radiology who in turn delegates authority to a Radiology director b Chief radiologic technologist 5 Identify the interrelationships external relationships for the service a Mission philosophy in relation to the coordination between the radiology department and all clinical activities of the medical facility b The director s or radiologist s function as part of the medical staff c Department s participation in the total hospital program 6 Identify the standards that guide the service performance a Professional society standards 1 American Registry for Radiological Technologist 2 American Society for Radiologic Technologist 3 291 STP 8 91P15 SM TG Performance Steps 3 American College of Radiology 4 American College of Surgeons b U S Army standards 1 Army regulations 2 Army technical manuals 3 Army field manuals 7 Identify the staffing guide and job descriptions a Staffing organization chart b Job description for each position 8
202. ble from the control assembly LINE OUT connector and from the x ray generator assembly connector pipe assembly lower section Removed safety pin lifted and pulled x ray generator assembly out of cross arm assembly and positioned x ray generator collimator assembly face down Fitted the face of the collimator into the stand corner brackets and fitted the yoke latching button into the yoke latching button bracket Secured safety pin 3 273 STP 8 91P15 SM TG Performance Measures 5 Pressed cross arm horizontal travel release brake and slid horizontal cross arm out of gear box assembly 6 Slid the cross arm assembly into cross arm bracket on the side of stand 7 Positioned pipe assembly upper section locking handle to the up unlocked position Lifted off pipe assembly upper section positioned on stand pipe assembly upper section support blocks and fitted pipe assembly into gear box pipe assembly spring clip 8 Removed leg locking pins and folded legs up into leg restraining clips Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None 3 274 Related CUSWORTH RITA J RADIOLOGY BRANCH SOP STP 8 91
203. btain the required resources identified in the conditions statement for each task Gather equipment and ensure it is operational e Coordinate for use of training aids and devices Prepare the training site according to the conditions statement and evaluation preparation section of the task summary as appropriate Prepare the soldiers e Tell the soldier what task to do and how well it must be done Refer to the standards statement and evaluation preparation section for each task as appropriate e Caution soldiers about safety environment and security e Provide any necessary training on basic skills that soldiers must have before they can be trained on the task Pretest each soldier to determine who needs training in what areas by having the soldier perform the task Use DA Form 5164 R and the evaluation guide in each task summary to make this determination NOTE Deficiencies noted in soldiers ability to perform critical tasks taught in schools or by extension training materials should be reported to the proponent school Train the soldiers who failed the pretest Demonstrate how to do the task or the specific performance steps to those soldiers who could not perform to SM standards Have soldiers study the appropriate materials Have soldiers practice the task until they can perform it to SM standards e Evaluate each soldier using the evaluation guide e Provide feedback to those soldiers who fail to perform
204. by accounting for all discrepancies in accordance with AR 735 5 5 Perform post inventory actions for a cyclic inventory a Report damaged equipment to unit maintenance personnel for corrective action 0 Report any discrepancies found during the inventory to the PBO c Prepare and process an Administrative Adjustment Report AAR to correct differences within sizes makes or models d Submit requests for issue to replace shortages 6 Perform post inventory actions for a change of PBO inventory a Report damaged equipment to unit maintenance personnel for repair 0 The outgoing PBO conducts causative research for differences When conclusive findings are made the following actions will be made 1 Turn in overages as found on installation property 2 Account for shortage according to AR 735 5 3 Prepare and process an AAR to correct difference within sizes make or models 4 Adjustment documents are posted to the property book 5 Submit request for issue to replace shortages c The incoming PBO will complete the statement of accountability for the property d When the inventory cannot be completed within the prescribed time of 30 days an extension may be requested from the commander or designated representative making the appointment e A maximum of two extensions may be requested 7 Perform post inventory actions for an annual PBO inventory a Report damaged equipment to unit maintenance person
205. by placing a sandbag on or against the hand 11 Place the appropriate identification marker on the cassette 12 Place the lead apron across the patient s lap 13 Tell the patient DO NOT MOVE 14 Make the exposure 15 Tell the patient RELAX and remove immobilization 16 Process the film Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette table crosswise N O A Positioned the elbow b Lateral view 9 Immobilized the body part by placing a sandbag on or against the hand 10 Placed the appropriate identification marker the cassette 11 Placed the lead apron across the patient s lap 12 Gave the proper pre post exposure instructions 3 93 STP 8 91P15 SM TG Performance Measures GO 13 Made the exposure 14 Processed the film Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correct
206. ce Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Letter markers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patients clothing is removed as required c Explain the procedure if applicable d Assist the patient onto the table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use an 8 X 10 cassette for all views 7 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 8 Position the zygomatic arches NOTE Because of the extreme mobility of the head on the neck all positions of the skull require a two way head alignment TWHA for exact positioning of the skull SMV view TWHA 1 Place the patient seated with back against the upright table 2 Adjust the vertex of the skull in contact with the table 3 Place the median plane perpendicular to and over the centerline of the table 4 Adjust the infraorbitomea
207. ce Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead aprons c Lead gloves d Letter markers e Contrast f Lead time markers 3 Attach any required accessories to the X ray table 4 Prepare the contrast medium CAUTION To simulate peristalsis use the cold isotonic method This method requires the use of ice cold water or normal saline mixed with the contrast medium 5 Prepare the equipment for fluoroscopy 6 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary c Explain the procedure to the patient d Assist the patient onto the X ray table 7 Assist the radiologist as directed 8 Prepare the equipment for the follow up radiographs a Measure the body part from the entry exit site of the central ray b Set the control panel 1 Consult the technique chart 2 Set the appropriate mAs and kVp on the control panel c Use a 14 x 17 cassette for all views d Place the cassette in the bucky lengthwise e Place the letter markers on the film NOTE Letter marker for corresponding side and time markers for 30 60 and 120 minutes must be placed on the film f Position the overhead tube 3 189 STP 8 91P
208. ce measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 135 STP 8 91P15 SM TG X RAY THE TOES 081 823 0222 Conditions You have a formal request for a radiologic examination of the toe You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Tape Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from patient as necessary 2 Ensure the patient s shoes are removed as required c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set
209. ch disc 11 Touched double edged box MOVE COUCH READY FOR SCAN 12 Pressed the START button after prompt on ELTP 13 After first scan is completed pressed STOP button 14 Pressed F1 CURSOR OPS Pressed RULER Placed ruler on superior edge of spinal cord Changed ruler length to 16 cm using window width wheel b Pressed F6 AREA ID c Touched SCAN REPROCESSS OPTIONS 3 211 STP 8 91P15 SM TG Performance Measures d Touched REPROCESS SCANS e Touched number on ELTP that corresponds to the image f Touched double edged box ACCEPT SELECTION amp PROCEED TO PRE SCAN g Touched double edged box READY FOR REPROCESS 15 Touched ENTER on keypad 16 Touched double edged box READY FOR SCAN 17 Touched START button after prompt on ELTP 18 When the plan is completed the boxes will return on ELTP Touched SELECT SCAN MODE 19 Touched ENTER on keypad 20 Touched double edged box READY FOR SCAN 21 Pressed START button after prompted on ELTP 22 Repeated for each plan Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all 86 performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None CUSWORTH RITA J MOSS ALBERT A RADIOLOGY BRANCH SOP 3 212 REPRINT
210. ck 1 Enter AF_ of an AE_ series status card if status has been received Circle block 1 with colored pencil or ink 2 Prepare a follow up document if no status has been received a Remake the supply request from the document register and proper supply publication b Card columns 1 3 Enter AT_ the series document identifier code IAW appendix H Circle the entry with colored pencil or ink 3 Column n Enter the AF_ or AT_ series used and the Julian date of the action from the document register c Prepare a request for an improved estimated delivery date 1 Use a previously received status card for 01 08 requests only 2 Block 1 Enter AFC of the latest status card and circle in colored pencil or ink 3 Column n Enter AFC and the Julian date of the action from the document register d Send the follow up to the SSA SOS e Post transaction to the document register f Disposition instruction IAW local SOP 9 Prepare a modification request for a previously submitted request IAW DA Pam 710 2 1 a Identify modification requirements 1 Verify that you use the modification process only when the change pertains to the entire quantity due in 3 299 STP 8 91P15 SM TG Performance Steps 2 Verify that a modification request is submitted for each open request when the unit force activity designator FAD or urgency of need designator changes Block 3 M and S Media and status code Block 18 TRC and EIC Block 1
211. cky at one end of the table NOTE Bucky should be at the opposite end of the area of interest 5 Rotate the conventional X ray tube away from the table and to the opposite side of the fluoro tower 6 Pull the fluoro tower out by releasing the stop lock button and pulling towards you 7 Select the proper film format on the fluoro tower console NOTE Film format options are from 1 X 1 to 9 X 1 8 Adjust the fluoro tower mirror so that you are able to view the fluoro receptor properly 9 Push the PREPARE button on the fluoro tower console to take and eject a film 10 Place film in fluoro tower bucky and push the X RAY button on the fluoro tower console to expose the film Performance Measures GO 86 1 Turned the console a Flipped the circuit breaker to the on position b Pushed the MAINS button on the power console 2 Properly set up the console for fluoroscopy a Pushed the AUTOTIMER button on the power console b Pushed the SPOT FILM button on the power console 3 254 STP 8 91P15 SM TG Performance Measures GO l Selected the appropriate density according to the patient s size by pushing the corresponding DENSITY button on the power console Pushed the RESET AUTOTIMER button the power console to reset the autotimer to zero e Selected the mA level by pushing the 200 LARGE SPOT button on the power console 3 Selected the appropriate fluoro tim
212. clude maximum knee and ankle joints 2 a YS Da Ow 1 2 3 4 5 6 b Lateral view 1 Patient in lateral recumbent position injured side down NOTE Generally the opposite leg may be placed behind the affected leg 2 Flex knee about 45 degrees and insure leg is in true lateral position NOTE Epicondyles should be perpendicular 3 Center and align the cassette to the long axis of the leg 4 Insure both knee and ankles joints are equal distance from their respective film borders 5 Central ray perpendicular to film directed to mid point of film 6 Collimate to both sides of the skin margins NOTE A small film may be taken of the joint nearest the injury site if needed 10 Place the appropriate identification marker on the cassette 11 Place the lead shielding across the patient s lap 12 Tell the patient DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX and remove immobilization 15 Develop the exposed cassette s with patient identification Performance Measures GO o N A Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette on the table lengthwise Positioned the overhead tube
213. control panel Selected the proper size of cassette Bg N O A Placed the cassette table crosswise for the lateral views and lengthwise the bucky for the Water s view Positioned the overhead tube 9 Positioned the nose a Water s view b Lateral bilateral view 3 81 STP 8 91P15 SM TG Performance Measures 10 11 12 13 14 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Placed the appropriate identification marker on the cassette Placed the lead apron across the patient s hips Gave the patient the pre post exposure instructions Made the exposure Developed the exposed film with the patient identification Wi performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References 3 82 Required None Related BONTRAGER KENNETH STP 8 91P15 SM TG Subject Area 4 General Radiography Upper Extremities X RAY THE HAND 081 823 0108 Conditions You have a request for an X ray examination of the hand and or thumb You have the assistance of additional personnel if required You will need properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers an
214. core each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Prepared the equipment for fluoroscopy Prepared the patient Notified the radiologist the patient is ready for fluoro Assisted the radiologist as directed Measured the body part at the entry exit site Set the control panel Positioned the overhead tube Positioned the patient for follow up radiographs a PA view b Lateral view c RAO view Made the exposure Gave the patient the pre post exposure instructions Developed the exposed cassette s with patient identification STP 8 91P15 SM TG GO FT TT dT performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 185 STP 8 91P15 SM TG ASSIST PHYSICIAN WITH UPPER G I EXAM 081 823 0145 Conditions You have received a formal request for an upper G I examination You have the assistance of additional personnel if required You will need a properly equipped radiographic fluoroscopic exposure room with the correct contrast medium and various sizes of film in cassettes Standards The radiographs were of diagnostic quality and properly demonstrated the requested body part The radiographs were correctly identified and free from artifacts Performance Steps
215. crewdriver slot Reset as required 5 Turn on the power switch and rotate the line set switch with the green lamp lights 6 Close the collimator shutters 7 Select 60 kVp 40 mA station 8 Set timer for 0 1 seconds 9 Step back from unit 6 feet with the exposure switch 0 Press the exposure switch to the first position PREP and observe that ready lamp goes off and on after about a one second delay 11 Press the exposure switch all the way down to the X ray position and observe the X Ray on lamp and audio tone operate Performance Measures GO 1 Checked the control module to the X ray generator connector 2 Ensured that the power line cord to the unit is connected to the primary power source 3 Ensured that the collimator power cord is attached to its connector 4 Verified that the 50 60 Hz switch is to the correct line frequency by lifting the protective cap in the lower right corner of the control and noting the position of the screwdriver slot Reset as required 3 239 STP 8 91P15 SM TG Performance Measures GO 86 5 Turned on the power switch and rotated the line set switch with the green lamp lights Closed the collimator shutters Selected 60 kVp 40 mA station Stepped back from unit 6 feet with the exposure switch 6 7 8 Set timer for 0 1 seconds 9 0 Pressed the exposure switch to the first position PREP
216. d None 3 132 Related BONTRAGER KENNETH L STP 8 91P15 SM TG X RAY THE HIP 081 823 0123 Conditions You have a formal request for a radiologic examination of the hip You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from patient as necessary 2 Ensure the patient s clothing is removed as required 3 Use a drape sheet or patient gown to cover the patient as needed c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Se
217. d various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Sandbags Lead apron Letter markers Calipers Radiolucent blocks 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure the patient s jewelry is removed as necessary 2 Ensure the patient s sleeves are rolled up as necessary c Explain the procedure if applicable d Seat the patient facing the X ray table 4 Place the lead apron across the patient s lap 5 Measure the body part through the entry exit site of the central ray 6 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 7 Select the proper size cassette NOTE Use 1 2 of a 10 x 12 cassette for the PA and oblique views and an 8 x10 cassette for the lateral view 8 Place the cassette onto he table according to the desired position a Crosswise for the PA and oblique views b Lengthwise for the lateral view 9 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c
218. d thumb abducted with fingers and hand slightly arched then rotate hand medially slightly until thumb is in a true lateral position 2 Align long axis of thumb to long axis of portion of film being exposed 3 Center 1st MP joint to central ray and to center of portion of film being exposed NOTE Entire lateral aspect of thumb should be in direct contact with cassette 4 Collimate to four sides of thumb 12 Place the appropriate identification marker on the cassette 13 Tell the patient DO NOT MOVE 14 Make the exposure 3 110 STP 8 91P15 SM TG Performance Steps 15 Tell the patient RELAX 16 Develop the exposed film with the patient identification Performance Measures GO 4 Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part at the entry exit site of central ray Set the control panel Selected the proper film size Positioned the overhead tube Placed the lead shielding over across the patient s lap oO ON DO A Positioned the finger a PA view b Oblique view c Lateral view 10 Positioned the thumb AP view b Oblique view c Lateral view 11 Placed the appropriate identification marker on the cassette 12 Gave the patient the pre post exposure instructions 13 Made the e
219. d with a slight twisting motion fully advance the catheter c While continuing to hold the hub press lightly on the skin over the needle or catheter tip with the fingers of the other hand NOTE This prevents the backflow of blood from the hub d If using a catheter over needle remove the needle from inside the catheter 10 Remove the protective cover from the needle adapter on the tubing Quickly and tightly connect the adapter to the catheter or needle hub WARNING Do not allow air to enter the blood stream 11 Tell the patient to unclench the fist and then release the constricting band 12 Unclamp the IV tubing and adjust the flow rate to keep the vein open TKO or KVO NOTE rate of about 30 per hour 7 to 10 drops per minute using standard drip tubing is adequate to keep the vein open 13 Check the site for infiltration If it is painful swollen red cool to the touch or if fluid is leaking from the site stop the infusion immediately 14 Secure the site IAW local SOP a Apply a sterile dressing over the puncture site leaving the hub and tubing connection visible b Loop the IV tubing onto the extremity and secure the loop with tape c Splint the arm loosely on a padded splint if necessary to reduce movement 15 Readjust the flow rate a Determine the total time over which the patient is to receive the dosage 3 27 STP 8 91P15 SM TG Performance Steps Example The patient is to receive the d
220. ded folder to archive file for future acquisition N O A Verified newly archived was correct folder and available for acquisition Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 221 STP 8 91P15 SM TG DIGITIZE CONVENTIONAL RADIOGRAPHIC IMAGES 081 823 0321 Conditions You must convert images on conventional radiographic film to digital computer images You will need on line digital work station film digitizer film to be digitized and DIN PACS operating instructions Standards Digitized the conventional film image without error IAW DIN PACS operating instructions Performance Steps 1 Display the patient record with the correct Exam ID on the Film Digitizer work station Order an exam to create the Exam ID if necessary Verify that the Exam ID correctly matches the film to be digitized Load the film into the digitizer Click OK to begin digitizing Remove the film from the output tray Performance Measures oa A Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary
221. dier fails any step show what was done wrong and how to do it correctly References None 3 219 STP 8 91P15 SM TG ACQUIRE IMAGES USING COMPUTED RADIOGRAPHY PICTURE ARCHIVAL AND COMMUNICATION SYSTEM CR PACS 081 823 0178 Conditions You must acquire digital computer images from picture archival system You will need on line digital work station and DIN PACS operating instructions Standards Acquired images without error IAW DIN PACS operating instructions Performance Steps 1 Open the Folder acquisition selection Menu Select appropriate search folder from the Folder menu Click on a Query Input field that applies to your search Type your search criteria in the Query Input field Select the off line examination Select Fetch Exam from the Images menu N 0 fF Verify correct operation through the validation of correct image information within the display area Performance Measures GO 1 Opened the Folder acquisition selection Menu Selected appropriate search folder from the Folder menu Clicked on a Query Input field that applies to the search Typed correct search the Query Input field Selected the off line examination N Selected Fetch Exam from the Images menu Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summa
222. dier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 280 STP 8 91P15 SM TG PERFORM SCREEN FILM CONTACT TEST 081 823 0265 Conditions You are to perform a screen film contact test You have assistance of additional personnel if necessary You will need a properly functioning radiographic exposure room with cassettes of various sizes letter markers lead shielding sandbags and positioning sponges Standards Properly conducted a screen film contact test and maintenance check on cassette to determine if poor screen film contact exist Performance Steps 1 Gather the necessary materials and supplies a Appropriate cassettes b Wire mesh c Paper clips 2 Set the control panel a Set mAs and then kVp NOTE Recommended 60 kVp 5 mAs for optical density b Small focal spot 3 Place the cassette on the table top with the wire mesh on top of cassette NOTE Make sure the wire mesh is evenly distributed 4 Position the overhead tube a Position the tube perpendicular to the cassette b Collimate to all four sides of the cassette 5 Make the exposure 6 Develop the exposed film 7 Place the processed film on the illuminator 8 Check cassette for any signs of poor film contact NOTE Usually poor screen film contact happens on the edges of the film The cassette is
223. ding to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all GO performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 103 STP 8 91P15 SM TG X RAY THE CLAVICLE 081 823 0115 Conditions You have a request for a radiologic examination of the clavicle You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes in various sizes lead shielding and letter markers Standards The radiograph s were of diagnostic quality properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure the patient s jewelry is removed as necessary 2 Ensure the patient has removed all clothing under the area of study as necessary NOTE Gown the patient as necessary c Explain the procedure if applicable d Assist the patient to the upright X ray table 4 Measure the body part the entry exit site of the cen
224. ding to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C CUSWORTH RITA J RADIOLOGY BRANCH SOP 3 238 STP 8 91P15 SM TG PERFORM PRE OPERATIONAL CHECK ON DEPMEDS PORTABLE RADIOGRAPHIC UNIT IDDC MODEL 1200 081 823 0188 Conditions You are in a tactical environment and the unit commander has given the order to set up You have completed the assembly of the portable unit You have the assistance of other soldiers if required You will need functional DEPMEDS portable radiographic unit IDDC Model 1200 and Operation and Maintenance Manual for Model 1200 Portable X Ray System Standards Performed pre operational check on the field portable IDDC Model 1200 radiographic unit Performance Steps 1 Check the control module to the x ray generator connector 2 Ensure that the power line cord to the unit is connected to the primary power source 3 Ensure that the collimator power cord is attached to its connector WARNING Be certain the LINE FREQ switch setting agrees with the primary power frequency 60 Hz or 50 Hz 4 Verify that the 50 60 Hz switch is set to the correct line frequency by lifting the protective cap in the lower right corner of the control and noting the position of the s
225. ding to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 249 STP 8 91P15 SM TG PREPARE ACR 2000 COMPUTED RADIOGRAPHY UNIT FOR OPERATION 081 823 0185 Conditions You are in a tactical environment and the unit commander has given the order to set up The ACR 2000 has been unloaded The assistance of other soldiers is available You will need the Lumiscan ACR 2000 service manual if available Standards Assembled the ACR 2000 units IAW Lumiscan ACR 2000 service manual Performance Steps 1 Unpack all PC and CR equipment from the storage cases NOTE Make sure ALL components are on a stable and even surface 2 Plug in the uninterrupted power supply 3 Plug the power strip into the uninterrupted power supply 4 Connect the CR power cord and plug in the power strip 5 Connect the ACR to the PC using the DAC cable 6 Connect the monitor to the PC with serial cable and plug the monitor power cord into the power strip 7 Connect PC peripheral devices keyboard mouse using the color codes on the back of the PC 8 Connect the PC power cord and plug into the power strip 9 Turn on the power for the uninterrupted power supply and the power strip 10 Turn on the power for the CR NOTE The power button is in back o
226. dvice code b Complete identification data section of DD Form 1348 6 Request For Issue for a NSN item 1 Complete blocks 2 through 9 with as much data as possible 2 Block 11 Remarks Use as required c Record DD Form 1348 6 in the appropriate document register d Forward the completed DD Form 1348 6 to the supporting SSA SOS 8 Prepare request for follow up IAW DA Pam 710 2 1 a Determine if follow up action is needed on previously submitted requests Follow ups are not mandatory 1 Submit follow up for priority 01 08 requests no earlier than nine calendar days from request submission or last receipt of status 2 Submit follow up for priority 09 15 requests if at the time of monthly reconciliation receipt no status has been received 3 Submit follow up for all priorities under the following conditions a At the time of monthly reconciliation receipt of expired shipment status 0 Valid existing supply status is unsatisfactory in terms of estimated availability date c Fourteen 14 days have passed since a cancellation request was submitted and supply or shipment status has not been received d Thirty 30 calendar days have passed since the date shipped as shown on shipment status document and the item has not been received CONUS e Sixty 60 calendar days have passed since the date shipped as shown on shipment status document and the item has not been received OCONUS b Prepare a request for follow up 1 Blo
227. e 4 Placed the table bucky at one end of the table 5 Rotated the conventional X ray tube away from the table and to the opposite side of the fluoro tower 6 Pulled the fluoro tower out by releasing the stop lock button and pulling towards self 7 Selected the proper film format on the fluoro tower console 8 Adjusted the fluoro tower mirror to view the fluoro receptor properly 9 Pushed the PREPARE button the fluoro tower console to take and eject a film 10 Placed film in fluoro tower bucky and pushed the X RAY button on the fluoro tower console to expose the film Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C 3 255 STP 8 91P15 SM TG OPERATE A DRY LASER PROCESSOR 081 823 0255 Conditions You are a staff technologist in a radiology section with the requirement to operate a dry laser processor You will need a fully operational and on line dry laser processor Standards Prepared a dry laser processor for processing IAW manufacturer directions and department SOP Performance Steps 1 Power on the dry laser processor a Ensure that the power light on the l
228. e Tell the patient STOP BREATHING AND DO NOT BREATHE OR MOVE Make the exposure Tell the patient RELAX AND BREATHE NORMALLY and remove immobilization Develop the exposed film with the patient identification for processing Performance Measures N A N 12 13 14 15 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Prepared the patient Set the control panel Selected the proper size cassette Positioned the overhead tube Positioned the pelvis for the AP view Immobilized the body part as required Selected the required view s based on the request Gathered the necessary materials and supplies Measured the body part through the entry exit site of the central ray Placed the cassette in the bucky crosswise Placed the appropriate identification marker on the cassette Placed gonadal shielding on patient as required Gave the proper pre post exposure instructions Made the exposure Developed exposed film with the patient s identification PTT TTT performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 143 STP 8 91P15 SM TG X RAY THE CHEST 081
229. e a Select Send Trans Via Floppy Diskette option 1 0 Select the drive Verify that the printer is online when message prompt Ensure printer is online is displayed then press any key Select Y or N to the message prompt Commander s Report Should Be Run Before Sending Transactions To Source of Supply Do You Wish To Continue 1 Selecting N returns you to the Send Transactions screen where you can then return to the Request Processes Menu to run the Commander s Reports 2 Selecting Y allows you to continue the process Label a diskette Insert the diskette into A drive Format the diskette e Select the diskette volume label e f g h i Select Y or N to format another diskette j Process the transactions k Review the Send Supply Transactions Report File the Send Supply Transactions Report in unit file Forward the diskette to the SOS 2 Send transactions via communications a Select Send Trans Via Communications option b Process the transactions d Review the Send Supply Transactions Report e File the report in unit files e Select Transactions for the Sign On DODAAC Previous Transactions option 2 from the Send Supply Transactions to SOS Menu 1 Send transactions via floppy diskette a Select the Send Trans Via Floppy Diskette option 1 0 Select the appropriate drive Verify that the printer is online when
230. e d Adjust the conefield to 4 X 4 coverage 9 Position temporomandibular joints schuller s bilateral open and closed two way head alignment TWHA NOTE Because of the extreme mobility of the head on the neck all positions of the skull require a TWHA for exact positioning of the skull a Place the patient semiprone on the table b Place the median plane parallel to the table c Adjust the interpupillary line perpendicular to the cassette 3 74 STP 8 91P15 SM TG Performance Steps NOTE Place the appropriate letter marker open or closed within the conefield 10 11 12 13 14 15 16 d Adjust the infraorbitomeatal line IOML perpendicular to the lateral edge of the cassette e Instruct the patient to open or close mouth f Project the tragus nearest the table to the center of the cassette Place the appropriate identification marker on the cassette Place the led apron across the patient s lap Instruct the patient a OPEN MOUTH AND DO NOT BREATHE OR MOVE CLOSE MOUTH AND DO NOT BREATHE OR MOVE Make the exposure Tell the patient BREATHE NORMALLY AND RELAX Develop the exposed cassette s with patient identification for processing Return the patient to the waiting area Performance Measures N oO A N gt Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the ta
231. e correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Sandbags c Letter markers d Tape e Positioning sponges f Lead shielding g Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary 3 Use a drape sheet to cover the patient as needed c Explain the procedure as applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size film cassette NOTE Use a 14 X 17 cassette for the AP and lateral views and a 8 X 10 cassette for the Lateral L 5 S 1 view 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette Adjust the cone field to 10 X 17 lengthwise for the AP and lateral views and 6 X 6 for the L 5 S 1 view 3 174 STP 8 91P15 SM TG Performance Step
232. e coverage 9 Position the femur NOTE When demonstrating long bones each view must include the joint nearest the site of injury a AP view distal and proximal 1 Place the patient supine on the table 3 130 STP 8 91P15 SM TG Performance Steps a Place the epicondyles parallel to the table for the distal view 0 Rotate the foot and leg of the affected side medially to form a 15 degrees with the table for the proximal view 2 Ensure the plane through the ASIS and midepicondyles is over the centerline of the table a Distal apex of the patella 3 below the lower edge of the cassette 0 Proximal ASIS 3 below the upper edge of the cassette b Lateral view distal and proximal 1 Place the patient laterally recumbent on the table 2 Place the epicondyles perpendicular to the table 3 Flex the knees 4 Ensure the plane through the greater trochanter and medial epicondyles of the knee is over the centerline of the table a Distal draw the unaffected leg forward and buttress at hip level 0 Proximal rotate the unaffected leg backward NOTE Rotate the unaffected leg just enough to prevent superimposition of the greater trochanters 5 Central ray a Distal apex of the patella 3 above the lower edge of the cassette 0 Proximal ASIS 3 below the upper edge of the cassette 10 Immobilize the body part as required 11 Place the appropriate identification marker on the cassette 12 Place the lead apr
233. e hand receipt 7 The incoming PBO will develop some method to keep track of those property book pages that have been compared to hand receipts f After completion of the action in 5 above inventory the items not issued on hand receipts a Check all items to make sure the item and their description on the property book match b Make a visual check of the condition of the property and prepare a list of any damaged property c Count all items not issued on hand receipt d Check end items for completeness e Verify serial numbers f Validate maintenance request if items are in maintenance 7 Conduct an annual PBO inventory a This inventory is required when property books are kept at other than using unit level The PBO conducts this inventory 1 Make sure all completed receipt turn in and adjustment documents have been posted to the property book 2 Compare hand receipts with the property book 3 Make sure there is a property book page for each property book item listed on the hand receipt STP 8 91P15 SM TG Performance Steps 0 Inventory the items as follows 1 Check all items to make sure the item and their description on the property match 2 Make a visual check of the condition of the property 3 Make a list of any damaged property 4 Count all items not issued on hand receipt 5 Check end items for completeness 6 Check the serial number on the item with that recorded on the property book 7
234. e search folder from the Folder menu Click on a Query Input field that applies to your search Type your search criteria in the Query Input field Select the off line examination Select Fetch Exam from the Images menu information within the display area Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 260 STP 8 91P15 SM TG OPERATE CR ACQUISITION WORKSTATION 081 823 0326 Conditions You have radiographed the patient The processing terminal is on line The CR plate reader is on line You will need imaging plate bar code scanner and Digital Imaging Network Picture Archiving and Communications Systems DIN PACS operating instructions Standards Operated acquisition workstation through the correct processing of a digital imaging plate IAW manufacturer s specifications Performance Steps 1 2 3 N N Took exposed imaging plate s to the processing terminal Ensured the processing terminal was on line and ready Scanned the patient information barcode selected patient information Take exposed imaging plate s to the proces
235. e to image receptor distance SID to 72 inches 182 cm c Center the tube to the cassette 9 Position the soft tissue study C spine a Patient erect lateral with shoulder against vertical film holder b Align mid coronal plane to midline of cassette holder c Ask patient to relax and drop their shoulder as much as possible NOTE lf needed have the patient hold sandbags of equal weights 5 10 Ibs in both hands d Extend chin so the AML is parallel to the floor 3 202 Performance Steps e Central ray is horizontal perpendicular to the film at the level of the upper margin of 10 11 12 13 14 15 the thyroid cartilage f Adjust collimation to full film coverage STP 8 91P15 SM TG Place the appropriate letter marker on the cassette Place lead shielding around the patient s lap Tell the patient TAKE INA DEEP BREATH BLOW IT OUT AND HOLD IT OUT Make the exposure Tell the patient RELAX AND BREATHE NORMALLY Develop the exposed radiograph with the patient s identification Performance Measures N oO A N i 12 13 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Prepared the patient Set the control panel Selected the proper size cassette Positioned the overhead tube Positioned the soft tissue study c spine
236. eaders to enhance and sustain their military competencies It consists of individual study research professional reading practice and self assessment Under the self develooment concept the NCO as an Army professional has the responsibility to remain current in all phases of the MOS The SM is the primary source for the NCO to use in maintaining MOS proficiency Another important resource for NCO self development is the Army Correspondence Course Program ACCP Refer to DA Pamphlet 350 59 for information on enrolling in this program and for a list of courses or write to AMEDDC amp S ATTN MCCS HSN 2105 11TH STREET SUITE 4191 FORT SAM HOUSTON TX 78234 5064 Unit learning centers are valuable resources for planning self development programs They help access enlisted career maps training support products and extension training materials A life cycle management diagram for MOS 91P soldiers is on page 1 4 You can find more information and check for updates to this diagram at http das cs amedd army mil ooc htm scroll down to LIFE CYCLE MANAGEMENT select ENLISTED and find the appropriate tab along the bottom This information combined with the MOS Training Plan in Chapter 2 forms the career development model for the MOS 1 7 Trainer s Responsibilities Training soldier and leader tasks to standard and relating this training to collective mission essential tasks is the NCO trainer s responsibility Trainers use the steps be
237. ed Head Study Touch PROCEED WITH NEW STUDY Press ENTER TEXT key on keyboard a Type patient information on display monitor b Press F1 Save Data Position patient for pilot scan Touch double edged box PROCEED TO PRE SCAN Touch double edged box READY FOR PILOT Press START button for Pilot After pilot image appears press F8 PLAN STUDY a Position red cursor for first slice and press F1 FIRST Use theta ring to angle cursor if necessary b Position red cursor for last slice and press F2 LAST c Press F8 SAVE PLAN Tilt gantry if necessary Touch double edged box MOVE COUCH READY FOR SCAN Press START after prompt on ELTP When plan is complete the boxes will return on the ELTP Selected proper HEAD study on ELTP Entered and saved the patient information into the computer B Positioned the patient 3 204 4 Performed pilot 5 Set protocol slices 6 Tilted gantry if necessary 7 Scanned the patient Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all STP 8 91P15 SM TG GO performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related CUSWORTH RITA J MOSS ALBERT A RADIOLOGY
238. ed the purpose of the mass casualty plan 2 Identified the scope of the Bb 3 Identified procedures to be followed concerning Process for recalling off duty personnel b Utilization of fixed X ray units c Utilization and location of portable units d Coordination communication with triage area physicians emergency room trauma room and intensive care units concerning 1 Availability of fixed x ray units 2 Availability of portable x ray units 3 Availability of CT unit s 4 Availability of MRI unit s 5 Availability of special procedures services 6 Patient movement to from radiology service 7 Interpretation of examinations a Delivery of immediate verbal report wet read 0 Delivery of written report 8 Handling of films and reports needed for urgent patient care 4 Defined coordinating instructions for a Examination request forms b Pre order quantity of forms needed available at each imaging section c Locations for utilization of portable units to perform less complex studies in the event a large influx of patients overwhelms availability of fixed units 1 Critically ill patients 2 Non critically ill patients 3 Use of litter bearers from labor pool 5 Established manpower utilization and areas of responsibility MRI and angiography sections Number of technologists needed to operate each section Process for review of examination
239. el 6 Select the proper size cassette NOTE Use 1 2 of a 14 X 17 cassette for the both views 7 Place the cassette on the table lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the portion of the film being used d Adjust the conefield to full field coverage 9 Position the humerus a AP view 3 95 STP 8 91P15 SM TG Performance Steps 1 Place the patient supine with the coronal plane rotated 10 to 15 degrees toward the affected side 2 Center the humerus to the appropriate half of the cassette 3 Position the epicondyles parallel to the cassette 4 Center the acromion process and epicondyles equidistant from the respective film borders b Lateral view 1 Place the patient supine with the coronal plane rotated 10 to 15 degrees towards the affected side 2 Center the humerus to the appropriate half of the cassette 3 Flex the elbow and rotate the humerus 90 degrees 4 Position the epicondyles perpendicular to the cassette 5 Turn the hand towards the body with the posterior surface in firm contact with the hip 6 Center the acromion process and epicondyles equidistant from the respective film borders NOTE The forearm should extend off the lateral edge of the cassette with the shaft of the humerus parallel to the lateral border of the cassette 10 11
240. elaxed 5 Place the cuff at the brachial artery site a Place the cuff so the lower edge is 1 to 2 inches above the elbow and the bladder portion is over the artery b Wrap the cuff just tightly enough to prevent slippage If applicable clip the gauge to the cuff in alignment with the palm 6 Position the stethoscope if used a Palpate for the brachial pulse b Place the diaphragm of the stethoscope over the pulse site 7 Inflate the cuff until the gauge reads at least 140 mm Hg or 10 mm Hg higher than the usual range for that patient if known NOTE pulsation is heard when the gauge reaches 140 mm Hg continue to inflate the cuff 10 mm Hg beyond the point at which the last pulsation was heard CAUTION The cuff should not remain inflated for more than 2 minutes 8 Determine the blood pressure a stethoscope is used complete the following steps 3 51 STP 8 91P15 SM TG Performance Steps 1 Rotate the thumbscrew slowly in a counterclockwise motion allowing the cuff to deflate slowly 2 Watch the gauge and remember the reading when the first distinct sound is heard systolic pressure 3 Continue to watch the gauge and remember the reading where the sound changes again and becomes muffled or unclear diastolic pressure 4 Release the remaining air b If a stethoscope is not used complete the following steps 1 Palpate for the radial pulse 2 Rotate the thumbscrew slowly in a counterclockwise mo
241. elbow flexed 90 degrees and hand and forearm resting on the table 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the central panel 6 Select the proper size cassette NOTE Use an 8 x 10 cassette divided in thirds crosswise 7 Place the cassette on the tabletop 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the region of the cassette used 9 Place the lead shielding across the patient s lap 10 Position the finger a PA view 1 Pronate hand with fingers extended 2 Center and align long axis of affected finger to long axis of portion of cassette being exposed 3 Center proximal interphalangeal PIP joint NOTE Separate the adjoining fingers from the affected finger 3 109 STP 8 91P15 SM TG Performance Steps 4 Central ray perpendicular to film directed to PIP joint 5 Collimate on four sides to area of affected finger b Oblique view 1 Place the fingers fully extended against a 45 degrees positioning sponge place the hand in a 45 degree lateral oblique NOTE Thumb side up 2 Position the cassette so the long axis of finger is aligned with long axis of the 1 3 of film being exposed 3 Center the PIP joint NOTE Separate fingers and carefully place fi
242. en and rarely an emergency b Focal 1 No loss of consciousness 2 Tingling stiffening or jerking in just one part of the body arm leg or face 3 May rapidly progress to generalized convulsions c Grand mal generalized 1 May be preceded by an aura 2 Has three distinct phases a Tonic phase characterized by rigidity and stiffening of the body 0 Colonic phase characterized by jerking about violently foaming at the mouth drooling and cyanosis around the face and lips c Postictal phase begins when convulsions stop The patient may regain consciousness and enter a state of drowsiness and confusion or remain unconscious for several hours 3 May involve incontinence biting of the tongue rare cyanosis or mental confusion CAUTION Never place anything in the mouth of a seizing patient d Status epilepticus 1 Two or more seizures without an intervening period of consciousness 2 A dire medical emergency if untreated it may lead to a Aspiration of secretions 0 Cerebral or tissue hypoxia c Brain damage or death d Fractures of long bones e Head trauma f Injured tongue from biting NOTE Mentally note the aspects of seizure activity for recording after the seizure 2 Place the patient on his or her side if possible a Observe the patient to prevent aspiration and suffocation b The patient s mouth and throat should be suctioned by trained personnel if possible CAUTIONS 1
243. ence Sustainment 6 8 C42 ANCOC NCOES 7 Weeks FSH TX Leadership 081 MD0959 Fluoroscopy and Special Radiographic TE Correspondence Sustainment 1 250 C5 U S ARMY SERGEANTS MAJOR 9 Months USASMA Ft Just in time MEL A 081 00960 Special Fluorographic Radiograph Procedures Correspondence Sustainment Bliss 521 1 Command Sergeant Major Course 1 wk USASMA Leadership 081 00961 Standard Positioning Techniques Correspondence Sustainment 521 SQIM First Sergeant Course 3 Weeks USASMA Just in time SQI M 081 00962 Standard Positioning Correspondence Sustainment 250 ASI2S Battle Staff Course 6 Weeks 2 USASMA Ft Optional 081 MD1530 ASMART Unit Training Sustainment Days Bliss Master Fitness Trainer 2 wks Multiple Sites Just in time ASI P5 081 01533 91P Rapid Train Up Unit Training Sustainment 081 91P Radiology Specialist Sust Correspondence Sustainment 081 ENHANC Combat Life Saver CLS Unit Training Just in Time Specialty Courses 5 13 520 10 CBRNE TRAINER EVALUATOR 2 Days Fort Sam Houston Just in Time TX 5K F7 520 F7 ADVANCED INSTRUCTOR TRAINING COURSE 1 Wk 3 FSH TX Ph 182 Days 5 8 520 8 EDUCATION AND TRAINING FOR THE 21ST CENTURY 4wks FSH TX PPSCP Just in Time 300 A0704 75 71 Personnel Retention Legal EO 4 days SA TX Just in Time 300 A0716 Enlisted Clinical Support NCO 91K 91P 91Q 4 days SA TX Sustainment 340 A0715 MEDCOM CSM SGM SR NCO 4 Days SA TX Optional 340 A0743 CSM SGM SR NCO Course 4 days Landst
244. ent s condition 3 Follow proper body mechanic rules Provide wide and stable base of support Keep patient well balanced and close to your body when lifting or carrying Keep your back straight avoid twisting while lifting or carrying Use leg muscles and abdomen to move or lift patients Do not bend at the waist Bend your knees and lower your body when picking up or lifting patients 4 Follow general rules Give only assistance the patient needs for comfort and safety Always transfer the patient at the shortest distance Lock all wheels on beds gurneys and wheelchairs Inform patient of the moving plan Give short and simple instructions Performance Measures GO 1 Determined what examination is to be performed based on the request 2 Assessed the patient s condition 3 Followed proper body mechanic rules 88 4 Followed general rules 3 1 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None FM 4 25 11 GURLEY AND CALLAWAY 3 2 STP 8 91P15 SM TG ASSESS PATIENT CONDITION BEFORE X RAY 081 823 0312 Conditions You have a patient w
245. ent upright facing the table 2 Let the arm hang in its natural position Do not rotate NOTE Superimposition of the humerus and scapula is desired for this view 3 Palpate borders of scapula and rotate patient until the scapula is in a true lateral position NOTE The average patient will be rotated 30 to 40 degrees from the lateral position 4 Central ray directed to the scapulohumeral joint 2 to 2 1 2 below top of shoulder 10 Place the appropriate identification marker on the cassette 11 Place the lead apron across the patient s lap 12 Tell the patient STOP BREATHING AND DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Process the film with the patient s identification Performance Measures GO Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central Set the control panel Selected the proper size cassette Properly positioned the cassette Properly positioned the overhead tube PTT TT dd df 8 N DO A Properly positioned the patient for the trauma shoulder routine a AP neutral rotation b Scapular Y lateral view 10 Placed the appropriate identification marker on the cassette 11 Placed the lead apron across the patient s lap
246. epare the patient a Bring the patient into the X ray room b Ensure the patient is dressed in a gown if necessary 1 Ensure foreign objects are removed from the patient as needed 2 Ensure the patient s clothing is removed as needed 3 Use a drape sheet to cover the patient as needed c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 14 X 17 cassette 7 Place the cassette in the bucky crosswise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101cm c Center the tube to the cassette d Adjust the cone field to full field coverage 9 Position the patient for the AP pelvis view a Place the patient supine with the midsagittal plane perpendicular to and over the centerline of the table b Extend the lower extremities 3 142 Performance Steps 10 11 12 13 14 15 Rotate the feet and legs medially to form 15 degree angle with table STP 8 91P15 SM TG d Place the iliac crest 2 below the upper edge of the cassette Immobilize the body part by placing sandbags against both feet Place the appropriate letter marker on the cassett
247. equest for issue IAW DA Pam 710 2 1 a Prepare DA Form 3161 1 Prepare the form in enough copies to meet local needs 2 Issue block Enter X for issue 3 Sheet No block Enter number of sheets consecutively 4 Number of Sheets block Enter total number of sheets included in the request for issue 5 Block 1 Enter the name and address of the SSA SOS 6 Block 2 Enter the name of the unit making the request 7 Block 3 Enter the document number assigned to the request from the document register 8 Block 4 Enter project code or leave blank 9 Block 5 Enter the RDD of material requested or leave blank 0 Block 7 Enter the priority designator 1 Block 8 Enter cost detail accounting information 2 Block 10 Enter the authorizing document publication 3 4 5 Column 12a Enter the item number sequence for each item requested Column 12b Enter the stock number for each item requested Column 12c Enter one or two words that describe each item requested Enter the words LAST ITEM after the last entry 16 Column 12d Enter the unit of issue of each item requested 17 Column 12e Enter the quantity of each item requested 18 Column 12f Enter the proper issue code from the form b Record the DA Form 3161 in the appropriate document register c Forward the DA Form 3161 to the supporting SSA SOS 1 1 1 1 1 1 3 297 STP 8 91P15 SM TG Performance Steps 1 Column 12g Co
248. equest forms 1 Form to be used SF 519 B 2 Preorder quantity of forms needed available at each imaging section b Preorder quantity of forms needed available at each imaging section 1 Need for patient monitoring while in the radiology department 2 Need for patient monitoring during transport c Locations for utilization of portable units to perform less complex studies in the event a large influx of patients overwhelms availability of fixed units 1 Critically ill patients 2 ill patients 3 Use of litter bearers from labor pool 3 318 STP 8 91P15 SM TG Performance Steps 5 Establish manpower utilization and areas of responsibility a CT MRI and angiography sections 1 Number of technologists needed to operate each section 2 Process for review of examination request 3 Process for determining exam protocol 4 Process for exam production accountability 5 Process for exam review reading 6 Process for films check out b Portables ER OR 1 Number of technologists needed 2 Process for review of examination request 3 Process for exam production accountability 4 Process for exam review reading 5 Process for films check out delivery 6 Process for communication c Film quality control 1 Number of technologists needed 2 Process for repeat notification 3 Process for film matching and sorting 4 Process for exam review reading 5 Process for films check out delivery arkroom and f
249. er the patient as needed c Explain the procedure d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper film size NOTE Use 1 2 of a 14 x 17 for the AP and LAT view NOTE For taller patients use a 14 x 17 for each view Place the cassette diagonally corner to corner to include the knee and ankle joint 7 Place the cassette on the table lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to a minimum 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to both sides of the skin 3 124 STP 8 91P15 SM TG Performance Steps 9 Position the leg a AP view Patient supine with no rotation of the pelvis Fully extend the affected leg Adjust pelvis knee and leg into a true AP position Place sandbags against ball of foot for stabilization Center and align midline of cassette 1 2 of 14 x 17 to long axis of the leg Insure that both knee and ankle joints are equal distance from the ends of each respective film border 7 Central ray perpendicular to the film directed to mid point of the film 8 Collimate on both sides of the skin margins with full collimation at ends of film borders to in
250. es USAR a In the USAR all property not on valid hand receipt must be inventoried 0 The incoming commander supervisor will check with the higher headquarters for specific instructions c The incoming commander supervisor will compare hand receipts with the property book to identify these items not issued on hand receipt 4 Conduct a tool room inventory a The tool room will be inventoried semi annually 0 Inventory all tools sets kits and outfits in the tool room 5 Conduct a cyclic inventory a The officer responsible for the units property will ensure that this inventory is conducted when 1 This inventory is performed in lieu of the annual responsible officer inventory 2 The responsible officer of a unit maintaining its own property book elects to do it 3 The property book is kept at other than unit level and the PBO requires it 3 311 STP 8 91P15 SM TG Performance Steps 3 312 0 When the cyclic inventory option has been chosen 1 Conduct cyclic inventories monthly quarterly or semiannually 2 If the location of hand subhand receipt holders make the inventory of a certain number of lines impractical then the PBO or responsible officer may choose that specific hand or subhand receipts be completely inventoried 3 The PBO or responsible officer will designate on a memorandum the items to be inventoried 4 The responsible officer notifies hand subhand receipt holders where when and h
251. es push the button again and proceed to step 6 0 If the chest fails to rise go to step 4 4 Reposition the head to ensure an open airway and attempt the breath again NOTE When using a BVM or FROPVD it is also important to check the mask seal a If the chest rises give another breath and go to step 6 b If the chest does not rise continue with step 5 3 16 STP 8 91P15 SM TG Performance Steps 5 Clear an airway obstruction if necessary see task 081 831 0019 When the obstruction has been cleared continue with step 6 6 Check the carotid pulse for 5 to 10 seconds a While maintaining the airway place the index and middle fingers of your hand on the casualty s throat Slide the fingers into the groove beside the casualty s Adam s apple and feel for a pulse for 5 to 10 seconds pulse is present go to step 7 If a pulse is not found begin CPR see task 081 831 0046 7 Continue rescue breathing a Ventilate the casualty at the appropriate rate 1 Adult 10 12 per minute 2 Adolescent 15 per minute 3 Children greater than a year of age 20 per minute mouth to mouth or mouth to nose 4 Children less than one year of age 40 per minute mouth to nose b Watch for rising and falling of the chest c Recheck for pulse and breathing after every 12 breaths NOTE Although not evaluated continue rescue breathing as stated in the task standard When breathing is restored watch the casualty
252. exposure factor chart and the manufacturer s rating chart for an X ray unit Standards Determined the safety of a given exposure for the X ray unit without error Performance Steps 1 Obtain the exposure factors kVp mA and S from the factor chart NOTE lf the factor chart gives mAs and not mA and S the mAs must be split into mA and S 2 Select the correct rating chart for the focal spot being used 3 Plot the mA and S intersection point 4 Identify the correct kVp curve 5 Use the exposure factors if the intersection point falls to the left of the kVp curve 6 Try different factors focal spot size or grid ratio if the intersection point falls to the right of the kVp curve CAUTION If a safe exposure cannot be found an X ray unit of higher capacity must be used Performance Measures GO NO GO 1 Obtained the exposure factors kVp mA and S from the factor chart NOTE If the factor chart gives mAs and not mA S the mAs must split into mA and S 2 Selected the correct rating chart for the focal spot being used 3 Plotted the mA 5 intersection point 4 Identified the correct kVp curve 5 Used the exposure factors if the intersection point falls to the left of the kVp curve 6 Tried different factors focal spot size or grid ratio if the intersection point falls to the right of the kVp curve CAUTION If a safe exposure cannot be found
253. f appropriate Assembled the top framework Laced the tent to the center and side top poles Raised the tent by attaching the uprights to the top framework Snapped the tent sleeves around the uprights Adjusted the sod cloths Moved the processor to the correct location Installed the cassette film transfer cabinet in the sponge rubber sealing collar Attached the exhaust fan to the frame and set it into the sponge rubber seal Positioned the four outlet receptacle cord and plugged in the fan Opened the light tight vents Checked for light leaks by closing the tent Made adjustments as necessary STP 8 91P15 SM TG GO performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 235 STP 8 91P15 SM TG PREPARE THE FIELD X RAY PROCESSOR FOR OPERATION 081 823 0186 Conditions You are in a tactical environment and the unit commander has given the order to set up The x ray processor has been unloaded The assistance of other soldiers is available You will need water developing and fixing chemicals and manufacturer s instructions if available Standards Prepared the x ray processor for operation Performance Steps 1 oa A NY N 11 12 13 14 15 16 17 18 Performance Measures GO 1 Set the processor on the selected site Using the leveling feet on base of unit and leveling bubble on
254. f soldier Tell the soldier to open the casualty s airway Performance Measures GO 1 Rolled the casualty onto his or her back if necessary 2 Established the airway using the head tilt chin lift jaw thrust method 3 Checked for breathing within 3 to 5 seconds 4 Took appropriate action 8b 5 Did not cause further injury to the casualty Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE STP 8 91P15 SM TG CLEAR AN UPPER AIRWAY OBSTRUCTION 081 831 0019 Conditions You are evaluating a casualty who is not breathing or is having difficulty breathing and you suspect the presence of an upper airway obstruction Standards Completed in order all the steps necessary to clear an object from a casualty s upper airway Continued the procedure until the casualty could talk and breathe normally or until relieved by a qualified person Performance Steps 1 Clear the airway a Conscious casualty 1 Determine whether or not the casualty needs help Ask the casualty whether he or she is choking a If the casualty has good air exchange is able to speak coughs forcefully wheezes between coughs d
255. f the CR 11 Turn on the power for the PC and monitor NOTE The power buttons are on front of PC and monitor Performance Measures GO 1 Unpacked all PC and CR equipment from the storage cases Plugged in the uninterrupted power supply Plugged the power strip into the uninterrupted power supply Connected the CR power cord in the power strip Connected the ACR to the PC using the DAC cable 8 Connected monitor to PC with the series cable and plugged the monitor power cord into the power strip 7 Connected PC peripheral devices keyboard and mouse using the color codes on the back of the PC 3 250 STP 8 91P15 SM TG Performance Measures 8 Connected the PC power cord and plugged into the power strip 9 Turned onto the power for the uninterrupted power supply and the power strip 10 Turned on the power for the CR 11 Turned on the power for the PC and monitor Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all GO performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 251 STP 8 91P15 SM TG Subject Area 14 Field Operation OPERATE DIGITAL FLUOROSCOPIC UNIT 081 823 0251 Conditions You
256. forearms 5 Use index fingers to push the angles of the patient s lower jaw forward 6 Use thumb to keep the casualty s mouth open if necessary CAUTION Do not tilt or rotate the casualty s head 3 Check for breathing within 3 to 5 seconds While maintaining the open airway position place an ear over the casualty s mouth and nose looking toward the chest and stomach a Look for the chest to rise and fall b Listen for air escaping during exhalation c Feel for the flow of air on the side of your face 4 Take appropriate action 3 10 STP 8 91P15 SM TG Performance Steps a If the casualty resumes breathing maintain the airway and place the casualty in the recovery position 1 Roll the casualty as a single unit onto his or her side 2 Place the hand of the upper arm under his or her chin 3 Flex the upper leg NOTE Check the casualty for other injuries if necessary b If the casualty does not resume breathing perform rescue breathing See task 081 831 0048 Evaluation Preparation Setup Place a CPR mannequin or another soldier acting as the casualty face down on the ground For training and evaluation you may specify to the soldier whether the casualty has a spinal injury to test step 2 or may create a scenario in which the casualty s condition will dictate to the soldier how to treat the casualty After step 3 tell the soldier whether the casualty is breathing or not and ask what should be done Brie
257. gainst the middle of the casualty s breastbone 3 Grasp the fist with your other hand and give backward thrusts 4 Continue giving thrusts until the blockage is expelled or the casualty becomes unconscious 3 12 STP 8 91P15 SM TG Performance Steps CAUTION Do not position the hand on the xiphoid process or the lower margins on the rib cage NOTES 1 Administer each thrust with the intent of relieving the obstruction 2 If the casualty becomes unconscious position the casualty on his or her back perform a finger sweep see step 1b 2 open the airway see task 081 831 0018 and then start rescue breathing procedures see task 081 831 0048 b Unconscious casualty NOTE Perform abdominal or chest thrusts on the unconscious casualty only after attempts to open the airway and ventilate the casualty indicate that the airway is obstructed 1 Apply abdominal or chest thrusts NOTE Use abdominal thrusts unless the casualty is in the advanced stages of pregnancy is very obese or has a significant abdominal wound a Abdominal thrusts 1 Kneel astride the casualty s thighs 2 Place the heel of one hand against the casualty s abdomen in the midline slightly above the navel and well below the tip of the xiphoid process 3 Place the other hand directly on top of the first 4 Press into the abdomen with quick upward thrusts up to five times 0 Chest thrusts 1 Kneel close to either side of the casualty s body 2 With the middle
258. graphs a AP or PA view b Lateral rectum view c Oblique view RPO LPO d AP axial view e Lateral decubitus views bilateral Gave the proper pre post exposure instructions 12 13 Made the exposure Developed the exposed cassette s with the patient identification performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 193 STP 8 91P15 SM TG ASSIST PHYSICIAN WITH INTRAVENOUS PYELOGRAM 081 823 0149 Conditions You have received a formal request for an intravenous pyelogram You have the assistance of additional personnel if required You will need a properly equipped radiographic fluoroscopic exposure room with the correct contrast medium and various sizes of film in cassettes Standards The radiographs were of diagnostic quality and properly demonstrate the requested body part The radiographs were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Lead gloves d Letter markers e Contrast medium f Anaphylactic shock tray CAUTION Ensure the anaphylactic shock tray is available at all times 3 Attach any required accessories to the table 4 Prepare the contrast medium CAUTION Ensure the appropriate contra
259. h a critical task TDA table of distribution and allowances TG trainer s guide TKO to keep open Train up The process of increasing the skills and knowledge of an individual to a higher skill level in the appropriate MOS It may involve certification TWHA two way head alignment ULLS Unit Level Logistics System Unit training Training individual collective and joint or combined conducted in a unit USAR United States Army Reserve Glossary 7 STP 8 91P15 SM TG REFERENCES New reference material is being published all the time Present references as listed below may become obsolete To keep up to date see DA Pam 25 30 Many of these publications and forms are available in electronic format from the sites listed below U S Army Publishing Agency Administrative Departmental Publications and Forms ARs Cirs Pams OFs SFs DD amp DA Forms General Dennis J Reimer Training and Doctrine Digital Library RDL Army Doctrinal and Training Publications FMs PBs TCs STPs USACHPPM Technical Bulletins Medical TB MEDs Required Publications Required publications are sources that are listed in task conditions statements and are required for the soldier to perform the task Army Regulations AR 11 9 The Army Radiation Safety Program 28 May 1999 AR 190 11 Physical Security of Arms Ammunition and Explosives 30 September 1993 AR 25 400 2 The Modern Army Recordkeeping System MARKS 1 October 2001 AR 4
260. he body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 10 X 12 cassette for the AP internal external views 7 Position the cassette a Place the cassette crosswise in the bucky for the AP internal external views b Place the cassette lengthwise on the tabletop for the inferiosuperior axial view 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101cm c Adjust the conefield to full field coverage 9 Position the shoulder 3 98 STP 8 91P15 SM TG Performance Steps 11 12 13 14 15 16 Performance Measures GO ON fF Selected the required view s based the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size film cassette Positioned the cassette Positioned the overhead tube Positioned the shoulder AP external rotation 1 Place the patient supine or erect with the coracoid process over the centerline of the table 2 Rotate the coronal plane 10 to 15 degrees toward the affected side 3 Place the arm in full extensi
261. he lower edge of the cassette 5 Center the midpoint of the IOML to the cassette Place the appropriate identification marker on the cassette Place the lead apron across the patient s lap Tell the patient DO NOT BREATHE OR MOVE Make the exposure Tell the patient BREATHE NORMALLY AND RELAX Develop the exposed cassette s wit patient identification for processing Return the patient to the waiting area Performance Measures N oO A N gt Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size of cassette Placed the cassette in the bucky lengthwise Positioned the overhead tube Positioned the facial bones Placed the appropriate identification marker on the cassette Placed the lead apron across the patient s lap 12 13 14 Gave the patient the pre post exposure instructions Made the exposure Developed exposed cassette s PTT TTT TTT performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 69 S
262. he performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all PTT TTT IIT B6 performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 190 STP 8 91P15 SM TG ASSIST PHYSICIAN WITH BARIUM ENEMA EXAM 081 823 0147 Conditions You have received a formal request for a barium enema examination You have the assistance of additional personnel if required You will need a properly equipped radiographic fluoroscopic exposure room with the correct contrast medium and various sizes of film in cassettes Standards The radiographs were of diagnostic quality and properly demonstrated the requested body part The radiographs were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Lead apron Lead gloves Letter markers Contrast medium Disposable enema bags and tips Hemostat Surgical lubricant 3 Attach any required accessories to the table 4 Prepare the contrast medium CAUTION Ensure the appropriate contrast medium is being used and verify the expiration date 5 Prepare the equipment for fluoroscopy 6 Prepare the patient a Bring the patient into the r
263. he request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size film cassette Placed the cassette in the bucky lengthwise Positioned the overhead tube N fF Positioned the sternum a RAO view b Lateral view 10 Placed the appropriate identification marker on the cassette 11 Placed the lead shield around the patient s waist 12 Gave the patient the pre post exposure instructions 13 Made the exposure 14 Developed the exposed radiograph s with patient identification 3 151 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 152 STP 8 91P15 SM TG X RAY THE ABDOMEN 081 823 0129 Conditions You have a formal request for a radiologic examination of the abdomen You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers
264. he vertical column to the floor Lift and slide the vertical column to the vertical position and the head end of the table a While holding the vertical column in the vertical position install four bolts securing the base of the column to the longitudinal carriage b Remove the four bolts that fasten the column hinge to the longitudinal carriage c Loosen the small hinge securing screw allowing the column hinge to swing up and secure it by tightening the securing screw d Remove the bolts that secure the transport brackets to the floor and remove brackets Remove the tube arm mounting bolts from the vertical carriage a Move the column longitudinally toward the head end so that the transverse tube arm aligns with the vertical carriage b Press the floating table top foot release to move the top to connect the tube arm to the vertical column c Attach the transverse tube arm to the vertical carriage with four bolts d Remove counterweight support pin from the back of the tube column Remove pull pins that hold the top on the tube collimator transport fixture and remove the top of the fixture a Lift tube head assembly vertically out of the tube collimator transport fixture b Place top back on the tube collimator transport and store with vertical column transport brackets until shelter is to be transported Release elastic strap on the back of the table holding bucky to the foot end of the table Apply power to
265. hes 101 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 3 153 STP 8 91P15 SM TG Performance Steps 9 Position the abdomen a AP KUB view 1 Place the patient supine with the median plane perpendicular to and over the centerline of the table 2 Extend the patient s legs and place a support under the knees NOTE This will relieve the strain on the abdomen 3 Center the iliac crests to the cassette b Upright view NOTE The AP upright view will demonstrate air fluid levels if present under the diaphragm 1 Place the patient standing with the median plane perpendicular to and over the centerline of the upright film holder or bucky 2 Place the back in contact with the film holder or bucky 3 Adjust height of film holder so that center of film is 2 inches above the iliac crests with the top of the film directly under the axilla 10 Place the appropriate letter marker on the cassette 11 Place the lead apron across the patient s lap 12 Tell the patient TAKE A DEEP BREATH BLOW IT ALL THE WAY OUT AND HOLD IT OUT 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the exposed film with the patient s identification Performance Measures GO Selected the required view s based the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry e
266. how to do it correctly References None 3 4 STP 8 91P15 SM TG PERFORM A PATIENT CARE HANDWASH 081 831 0007 Conditions You are about to administer patient care or have just had hand contact with a patient or contaminated material You will need running water or two empty basins a canteen a water source soap towels cloth or paper and a towel receptacle or trash can Standards Performed a patient care handwash without recontaminating the hands Performance Steps 1 Remove wristwatch and jewelry if applicable NOTE Rings should not be worn If rings are worn they should be of simple design with few crevices for harboring bacteria Fingernails should be clean short and free of nail polish 2 Roll shirt sleeves to above the elbows if applicable 3 Prepare to perform the handwash a If using running water turn on the warm water b If running water is not available set up the basins and open the canteen 4 Wet your hands wrists and forearms a If using running water hold your hands wrists and forearms under the running water b If running water is not available fill one basin with enough water to cover your hands and refill the canteen 5 Cover your hands wrists and forearms with soap NOTE For routine patient care use regular hand soap For an invasive procedure such as a catheterization or an injection use antimicrobial soap 6 Wash your hands wrists and forearms a Use a circular scrubbing
267. i weekly WK Weekly Figure 2 2 Sustainment Training Frequency Codes Sustainment Training Skill Level column This column lists the skill levels of the MOS for which soldiers must receive sustainment training to ensure they maintain proficiency to soldiers manual standards 2 2 STP 8 91P15 SM TG 2 2 Part One Section I Subject Area Codes Skill Level 1 1 General Medical 2 Basic X Ray Skills 3 General Radiography Head 4 General Radiography Upper Extremities 5 General Radiography Lower Extremities 6 General Radiography Trunk 7 General Radiography Spine 8 Contrast Media Studies 9 Other Procedures 10 Computerized Tomography CT 11 Computed Radiography 12 Film Processing 13 Field Set Up 14 Field Operation 15 Field Movement 16 Quality Control Skill Level 2 17 Admin SL2 Skill Level 3 18 Admin 513 2 3 STP 8 91P15 SM TG 2 3 Part One Section Duty Position Training Requirements DUTY POSITION SUBJECT CROSS TRAIN UP AREAS TRAIN MERGER Radiology Specialist 91P2 Radiology Sergeant Radiology Sergeant 91P3 Radiology NCO Radiology NCO NA Senior Radiology NCO NA Chief Radiology NCO 9125 Chief Medical NCO 2 4 STP 8 91P15 SM TG 2 4 Part Two Critical Tasks List Subject Area 1 General Medical Task Number 081 823 0306 081 823 0312 081 823 0316 081 831 0007 081 831 0035 081 831 0018 081 831 0019 081 831 0048 081 831 0046 081 833 003
268. ials and supplies Attached any required accessories to the table Prepared the contrast medium Prepared the equipment for fluoroscopy Prepared the patient Assisted the radiologist as directed Prepared the equipment for follow up radiographs Positioned the bladder N A Placed the appropriate identification marker on the cassette Gave the patient the pre post exposure instructions Made the exposure FT TTT ITT TT ttt Developed the exposed cassette s 3 198 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 199 STP 8 91P15 SM TG Subject Area 9 Other Procedures PERFORM X RAY STUDY DURING GENERAL SURGICAL PROCEDURE 081 823 0228 Conditions You have a radiologic request for an AP ankle in the operating room You have the assistance of additional personnel if necessary You will need a fully charged AMX 400 portable machine cassettes of various sizes lead shielding letter markers and plastic cassette covers Standards The radiogr
269. ic Unit into Transport Position IDDC Model 1200 and Operation and Maintenance Manual for Model 1200 Portable X Ray System Standards Re assembled DEPMEDS Portable Radiographic Unit into Transport Position IDDC Model 1200 Performance Steps 1 8 Performance Measures GO Locked rear wheel brakes and cranked gear box assembly down onto Disconnect the interconnect cable from the control assembly LINE OUT connector and from the x ray generator assembly connector Lock rear wheel brakes and crank gear box assembly down onto the pipe assembly lower section Remove safety pin lift and pull x ray generator assembly out of cross arm assembly and position x ray generator collimator assembly face down Fit the face of the collimator into the stand corner brackets and fit the yoke latching button into the yoke latching button bracket Secure safety pin Press cross arm horizontal travel release brake and slide horizontal cross arm out of gear box assembly Slide the cross arm assembly into cross arm bracket on the side of stand Position pipe assembly upper section locking handle to the up unlocked position Lift off pipe assembly upper section position on stand pipe assembly upper section support blocks and fit pipe assembly into gear box pipe assembly spring clip Remove leg locking pins and fold legs up into leg restraining clips 185 Disconnected the interconnect ca
270. id coronal plane to centerline of film holder 5 Central ray directed to the center of film 11 Immobilize the patient as necessary 12 Place the appropriate identification marker on the cassette NOTE For the lateral decubitus chest the film should be marked according to the side up For the dorsal decubitus chest the film should be marked side closest to film 13 Tell the patient TAKE IN A FULL BREATH BLOW IT OUT AND HOLD IT OUT 14 Make the exposure 15 Tell the patient RELAX AND BREATHE NORMALLY 16 Develop the exposed film with the patient s identification Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary material and supplies Prepared the patient 2 3 4 Measured the body part at the entry exit site of the central ray 5 Set the control panel 3 157 STP 8 91P15 SM TG Performance Measures N 11 12 13 14 15 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Selected the proper size cassette Placed the cassette in an upright cassette holder lengthwise Positioned the overhead tube Used gonad shield on males Positioned the decubitus abdomen a Lateral decubitus abdomen view b Dorsal decubitus abdomen view Immobilized the patient
271. ies Prepared the patient Measured the body part for entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette grid on the table bucky according to the desired position Positioned the overhead tube Positioned the hip a AP hip tis 3 163 STP 8 91P15 SM TG Performance Measures b Axiolateral hip 10 Shielded the patient without obscuring the area of interest 11 Placed appropriate letter marker on the cassette 12 Gave the proper pre post exposure instructions 13 Made the exposure 14 Developed the film with the patient s identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all 86 performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None 3 164 Related BONTRAGER KENNETH STP 8 91P15 SM TG Subject Area 7 General Radiography Spine X RAY TRAUMA CERVICAL SPINE 081 823 0215 Conditions You have a request for an X ray examination of a trauma cervical spine You have the assistance of additional personnel if required You will need a properly equipped X ray room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges S
272. ification number NIIN management control number MCN or manufacturer s part number MPN 0 Enter the subhand receipt number SHRN c Enter the quantity d Enter the component list number if applicable e Process the entries Enter the priority if the item is expendable non Class IX or non SSSC item Select Y or N to answer deployment questions if priority 01 03 was entered Complete the Request for Issue Higher Level Supply Data screen if the priority is 01 03 i Complete the bottom portion of the Request for Issue screen as needed and if priority was other than 01 03 j Process the request 2 Complete a request using the FED LOG a Enter the NIIN MCN or MPN e f g h 3 300 STP 8 91P15 SM TG Performance Steps 0 Select any key after the message prompt NIIN Not Found On The Catalog File c Select any key after the CD ROM light is off if FED LOG disc 3 is already in the CD Drive d Load FED LOG disc 3 into CD drive and press any key after the message prompt Insert ARMYLOG Disk if disk was not already loaded 1 Select lt ESC gt if you want to cancel this process 2 Select any key to continue Select lt ENTER gt after catalog data has been extracted f Enter the SHRN g Enter the quantity h Enter the component list number if applicable i Process the entries j Enter the priority if the item is expendable non Class IX or non SSSC item k Select
273. ight angle to leg NOTE lf needed place support against ball of foot to immobilize or to maintain this position 7 Central ray is perpendicular to the film directed to a point 1 1 2 inches inferior to the medial malleolus 11 Place the appropriate letter marker on the cassette 12 Tell the patient DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX and remove the immobilization 15 Develop the exposed cassette s with the patient identification Performance Measures GO Selected the required view s based request Gathered the necessary materials and supplies Prepared the patient Placed the lead apron across the patient s lap Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette under the body part N Positioned the lead mask over the unused portion of the cassette as needed 3 122 10 11 12 13 14 15 16 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Positioned the overhead tube Positioned the calcaneus a Plantodorsal Axial projection b Lateral view Immobilized the body part as required ST
274. ile Remove with care 3 Remove table top a Remove the three screws on the back of the table top b Remove table top handle with care 4 Install spot film device image intensifier fluoroscopy x ray tube and collimator 5 Release spot film carriage a Remove carriage locking pin from Shipping Position b Store locking pin in Operational Position NOTE Carriage locking pin is located on left bottom of fluoroscopy tower carriage assembly 6 Release table a Release jack screw handles from holes on side of table support frames b Turn jack screws to lower table until clear of table bottom c Swing head end and foot end table supports down 7 Release grid cabinet by unlatching the spring loaded pin NOTE Spring loaded pin is located on the front left of the table It holds the grid cabinet secured 8 Secure locks in counterweight pulleys by pulling locks 1 and 2 to fully up position 9 Release spring loaded pin from ceiling bracket Do not remove from tube stand 10 Release the hook and pile Velcro strips on the overhead tube arm 11 Unlatch spring loaded pin that secures the bottom of the tube stand to the rail 12 Unlatch the spring loaded pin that secures the tube arm 3 241 STP 8 91P15 SM TG Performance Steps 13 Move bolt on back of tube arm from Shipping Position center hole to Operational Position upper hole 14 Unscrew the lock handle on the tube stand base Release tension
275. ilm processors 1 Number of technologists needed 2 Process for cassette handling a Exposed 0 Unexposed 3 Process for processor trouble shooting 4 Primary and alternated processors e Film file room 1 Number of personnel needed 2 Process for report distribution 3 Process form film sign out in Reception area 1 Number of personnel needed 2 Process for logging examination requests 3 Process for dissemination of requests to exposure rooms g Telephonic communications 1 Number of personnel needed 2 Process for transferring emergency calls 3 Process for communicating with other imaging areas 4 Process for communicating with portable X ray operators h Floor supervising 1 Number of personnel needed Process for examination distribution Process for determining priority care Process for coordinating patient delivery and retrieval Process for reporting equipment problems a D 2 3 4 5 X r 1 y exposure rooms Number of technologists needed 3 319 STP 8 91P15 SM TG Performance Steps 2 Types of equipment available a Head X ray rooms 0 Trauma X ray rooms c Routine X ray rooms d Fluoroscopy rooms 3 Patient flow coordination 6 Establish a process for determining sleep and work time schedules if the mass casualty situation continues for an undetermined extended time period Performance Measures GO 1 Identifi
276. imes 3 Attached any required accessories to the table 3 195 STP 8 91P15 SM TG Performance Measures 4 Prepared the contrast medium CAUTION Ensured the appropriate contrast medium was being used and verified the expiration date 5 6 7 8 9 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Prepared the equipment for fluoroscopy Prepared the patient Assisted the radiologist as directed Prepared the equipment for follow up radiographs Positioned the patient for the follow up radiographs a AP view KUB b Oblique RPO LPO view c Post void view Told the patient BLOW YOUR BREATH OUT AND HOLD IT DO NOT BREATHE OR MOVE Made the exposure Told the patient RELAX AND BREATHE NORMALLY Repeated steps 9 through 12 to take additional views as required Forwarded the exposed cassette s with patient identification for processing Delivered all the radiographs to the radiologist prior to releasing the patient Released the patient when instructed by the radiologist performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 196 STP 8 91P15 SM TG ASSIST PHYSICIAN WITH CYSTOGRAM 081 823 0238 Conditions You have a request for a cystogram You have
277. in the radiographic exposure room Performance Steps 1 Gather the necessary materials and supplies Appropriate cassette s Letter markers Calipers Masking tape Sandbags Positioning sponges g Metal objects keys coins and pens 2 Measure the body entry exit site 3 Set the control panel a Consult the technique chart b Set the proper mAs and kVp on the control panel 4 Position the mannequin for a lateral lumbar spine a Place lateral recumbent with knees and hips flexed NOTE To support the position place the positioning sponge behind the mannequin and then place the sandbags against the sponge b Align coronal plane to midline of table c Central ray will be perpendicular to the long axis of the spine d Center central ray to the iliac crest centered to the film NOTE Place 14 x 17 cassette in the bucky 5 Tape the keys coins and pens to fronts of three 8 x 10 cassettes NOTE Each cassette should be labeled with a lead numeral 6 Place the three 8 x 10 cassettes at the specified distances from the central ray a First cassette placed 15 inches away b Second cassette placed 30 inches away c Third cassette placed 6 feet away NOTE All three 8 x 10 cassettes should be standing upright to detect the presence of scatter radiation from the patient 7 Make the exposure 8 Develop all films 3 283 STP 8 91P15 SM TG Performance
278. ing on an extremity a constricting band should be applied 2 to 3 inches above and below the site The band should be loose enough to allow arterial flow but tight enough to restrict venous circulation A distal pulse must be palpable 7 Provide supportive measures for the treatment of shock respiratory failure circulatory collapse or cardiac arrest a Infuse additional IV fluid if blood pressure continues to drop b Position the patient in the supine position with legs elevated if injuries permit c Apply pneumatic anti shock garment if necessary See task 081 833 301 1 d Perform rescue breathing if necessary See task 081 831 0048 e Administer external chest compressions if necessary See task 081 831 0046 8 Check the casualty s vital signs every 3 to 5 minutes until the casualty is stable 9 Record the procedure on the appropriate form 10 Evacuate the casualty providing supportive measures en route Performance Measures GO 1 Checked the casualty for signs and symptoms of anaphylactic shock Transported the casualty to the aid station if feasible Opened the airway if necessary Administered oxygen Administered epinephrine Initiated I tis N O O A Provided supportive measures for the treatment of shock respiratory failure circulatory collapse or cardiac arrest 8 Checked the casualty s vital signs every 3 to 5 minutes until
279. ing the keys to the arms storage facility receipt for the weapon and ammunition 0 The monthly USAR and ARNG quarterly inventory of weapons by serial number is conducted by the responsible officer or an NCO Warrant Officer Commissioned officer or Department of Defense DOD civilian appointed by the responsible officer The unit armorer will not conduct this inventory Use the following procedures 1 Compare the serial number of the weapons with those listed on the property book hand subhand receipt as appropriate 2 If weapons or ammunition have been signed out or are in support maintenance make sure they are supported by proper hand receipt or maintenance job order 3 Inventory ammunition by listing it by purpose i e basic load operational load or training Department of Defense Identification Code DODIC lot number quantity on hand and quantity signed out on the inventory form 4 Record the results of the inventory on a memorandum or automated listing example PCN ALV 441 sensitive items inventory list produced in Standard Property Book System Redesigned SPBS R 5 SPBS R and Installation Table of Distribution and Allowances listings are provided by the PBO 10 Conduct a special COMSEC equipment inventory a COMSEC custodians are appointed to account for all COMSEC material issued on hand receipt to the unit 3 313 STP 8 91P15 SM TG Performance Steps 0 Detailed procedures for conducti
280. instructions for the operation of the automatic film processor Performance Steps 1 Flash the patient identification on the film if required Open the film cassette Remove the film Place film on the film feed tray Advance the film along the edge of the film tray until it is grabbed by the intake roller Ensure that the film is taken in evenly and completely Reload the cassette with unexposed film of proper size Close the cassette ON A Remove processed film from the receiving bin Performance Measures GO 1 Flashed the patient identification on the film if required Opened the film cassette Removed the film Placed film on the film feed tray N Advanced the film along the edge of the film tray until it was grabbed by the intake roller Ensured that the film was taken in evenly and completely Reloaded the cassette with unexposed film of proper size Closed the cassette N Removed processed film from the receiving bin Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 228 STP 8 91P15 SM TG References Required Related None BUSHONG STEWART
281. ioclavicular joints for the AP view Placed the appropriate identification marker on the cassette Secured the lead apron around the patient s waist 12 13 14 Gave the patient pre post exposure instructions Made the exposure Processed the film PT TTT TT Titi tt performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 107 STP 8 91P15 SM TG References Required Related None BONTRAGER KENNETH L 3 108 STP 8 91P15 SM TG X RAY FINGER OR THUMB 081 823 0219 Conditions You have a request for a radiologic examination of a finger or thumb You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes lead shielding letter markers sandbags calipers and a variety of positioning sponges Standards The radiographs were of diagnostic quality and demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers d Calipers e Positioning sponges 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient removes all jewelry c Explain the procedure d Have patient sit at end of the table with
282. ith a request for a radiologic examination and must assess the patient before the radiograph Standards The patient was properly assessed All the necessary steps were taken to ensure that no further injury was caused to the patient Performance Steps 1 Determine what examination you will be performing based on the request 2 Carefully assess the patient from head to toe to identify the following a Patient condition b Patient mobility c The strength and endurance of patient d Patient s ability to maintain balance e Patient s responsiveness and ability to understand 3 Take the necessary actions to ensure that you do not cause any further injury to the patient Performance Measures GO 1 Determined what examination you were performing based the request 2 Carefully assessed the patient from head to toe and identified the following a Patient condition b Patient mobility c The strength and endurance of patient d Patient s ability to maintain balance Patient s responsiveness and ability to understand 3 Took the necessary actions to ensure that you did not cause any further injury to the patient Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do
283. ithout error Performance Steps 1 Measure the body part with the calipers NOTE The calipers should barely touch the skin at the points of entry and exit of the central ray 2 Determine the measurement variation if any 3 Calculate the correct exposure by using the appropriate formula if there is a variation See Figure 3 3 Exposure Factor Compensation Formulas Measurement Variation Exposure Calculation 3 5 cm below range 1 2 1 2 below range 2 2 3 1 2 2 mAs 4 x 3 2 3 5 2 2 Figure 3 3 Performance Measures GO 1 Measured the body part with the calipers NOTE The calipers should barely touch the skin at the points of entry and exit of the central ray 2 Determined the measurement variation if any 3 Calculated the correct exposure by using the appropriate formula if there is a variation Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 59 STP 8 91P15 SM TG CALCULATE EXPOSURE FACTORS FOR DIFFERENT GRIDS 081 823 0105 Conditions You have an exposure factor chart grid cassettes with different g
284. ity and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Tape Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure all foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as necessary NOTE All clothing from the waist up should be removed and the patient will wear a gown c Explain the procedure 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 14 X 17 cassette for both views 7 Place the cassette in an upright cassette holder lengthwise NOTE A moving or stationary grid may be used 8 Position the overhead tube a Set the tube angle horizontal perpendicular to the cassette b Set the source to image distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Place a gonad shield on males 10 Position the decubitus
285. kers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary c Explain the procedure if applicable d Stand the patient in front of the upright bucky or assist the patient onto the X ray table NOTE An X ray examination of the ribs may be performed either supine or upright depending on the condition of the patient 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size of film cassette NOTE Use a 14 X 17 cassette for the all views 7 Place the cassette in the bucky according to the desired position a Lengthwise for the views above the diaphragm b Crosswise for the views below the diaphragm 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Position the ribs a AP view above 3 147 STP 8 91P15 SM TG Performance Steps 1 Place the patient upright with the median plane perpendicular to and over the centerline of the table 2 Place the back in contact
286. l Placed the appropriate identification marker on the cassette B 3 63 STP 8 91P15 SM TG Performance Measures 11 Placed the lead apron across the patient s lap 12 Gave the patient the pre post exposure instructions 13 Made the exposure 14 Developed exposed cassette s Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References 3 64 Required None Related BONTRAGER KENNETH STP 8 91P15 SM TG X RAY THE PARANASAL SINUSES 081 823 0136 Conditions You have a request for a radiologic examination of the sinuses You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes lead shielding letter markers and calipers Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers d Calipers 3 Prepare the patient a Bring the pa
287. lap 5 Measure the body part through the entry exit site of the central ray 6 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 7 Select the proper size cassette NOTE Use 1 2 of a 10 X 12 cassette for the PA and ulnar flexion views and 1 2 of a 10 X 12 cassette for the lateral and oblique views 8 Place the cassette on the table according to the desired position 9 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the portion of the film being used d Adjust the conefield to area of interest 10 Position the wrist 3 86 STP 8 91P15 SM TG Performance Steps a PA view 1 Center the wrist on the appropriate 1 2 of the cassette should be with the ulnar flexion view coming off the lateral border of the cassette 2 Flex the elbow 90 degrees 3 Ensure that shoulder elbow and wrist are on the same horizontal plane 4 Place the wrist and forearm parallel to the long axis of the cassette 5 Position the styloids parallel to the cassette 6 Instruct the patient to flex the fingers loosely to bring the wrist in contact with the film but not so much as to superimpose the fingers with the carpal bones 7 Central ray directed towards the midcarpal region b PA ulnar flexion view WARNING Do NOT attempt the ulnar flexion view with
288. lect the proper size cassette NOTE Use a 10 X 12 cassette for the AP view and a 14 X 17 cassette for the frog leg view 7 Place the cassette in the bucky according to the required view a Lengthwise for the AP view b Crosswise for the frog leg view 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 3 133 STP 8 91P15 SM TG Performance Steps 9 Position the hip a AP view 1 Place the patient supine with the midsagittal plane perpendicular to the table 2 Extend the lower extremities 3 Rotate both feet and legs medially to form a 15 degree angle NOTE This will ensure the head and neck of each femur are parallel to the film 4 Place the sagittal plane 2 medial to the ASIS and the transverse plane through the greater trochanter to the center of cassette b Frog leg view 1 Place the patient supine with the midsagittal plane perpendicular to and over the centerline of the table 2 Flex both knees 3 Place the soles of both feet together and over the centerline of the table 4 Abduct each thigh to form a 40 degree angle from the vertical position NOTE This will create and angle of approximately 80 degrees 5 Place the iliac crests 2 below the upper edge of the cassette 10 Immobilize the body part as necessary 11
289. lect the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Sandbags c Lead shielding d Letter markers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient has removed all clothing under the area of interest as necessary NOTE Have the patient put on a gown if necessary c Explain the procedure 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Place the lead shielding around the patient s waist 7 Select the proper film size NOTE Use 1 2 half of a 14 x 17 cassette crosswise for both views If the patient is too broad for the 14 x 17 cassette use two 8 x 10 cassettes crosswise placed side by side and expose simultaneously to include both AC joints on one exposure 8 Position the overhead tube a Set the tube perpendicular to the cassette b Set the source to image receptor distance SID to 72 inches 182 cm c Center the tube to the cassette d Adjust the conefield to the full field coverage 9 Position the acromioclavicular joints for the AP view NOTE The first view is taken without weights and the second view is taken with the patient holding a minimum
290. leg internally about 5 degrees for a true AP NOTE Generally the patella will be slightly medial to the center of the dismal femur NOTE Place sandbags by the foot and ankle to stabilize and maintain this position 4 Direct the central ray to a point 3 4 in or 1 cm distal to the apex of the patella b Lateral view 1 Place the patient in a lateral recumbent position affected side down NOTE Place the opposite limb behind the knee being examined 2 Adjust rotation of the body until the knee is in a true lateral position NOTE Femoral epicondyles directly superimposed and the plane of patella perpendicular to the plane of the film 3 Flex the knee 15 20 degrees 4 Align and center long axis of leg and knee to the midline of cassette NOTE True lateral femoral condyles should be directly superimposed The 5 10 degree cephalad angle of the central ray should result in direct superimposition of the distal borders of the condyles 5 Direct the central ray to a point 3 4 in or 1 cm to the medial epicondyles 10 Place the appropriate letter marker on the cassette 11 Place the lead shielding across the patient s lap 12 Tell the patient DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX and remove the immobilization 15 Develop the exposed cassettes with the patient identification Performance Measures GO Selected the required view s based on request Gathered the necessary
291. lication is HQ TRADOC Send comments and recommendations on DA Form 2028 Recommended Changes to Publications and Blank Forms directly to Academy of Health Sciences ATTN MCCS HTI 1750 Greeley Rd STE 135 Fort Sam Houston 78234 5078 vii STP 8 91P15 SM TG CHAPTER 1 Introduction 1 1 General This manual identifies the individual MOS training requirements for soldiers in MOS 91P Commanders trainers and soldiers should use it to plan conduct and evaluate individual training in units This manual is the primary MOS reference to support the self development and training of every soldier Use this manual with Soldier s Manuals of Common Tasks STP 21 1 SMCT and STP 21 24 SMCT Army Training and Evaluation Programs ARTEPs and FM 25 101 Battle Focused Training to establish effective training plans and programs that integrate soldier leader and collective tasks 1 2 Battle Focused Training As described in FM 25 100 Training the Force and FM 25 101 Battle Focused Training the commander must first define the mission essential task list as the basis for unit training Unit leaders use the METL to identify the collective leader and soldier tasks which support accomplishment of the METL Unit leaders then assess the status of training and lay out the training objectives and the plan for accomplishing needed training After preparing the long and short range plans leaders then execute and evaluate training
292. ll merge into on promotion Part Two lists by general subject areas the critical tasks to be trained in an MOS and the type of training required resident integration or sustainment Subject Area column This column lists the subject area number and title in the same order as Section Part One of the MTP e Task Number column This column lists the task numbers for all tasks included in the subject area Title column This column lists the task title for each task the subject area e Training Location column This column identifies the training location where the task is first trained to soldier training publications standards If the task is first trained to standard in the unit the word Unit will be in this column If the task is first trained to standard in the training base it will identify by brevity code ANCOC etc the resident course where the task was taught Figure 2 1 contains a list of training locations and their corresponding brevity codes 2 1 STP 8 91P15 SM TG AIT Advanced Individual Training UNIT Trained in the Unit BNCOC Basic NCO Course Figure 2 1 Training Locations Sustainment Training Frequency column This column indicates the recommended frequency at which the tasks should be trained to ensure soldiers maintain task proficiency Figure 2 2 identifies the frequency codes used in this column Biannually Annually Semiannually Quarterly MO Monthly BW B
293. ll need the manufacturer s manual for setting up the ACR 2000 if available as well as all packing materials that came with the equipment Standards Prepared the ACR 2000 for movement IAW manufacturer s instructions Performance Steps 1 2 Turn off the power to the computer and the monitor Turn off the power to the CR unit NOTE Switch on the back of the unit turns it off 3 Performance Measures GO Turned off the power to the computer and the monitor Turned off the power to the CR unit Turned off the power for the uninterrupted power supply and the power Turn off the power for the uninterrupted power supply and the power strip Disconnect the computer s power cord from the power strip Disconnect all peripheral devices keyboard mouse etc from the back of the computer processing unit Disconnect the monitor s power cord from the power strip Disconnect the monitor s serial cable from the computer processing unit Disconnect the ACR s DAC cable from the computer processing unit Disconnect the CR s power cord from the power strip Disconnect the power strip from the uninterrupted power supply Disconnect the uninterrupted power supply form the source 12 Pack all the components in the proper storage cases ensuring that all cables and manuals are stored inside Bg strip Disconnected the computer s power cord from the power strip
294. loosen the locking device and move to the left Secure the locking device in place Lowered tube collimator assembly until counterweight retainer pin could be placed in back of tower Disconnected tube collimator and placed it in the storage container 3 Secured tube collimator storage container to floor with bolts provided Removed tower bolts that connect to base lowered and secured to shipping brackets 5 Secured bucky for shipping by using bungy cord and connecting it to end of table Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None CUSWORTH RITA J 3 272 RADIOLOGY BRANCH SOP STP 8 91P15 SM TG PREPARE DEPMEDS PORTABLE RADIOGRAPHIC UNIT IDDC MODEL 1200 FOR MOVEMENT 081 823 0194 Conditions You are in a tactical environment and the unit commander has issued an order to transport the portable unit to another room up or down stairs or to another location where moving the unit in the ready position will create a hazard The IDDC Model 1200 portable unit is fully assembled and operational Ready Position You have the assistance of other soldiers if required You will need DEPMEDS Portable Radiograph
295. loppy Diskette option 0 Select the drive Verify that the printer is online when message prompt Ensure printer is online is displayed then press any key 3 306 STP 8 91P15 SM TG Performance Steps Select Y or N to the message prompt Commander s Report Should Be Run Before Sending Transactions To Source of Supply Do You Wish To Continue 1 Selecting N returns you to the Send Transactions screen where you can then return to the Request Processes Menu to run the Commander s Reports 2 Selecting Y allows you to continue the process e Label a diskette f Insert the diskette into A drive g Format the diskette h Select the diskette volume label i Select or N to format another disk j Process the transactions k Print the Send Supply Transactions Report I Process transaction for all DSUs m Review the Send Supply Transactions Report n File the Send Supply Transactions Report in the unit file Forward the diskette to the SOS 2 Send transactions via communications a Select Send Trans Via Communications 0 Verify that the printer is online c Process the transactions d Review the Send Supply Transactions Report e File the Send Supply Transactions Report in the unit files 3 Select Send Transaction for All Units on File Previous Transactions option 4 Send transactions via floppy disk Select Send Trans Via Floppy Diskette Selec
296. low to plan and evaluate training e Identify soldier and leader training requirements The NCO determines which tasks soldiers need to train on using the commander s training strategy The unit s METL and ARTEP and the MOS Training Plan MTP in the TG are sources for helping the trainer define the individual training needed e Plan the training Training for specific tasks can usually be integrated or conducted concurrently with other training or during slack periods The unit s ARTEP can assist in identifying soldier and leader tasks which can be trained and evaluated concurrently with collective task training and evaluation Gather the training references and materials The SM task summary lists all references which can assist the trainer in preparing for the training of that task 1 3 Ft LW Ft Sill Ft Jackson Ft Benning MOS 91 RADIOLOGY SPECIALIST CAREER TRAINING LIFE CYCLE Army Correspondence Course Program 313 91P10 46 wks FSH TX AIT MOS 081 CBRNE W Introduction to CBRNE On Line Just in Time PLDC NCOES 4wks Multiple sites Leadership 081 00006 Basic Human Anatomy Correspondence Sustainment 6 8 C40 91P30 BNCOC NCOES 7 Wks 1 Day FSH TX Leadership 081 00010 Basic Medical Terminology Correspondence
297. lty Instruct the number two assistant to reach across the board to the far edge and hold it in place to prevent board movement 7 Instruct the assistants to slowly roll the casualty back onto the board Keep the head and spine in a straight line 8 Place the casualty s wrists together at the waist and tie them together loosely NOTE If the cervical collar or improvised collar does not fit flush with the spine board place roll in the hollow space between the neck and board The roll should only be large enough to fill the gap not to exert pressure on the neck b The straddle slide technique NOTE Use this method when limited space makes it impossible to use the log roll technique 1 Stand at the head of the casualty with your feet wide apart 2 Apply stabilization to the casualty s head and apply cervical collar See steps 3a 2 through 3a 3 3 Instruct the first assistant to stand behind you facing your back to line up the spine board and to gently push the spine board under the casualty at your command 4 Instruct the second assistant to straddle the casualty while facing you and gently elevate the shoulders so that the spine board can be slid under them 5 Instruct the third assistant facing you to carefully elevate the hips while the spine board is being slid under the casualty 6 Instruct the fourth assistant facing you to carefully elevate the legs and ankles while the board is being slid into place u
298. luation guide Unless otherwise stated in the task summary the soldier must pass all Wi performance measures to be scored GO If the soldier fails step show what was done wrong and how to do it correctly References Required None 3 100 Related BONTRAGER KENNETH STP 8 91P15 SM TG X RAY THE SCAPULA 081 823 0114 Conditions You have a formal request for a radiologic examination of the scapula You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary c Explain the procedure as applicable d Assis
299. luation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related CUSWORTH RITA J RADIOLOGY BRANCH SOP 3 243 STP 8 91P15 SM TG PREPARE DEPMEDS RADIOGRAPHIC UNIT PICKER CLINIX VP4 FOR OPERATION 081 823 0190 Conditions You are in a tactical environment and the unit commander has given the order to set up The tactical shelter has been positioned leveled and expanded You have the assistance of other soldiers if required You will need DEPMEDS Radiographic Unit Picker Clinix VP4 and Picker System Operator s Guide Standards Assembled DEPMEDS Radiographic Unit Picker Clinix VP4 Performance Steps 1 2 Place the foam pad on the table to protect equipment Using the hex key that is located in the employment set loosen and remove the bolts securing the tube transport fixture to the floor Employing two people lift the tube collimator transport fixture onto the head end of the table a Ensure the table top is extended all the way to the foot end of the table allowing the transport fixture to be supported over the table base b Ensure transport fixture is set firmly on the pad and square on the table top avoiding the fixture from slipping off table top Use the hex key to loosen and remove the transport security brackets holding t
300. ly References Required Related None BONTRAGER KENNETH L 3 94 STP 8 91P15 SM TG X RAY THE HUMERUS 081 823 0112 Conditions You have a formal request for a radiologic examination of the humerus You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure the patient s jewelry is removed as necessary 2 Ensure the patient has removed all clothing under the area of study as necessary NOTE Gown the patient as necessary c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control pan
301. m with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Sandbags c Lead apron d Letter markers e Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary 3 Use a drape sheet to cover patient as needed c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 14 X 17 cassette for the AP and lateral views distal and proximal 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette Adjust the conefield to a 10 17 lengthwis
302. mance Measures GO 86 1 Turned the CR plate reader a Ensured that the power light on the local panel was b Waited for the processor to perform self diagnostic test and begin warm up cycle c Observed local panel to display Ready 2 Loaded image plate cassette into the CR reader a If the cassette door did not already open pressed the Open Door button on the local panel b Fed image plate cassette into the CR reader c Pushed cassette firmly but gently into the cassette entry door far enough for the cassette door to close behind the cassette or the feeding mechanism to grasp the IP cassette 3 Removed cassette from the CR reader 3 263 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 264 STP 8 91P15 SM TG OPERATE ACR 2000 COMPUTED RADIOGRAPHY UNIT 081 823 0253 Conditions You must operate ACR 2000 through the acquisition of digital computer images You will need the on line digital work station and Lumiscan ACR 2000 service manual Standards Operated the ACR 2000 without errors IAW Lumiscan ACR 2000 service manual Performance Steps 1 To start the DI 2000 acquisition program double click D
303. materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size of cassette Placed the cassette the bucky lengthwise for the and lateral views Positioned the overhead tube N A Positioned the knee b Lateral view 10 Immobilized the body part as required 3 128 STP 8 91P15 SM TG 11 Placed the appropriate identification marker on the cassette 12 Placed the lead apron across the patient s lap 13 Gave the patient the pre post exposure instructions 14 Made the exposure 15 Developed the exposed cassette s with patient identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all GO Wi performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 129 STP 8 91P15 SM TG X RAY THE FEMUR 081 823 0122 Conditions You have a request for an X ray examination of the femur You have the assistance of additional personnel if required You will need a properly equipped X ray exposure roo
304. may be green yellow gray or blood tinged and may have a foul or sweetish smell 4 Record the rate of respirations and any observations noted on the appropriate forms 5 Report any abnormal respirations to the supervisor immediately Evaluation Preparation Setup You must count the rate with the soldier If you are using a simulated patient you may test step 2 by having him or her purposely exhibit abnormal breathing characteristics A tolerance of plus or minus two counts will be allowed Brief soldier Tell the soldier to count evaluate and record a patient s respirations Performance Measures GO 1 Counted the number of times the chest rose in 1 minute Evaluated the respirations Checked for the physical characteristics of abnormal respirations B Recorded the rate of respirations and any observations noted the appropriate forms 5 Reported any abnormal respirations to the supervisor immediately Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 50 STP 8 91P15 SM TG MEASURE A PATIENT S BLOOD PRESSURE 081 831 0012 Conditions You will need sohygmomanome
305. mes unconscious Performance Measures GO 1 Determined whether the casualty needs help Moved the casualty to a sitting or standing position if necessary Stood behind the casualty Positioned arms and hands properly to perform the thrusts Stated how to perform the thrusts and how many should be performed Bg A Stated that the following actions would be taken if the casualty becomes unconscious a Reposition the casualty b Perform a finger sweep c Open the airway d Perform rescue breathing procedures 7 Completed all necessary steps in order Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 14 STP 8 91P15 SM TG PERFORM RESCUE BREATHING 081 831 0048 Conditions You are treating a casualty who is unconscious and is not breathing You are not in an NBC environment Standards Completed in order all the steps necessary to restore breathing Continued the procedure until the casualty started to breathe or until relieved by another qualified person stopped by a physician required to perform CPR or too exhausted to continue Performance Steps 1
306. motion going from the fingertips toward the elbows for at least 15 seconds b Give particular attention to creases and folds in the skin c Wash ring s if present 7 Rinse your hands wrists and forearms a If using running water 1 Hold your hands lower than the elbows under the running water until all soap is removed 2 Do not touch any part of the sink or faucet b If not using running water 1 Use a clean towel to grasp the canteen with one hand 2 Rinse the other hand wrist and forearm letting the water run into the empty basin Hold your hands lower than the elbows 3 Repeat the procedure for the other arm 4 Do not touch any dirty surfaces while rinsing your hands 8 Dry your hands wrists and forearms a Use a towel to dry one arm from the fingertips to the elbow without retracing the path with the towel b Dispose of the towel properly without dropping your hand below waist level c Repeat the process for the other arm using another towel 3 5 STP 8 91P15 SM TG Performance Steps 9 Use a towel to turn off the running water if applicable 10 Reinspect your fingernails and clean them and rewash your hands if necessary Evaluation Preparation Setup None Brief soldier Tell the soldier to perform a patient care handwash You may specify which method to use The soldier need not perform both Performance Measures N A N Evaluation Guidance Score each
307. mplete this entry after items are received The person signing for receipt of items will complete this entry in ink 2 Block 13 Print name date and sign in Include rank 3 Block 15 Print name date and sign in Include rank d File the completed document in the unit supply file 6 Prepare DD Form 1348 6 as a request for issue for a non NSN item IAW DA Pam 710 2 1 a Complete the card column section of DD Form 1348 6 1 Card column 8 22 Enter the commercial and Government entity CAGE when available and the part number 2 Card column 23 24 Enter the unit of issue 3 Card column 25 29 Enter the quantity requested Use all five positions Enter zeros 0 to the left of the quantity 4 Card column 30 35 Enter the unit DODAAC 5 Card column 36 39 Enter the Julian date 6 Card column 40 43 Enter the serial number 7 Card column 44 Enter the demand code R for recurring N for nonrecurring 8 Card column 54 56 Enter the proper Use the that identifies the major end item for which the request applies 9 Card column 57 59 Enter the project code if assigned otherwise leave blank 10 Card column 60 61 Enter the priority designator 11 Card column 62 64 Enter RDD or leave blank Enter 999 for not mission capable supply NMCS request requiring expedited handling originating overseas or in CONUS units deploying within 30 days For all other NMCS anticipated not mission capable supply ANMCS reque
308. n cord with switch and a tent repair kit c The field cassette transfer cabinet 2 Select a dry level site close to the X ray units NOTE The darkroom tent may be set up inside or outside of the X ray tent 3 Move the field processor to the site NOTE may be easier to set up the tent over the field processor rather than to move the processor into the tent 4 Unfold the tent over the processor if appropriate Assemble the top framework Lace the tent to the center and side top poles 5 6 7 Raise the tent by attaching the uprights to the top framework 8 Snap the tent sleeves around the uprights 9 Adjust the sod cloths a Smooth the sod cloths to lie flat inside the tent b Shovel dirt on the sod cloths as necessary 10 Move the processor to the correct location 11 Install the cassette film transfer cabinet in the sponge rubber sealing collar 12 Once processor is functioning run test film assessing the film fog for light leaks Performance Measures GO 1 Ensured all components are on hand 2 Selected dry level site close to the X ray units 86 3 Moved the field processor to the site 3 234 13 14 15 16 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Unfolded the tent over the processor i
309. n marker on the cassette Gave proper pre post exposure instructions 12 13 Made the exposure Processed the film STP 8 91P15 SM TG GO Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 179 STP 8 91P15 SM TG X RAY TRAUMA LUMBAR SPINE 081 823 0218 Conditions You have a request for a radiologic examination of a trauma lumbar spine You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sand bags lead shielding letter markers and positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead aprons c Letter markers d Moving grid 3 Prepare the patient a Bring the patient into the room b Explain the procedure to the patient c Try to remove all foreign objects from the area of interest NOTE This should be done without manipulating the patient any more then necessary 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the
310. n wall by the needle catheter or later dislodgement of the needle catheter 1 Solution flows sluggishly or not at all 2 Discoloration or cool feeling around the infusion site 3 Swollen extremity 4 Fluid leaking from the infusion site 5 Patient complains of pain tenderness irritation or burning at the infusion site b Phlebitis is an inflammation of the wall of the vein It is caused by injury to the vein during puncture from later needle movement or from irritation to the vein caused by long term therapy incompatible additives or use of a vein that is too small to handle the amount or type of solution 1 Swelling redness and or tenderness around the venipuncture site 2 Sluggish flow rate c Infection is a yellowish foul smelling discharge pus from the venipuncture site d Air embolism is the obstruction of a blood vessel by air carried via the bloodstream usually occurring in the lungs or heart It is caused by conditions such as air bubbles in the IV tubing a solution container that has run dry or disconnected IV tubing 1 Abrupt drop in blood pressure 2 Chest pain 3 Weak rapid pulse 4 Cyanosis 5 Loss of consciousness e Circulatory overload is an increased blood volume that is caused by excessive IV fluid infused too rapidly into the vein overhydration 1 Elevated blood pressure 2 Distended neck veins 3 Rapid breathing shortness of breath tachycardia 4 Fluid i
311. nation pop up menu Selected Send Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 223 STP 8 91P15 SM TG INITIATE CR APPLICATIONS SOFTWARE AND HARDWARE 081 823 0328 Conditions You must initiate computed radiography hardware and loaded software for use by qualified personnel in order to adequately display and manipulate archived images You will need on line digital work station optical disk storage system and DIN PACS operating instructions Standards Initiated computed radiography software and hardware without error IAW DIN PACS operating instructions Performance Steps 1 Ensure all PC based hardware is properly connected at CR work station NOTE lf cables appear disconnected loose or frayed notify qualified computer technician for repair 2 Ensure all PC based hardware is connected to appropriate power source 3 Check power supply indicator light for illumination at the Central Processing Unit a If power indicator does not illuminate check for proper power source connection NOTE lf power cord is disconnected reconnect to power source If damage is suspected notify qualified personnel for repair b
312. nce SID to 40 inches 101 cm c Center the tube to the portion of the film being used d Adjust the conefield to full field coverage 9 Position the ankle a AP view 1 Place the patient supine or seated with both legs fully extended on the table 3 118 STP 8 91P15 SM TG Performance Steps 2 Place the epicondyles parallel to the table 3 Place the planter surface of the foot perpendicular to the cassette 4 Center the midmalleolar plane to the cassette b Oblique view 1 Place the patient supine or seated with both legs fully extended on the table 2 Place the planter surface of the foot perpendicular to the cassette 3 Rotate the foot and leg medially until the midpoint of the foot forms a 20 degree angle with the cassette 4 Center the midmalleolar plane to the cassette c Lateral view 1 Place the patient laterally recumbent on the table 2 Place the epicondyles perpendicular to the table 3 Center the ankle to the cassette 4 Position the foot and leg to form a 90 degree angle 5 Center medial malleolus to the cassette 10 Immobilize the body part as required 11 Place the appropriate identification marker on the cassette 12 Place the lead apron across the entire pelvic area 13 Tell the patient DO NOT MOVE 14 Make the exposure 15 Tell the patient RELAX and remove immobilization 16 Develop the exposed cassette s with patient identification for processing Performance
313. nd ammunition inventory a Report any discrepancies to the responsible officer immediately 3 315 STP 8 91P15 SM TG Performance Steps 3 316 0 The responsible officer will report discrepancies to the PBO c When no conclusive findings are made the following actions will be completed 1 Turn in overages as found on installation property 2 Account for shortages according to Policies and Procedures for Property Accountability AR 735 5 3 Post adjustment documents to the property book 10 Perform post inventory action for COMSEC equipment inventory COMSEC custodians will not be relieved of their responsibilities and will not depart their organization until this COMSEC account is cleared 11 Perform post inventory action for a semiannual Central Issue Facility CIF property book inventory a Prepare a DA Form 444 Inventory Adjustment Report IAR IAW AR 735 5 Ch 14 for any discrepancies 0 Document causative research on IAR when adjustment are 1 Sensitive items having Control Item Inventory Code CIIC 1 6 8 9 N P Q or R and night vision devices with a Secure Equipment Code SEC of Y 2 Adjustment exceeding one half of 1 percent of the combined total dollar value of issues and turn ins of a single LIN since last inventory 3 Adjustments over 500 in extended line item value 4 Adjustment that do not require causative research Process the 1 Assign a document number from
314. nder the casualty 3 43 STP 8 91P15 SM TG Performance Steps WARNING Complete all movements simultaneously keeping the head and spine in a straight line NOTE lf the cervical collar or improvised collar does not fit flush with the spine board place a roll in the hollow space between the neck and board The roll should only be large enough to fill the gap not to exert pressure on the neck 5 Secure the casualty to the long spine board a Secure the casualty s head and head supports to the board with straps or cravats WARNING Do not release manual stabilization until the cravats or head straps are firmly in place 1 Apply head supports 2 Use two rolled towels blankets sandbags or similar material 3 Place one close to each side of the head 4 Using a cravat like material across the forehead make the supports and head One unit by tying to the board See Figure 3 1 Figure 3 1 b Secure the casualty with straps across the chest hips thighs and lower legs NOTE Include the arms if the straps are long enough If the spine board is not provided with straps and fasteners use cravats or other long strips of cloth WARNING Securely immobilize the casualty s head and neck Fill socks with sand and place them on both sides of the head and neck to keep it from moving 6 Record the treatment on the Field Medical Card 7 Evacuate the casualty 3 44 STP 8 91P15 SM TG Evaluation Preparation Setup
315. ne with the vertebral column over the centerline of the table 3 168 STP 8 91P15 SM TG Performance Steps 2 Adjust the median plane and acanthiomeatal line AML perpendicular the table 3 Project the central ray to the lower level of the thyroid cartilage b Open mouth view 1 Place the patient supine with the vertebral column over the centerline of the table 2 Adjust the median plane and the AML perpendicular to the cassette 3 Have the patient open their mouth to the extreme limits for the exposure NOTE Make sure that when the patient is instructed to open their mouth that only the lower jaw moves Instruct the patient to keep their tongue in the lower jaw This will prevent its shadow from being over the atlas and axis 4 Central ray to the center of the open mouth projected to the center of the film c Lateral view 1 Have the patient standing or seated with their shoulder in firm contact with the cassette 2 Adjust the median plane parallel to the cassette 3 Place the AML parallel to the floor 4 Central ray is horizontal perpendicular to the film centered at a level of the upper margin of the thyroid cartilage 11 Place the appropriate letter marker on the cassette 12 Tell the patient DO NOT BREATHE OR MOVE NOTE Instruct the patient to say AH for the open mouth view 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the exposed radiograph s with the p
316. nel for repair 0 Conduct causative research for differences When no conclusive findings are made 1 Turn in in overages as found on installation property 2 Account for shortages according to AR 735 5 3 Prepare and process an AAR to correct differences within sizes make models NSN changes unit of issue Army recoverability code changes assemble or disassemble and consumption of Classes Il Ill and 4 Post adjustment documents to the property book 5 Submit requests for issue to replace shortages c When the inventory is completed prepare a memorandum for the PBO s signature 8 Perform post inventory action for a sensitive item inventory a The responsible officer reports differences pertaining to property book items to the PBO When no conclusive findings are determined 1 Turn in overages as found on installation property 2 Account for shortage according to AR 735 5 3 Prepare and process an AAR to correct differences within sizes makes or models 4 Adjustment documents must be posted to the property book 5 Submit requests for issue to replace shortages 0 Record the results of the sensitive item inventory on a memorandum prepared for the responsible officer or PBO s signature as appropriate c Record the results of the sensitive item inventory on the cyclic inventory memorandum when the unit conducts monthly sensitive items inventory 9 Perform the post inventory action for a weapons a
317. ng inventories and reporting results contained in TB 380 41 3 Procedures for Safeguarding Accounting and Supply Control of COMSEC Material 11 Conduct a Semiannual Central Issue Facility CIF property book inventory a This is a 100 percent physical count of all Organizational Clothing and Individual Equipment OCIE recorded on property book 0 The date of inventory is based on the date of the last change of PBOs or on the last semiannual inventory c Cyclic inventories may be used in lieu of the semiannual inventory however all property must be inventoried at least semiannually d Prior to the inventory 1 Select a date for an inventory cutoff and notify supported units 2 Make sure all receipt and turn in documents are posted 3 Select personnel to assist in the inventory e Conduct the count after completing the pre inventory requirements 1 Compare hand receipts with the property records to find the items not on hand receipt 2 Validate maintenance and laundry requests 3 Count all items listed on the property records 3 Conduct post inventory procedures IAW DA Pam 710 2 1and AR 25 400 2 a Perform the following general actions after completing an inventory 1 Compare inventory results with hand receipts property listings or component listings to verify shortages 2 Inform commander of inventory results 3 Report discrepancies to the accountable officer 4 Cross level transfer or turn in
318. ng is absent perform rescue breathing only See task 081 831 0048 8 Resume CPR with compressions 9 Recheck for pulse every 3 to 5 minutes 10 Continue to alternate chest compressions and rescue breathing until a The casualty is revived b You are too tired to continue c You are relieved by competent person s d The casualty is pronounced dead by an authorized person A second rescuer states know CPR and joins you in performing two rescuer CPR NOTE A qualified second rescuer joins the first rescuer at the end of a cycle after a check for pulse by the first rescuer The new cycle starts with one ventilation by the first rescuer and the second rescuer becomes the compressor Two rescuer CPR is then initiated 11 Perform two rescuer CPR if applicable a Compressor Give 15 chest compressions at the rate of 100 per minute Ventilator Maintain an open airway and monitor the carotid pulse occasionally for adequacy of chest compressions b Compressor Pause Ventilator Give two full breaths over 2 seconds c Compressor Continue to give chest compressions until a change in positions is initiated Ventilator Continue to give ventilations until the compressor indicates that a change is to be made d Compressor Give a clear signal to change positions Ventilator Remain in the rescue breathing position e Compressor Give the 15th compression Ventilator Give two breaths following the 15th compression Com
319. nger being examined against the positioning sponge so it is supported in a 45 degree and is parallel to the film 4 Central ray perpendicular to the film directed to PIP joint 5 Collimate to fours sides of finger being examined c Lateral view 1 Place hand in lateral position with finger to be examined fully extended centered to a 1 3 portion of film NOTE Thumb side up 2 Align and center finger to long axis of portion of film being exposed 3 Use positioning sponge to support finger and prevent motion NOTE Flex unaffected fingers 4 Center central ray to PIP joint 5 Collimate to four sides of finger being exposed 11 Position thumb NOTE Thumb includes the entire first metacarpal a AP view 1 Internally rotate hand with fingers extended until posterior surface of thumb is in contact with film 2 Align thumb to long axis of portion of film being exposed 3 Center 1st metacarpal phalange MP joint to central ray and center to portion of film being exposed 4 Collimate on four sides of area of thumb b Oblique view 1 Abduct thumb slightly with palmar surface of hand in contact with cassette NOTE This will naturally place the thumb in an oblique position 2 Align long axis of thumb to long axis of third of cassette being exposed 3 Center 1st MP joint to central ray and to center of portion of film being exposed 4 Collimate to four sides of thumb c Lateral view 1 Start with hand pronated an
320. ntake is much greater than urine output 2 Perform the nursing interventions for IV therapy complications a Infiltration 1 Stop the infusion 2 Notify your supervisor 3 Record observations and action taken b Phlebitis 1 Stop the infusion 3 30 STP 8 91P15 SM TG Performance Steps 2 Report observations to your supervisor 3 Record observations and actions taken c Infection 1 Report observations to your supervisor 2 Record observations and actions taken d Air embolism 1 Report observations to your supervisor 2 Record observations and actions taken e Circulatory overload 1 Slow the infusion rate to TKO 2 Place the patient the semi Fowler s position 3 Notify the physician or supervisor 4 Record observations and actions taken 3 Document the IV therapy a Frequency 1 When the IV is initiated 2 Each time any part of the IV equipment is changed b Label the dressing 1 Cut adhesive tape and place it on a flat surface NOTE Never write on the tape after it has been placed on the dressing 2 Record the information on the piece of tape a The gauge of the catheter needle 0 The time and date the dressing was applied c Your initials 3 Place the labeled tape over the dressing c Label the solution container 1 Cut adhesive tape and place it on a flat surface 2 Record the information on the piece of tape a The patient s name 0 The patient s identifica
321. o full field coverage 3 165 STP 8 91P15 SM TG Performance Steps 9 Place shielding on the patient s lap 10 Position for the cervical spine a Lateral view 1 Patient supine or on stretcher 2 Median plane parallel to cassette CAUTION Do not remove cervical collar or move patient s head or neck until cervical fractures have been ruled out 3 Cassette against shoulder 4 Top of cassette 1 to 2 inches above level of EAM Ensure that C7 region is included 5 Have patient relax and depress shoulders as much as possible NOTE needed have nonradiology personnel pull down on both arms to further depress shoulders to visualize C7 region Supply with lead apron b AP view 1 Patient supine 2 Median plane perpendicular to and over long axis of the cassette 3 AML as perpendicular to cassette as possible 4 Project the central ray to the level of the lower margin of the thyroid cartilage 11 Place the appropriate letter marker on the cassette 12 Tell the patient DO NOT BREATHE OR MOVE NOTE Instruct the patient to BREATHE OUT AND HOLD IT for the lateral view 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the radiograph s with the patient s identification Performance Measures GO Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the en
322. o not interfere except to encourage the casualty 0 If the casualty has poor air exchange weak ineffective cough high pitched noise while inhaling increased respiratory difficulty and possible cyanosis continue with step 1a 2 c If the casualty has a complete airway obstruction is unable to speak breathe or cough and may clutch the neck between the thumb and fingers continue with step 1a 2 2 If the casualty is lying down bring him or her to a sitting or standing position 3 Apply abdominal or chest thrusts NOTE Use abdominal thrusts unless the casualty is in the advanced stages of pregnancy is very obese or has a significant abdominal wound a Abdominal thrusts 1 Stand behind the casualty and wrap your arms around his or her waist 2 Make a fist with one hand and place the thumb side of the fist against the casualty s abdomen in the midline slightly above the navel and well below the tip of the xiphoid process 3 Grasp the fist with your other hand and press the fist into the casualty s abdomen with quick backward and upward thrusts 4 Continue giving thrusts until the blockage is expelled or the casualty becomes unconscious NOTE Make each thrust a separate distinct movement given with the intent of relieving the obstruction 0 Chest thrusts 1 Stand behind the casualty and encircle his or her chest with your arms just under the armpits 2 Make a fist with one hand and place the thumb side of the fist a
323. ocal panel is on b Wait for the processor to perform self diagnostic test and begin warm up cycle c Observe local panel to display Ready NOTE Images be acquired during warm up period but no printing will occur until ready message is displayed 2 Load film cartridge into dry laser processor NOTE Most dry laser processors will indicate when film cartridge is empty most cartridge doors will open automatically a If the supply door is not already open press the supply button on the local panel b Remove empty film cartridge 1 Lift edge of film cartridge slightly 2 Slide film cartridge out of processor c Install new film cartridge 1 Set leading edge of new film cartridge on cartridge receiving guides 2 Slide film cartridge into processor until detents engage bottom of cartridge d Close supply door 3 Press button on local panel to print test film 4 Evaluate test film for proper calibration Performance Measures GO 1 Powered on the dry laser processor Removed empty film cartridge Installed new film cartridge 8 2 3 4 Pressed button on local panel to print test film 5 Evaluated test film for proper calibration Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step
324. od NOTE Use different techniques for different basic body structures based on body size and build heavyset normal or slender b Variable kVp method NOTE The mAs stays constant and kVp ranges are adjusted for different part thickness c Optimum kVp method NOTE The kVp and SID remain constant and mAs is adjusted for different part thickness d Automated exposure 2 Determine the factors to be considered for formulating your technique chart a Check the type of film holders and screens and determine the speeds b Determine grid ratios for all grids used c Determine the tube limits and capabilities as well as the rectification of your machine NOTE Heat units are different in a three phase unit than in a single phase unit d Determine the patient thickness and make adjustments accordingly e Adjust technique accordingly when adjusting conefields NOTE lf you decrease conefield you increase your technique If you increase your conefield you decrease your technique 3 Record any adjustments to the original technique and annotate on a piece of stationery 4 Record what factors resulted in a change in technique 5 Post technique chart near the control panel for use in all future exams 6 Make the necessary corrections as needed Performance Measures GO 1 Determined the method for selecting technique factors 2 Determined the factors to be considered for formulating technique chart
325. oes to check for paralysis e Palpate the spine for pain 1 Carefully insert the hand under the neck and feel along the cervical spine as far as can be done without disturbing the casualty s spine 2 Carefully insert the hand into the cavity formed by the small of the back and feel along the thoracic spine and down the lumbar spine as far as possible without disturbing the spine 3 If the casualty says that an area of the spine is tender consider that he or she has a spinal injury 2 Secure the casualty to a short spine board if using Kendrick Extrication Device KED go to step 3 NOTE Apply a short spine board when extricating a casualty from a vehicle or location that will not accommodate the use of a long spine board If available use a KED which is a commercial spine board a Direct an assistant to immobilize the casualty s head and neck using manual stabilization 1 Place the hands on both sides of the casualty s skull with the palms over the ears 2 Support the jaw mandible with the fingers 3 Maintain manual stabilization until directed to release the stabilization b Apply a cervical collar if available or improvise one c Push the board as far into the area behind the casualty as possible 3 41 STP 8 91P15 SM TG Performance Steps d Tilt the upper end of the board toward the head e Direct the assistant to position the back of the casualty s head against the board maintaining manual stabilization by
326. of 5 Ibs in each hand 3 106 Performance Steps a Stand the patient with equal weight on both feet and with his her back against the upright film holder NOTE Seat all tall patients b Place the median plane perpendicular to the center of the cassette c Place both shoulders in the same transverse plane NOTE Place the feet a comfortable distance apart 10 11 12 d Place the manubrial notch over the centerline of the cassette e Direct the central ray midpoint between the AC joints perpendicular to the film Place the appropriate letter marker on the cassette Tell the patient DO NOT BREATHE OR MOVE Make the exposure STP 8 91P15 SM TG 13 Tell the patient RELAX AND BREATHE NORMALLY and remove the weights if used 14 Develop the exposed cassette s with patient identification Performance Measures N Oo A N Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size film cassette Placed the cassette in the film holder crosswise Positioned the overhead tube Positioned the acrom
327. oldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 18 STP 8 91P15 SM TG ADMINISTER EXTERNAL CHEST COMPRESSIONS 081 831 0046 Conditions You are treating a casualty who is not breathing and has no pulse The airway is open and is clear Another soldier who is CPR qualified may be available to assist or may arrive while you are performing one rescuer CPR You are not in an NBC environment Standards Continued CPR until the pulse was restored or until the rescuer s were relieved by other qualified persons stopped by a physician or too tired to continue Performance Steps Perform one rescuer CPR 1 Ensure that the casualty is positioned on a hard flat surface 2 Position the hands for external chest compressions a With the middle and index fingers of the hand nearest the casualty s feet locate the lower margin of the casualty s rib cage on the side near the rescuer b Move the fingers up the rib cage to the notch where the ribs meet the sternum in the center of the lower part of the chest c With the middle finger on the notch place the index finger next to it on the lower end of the sternum d Place the heel of the other hand on the lower half of the sternum nex
328. oldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 182 STP 8 91P15 SM TG Subject Area 8 Contrast Media Studies ASSIST PHYSICIAN WITH ESOPHAGRAM BARIUM SWALLOW 081 823 0144 Conditions You have received a formal request for an esophagram You have the assistance of additional personnel if required You will need a properly equipped radiographic fluoroscopic exposure room with the correct contrast medium and various sizes of film in cassettes Standards The radiographs will be of diagnostic quality and will properly demonstrate the requested body part The radiographs must be correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead aprons c Lead gloves d Letter markers e Contrast medium 3 Prepare the contrast medium CAUTION Ensure the appropriate contrast medium is being used and verify the expiration date 4 Prepare the equipment for fluoroscopy 5 Prepare the patient a Bring the patient into the X ay room b Ensure the patient is properly dressed 1 Ensure all foreign objects are removed from the
329. omedical maintenance for repair 11 Run a test film to check for film fog due to light leakage Performance Measures GO 1 Ensured that the film bin was closed and then turned on the light 2 Wiped off all of the dirt and dust that had accumulated inside the darkroom with all purpose cleaner and a rag Ensured that the film bin was free of dirt and dust _ Checked the darkroom tent for light leaks Repaired all light leaks in darkroom Checked the laces of the darkroom tent to ensure have come 3 230 STP 8 91P15 SM TG Performance Measures GO 7 Checked the snaps of the darkroom tent sleeves to ensure that none have come undone 8 Ran a test film to check for film fog due to light leakage Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C 3 231 STP 8 91P15 SM TG MAINTAIN INTENSIFYING SCREENS AND CASSETTES 081 823 0242 Conditions You have intensifying screens that need to be maintained You will need a table cleaning solution cleaning cloth and radiographic cassettes and film Standards The intensifying
330. on across the patient s lap 13 Tell the patient DO NOT MOVE 14 Make the exposure 15 Tell the patient RELAX and remove immobilization 16 Develop the exposed cassette s with patient identification for processing Performance Measures GO Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size of cassette Placed the cassette in the bucky lengthwise Positioned the overhead tube FT TTT IT ON DO A Positioned the femur view distal and proximal 3 131 STP 8 91P15 SM TG Performance Measures b Lateral view distal and proximal 10 Immobilized the body part as required 11 Placed the appropriate identification marker on the cassette 12 Placed the lead apron across the patient s lap 13 Gave patient pre post exposure instructions 14 Made the exposure 15 Developed exposed cassette s Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all 96 performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Require
331. on site Smoothly pull out the needle following the course of the vein WARNING Do not twist raise or lower the needle g Apply pressure to the site with the gauze h Examine the needle or catheter to ensure that it was removed intact i Apply an adhesive bandage to the site if necessary j Dispose of the used equipment IAW local SOP 0M 8 Record the procedure on the appropriate form NOTE Ensure that the fluids received have been recorded on the appropriate form s Evaluation Preparation Setup If the performance of this task must be simulated for training or evaluation assemble the IV materials and equipment as indicated in task 081 833 0033 It is not necessary to have the catheter or needle inserted into a person A simulated arm or other material may be used Brief soldier Tell the soldier to manage a patient with an intravenous infusion Performance Measures GO 1 Assessed for signs and symptoms of IV therapy complications Performed the nursing interventions for IV therapy complications Documented the IV therapy Replaced the solution container as necessary Changed the dressing as required Replaced the solution container and tubing as necessary N O Oo A Discontinued the infusion as required 3 33 STP 8 91P15 SM TG Performance Measures 8 Recorded the procedure on the appropriate form 9 Did not violate aseptic technique
332. on with the epicondyles parallel to the tabletop 4 Place the acromion process 2 below the upper edge of the cassette b AP internal rotation 1 Place the patient supine or erect with the coracoid process over the centerline of the table 2 Rotate the coronal plane 10 to 15 degrees toward the affected side 3 Rotate the humerus internally placing the epicondyles perpendicular to the tabletop 4 Place the acromion process 2 below the upper edge of the cassette Immobilize the body part as required a Place a sandbag on or against the hand for the AP internal external views b Place a sandbag under the hand and wrist for the inferiosuperior axial view Place the appropriate identification marker on the cassette Place the lead apron across the patients lap Tell the patient DO NOT BREATHE OR MOVE Make the exposure Tell the patient RELAX AND BREATHE NORMALLY and remove immobilization Process the film FT TTT TI 1 a external rotation b AP internal rotation c Inferiosuperior axial view Immobilized the body part 3 99 STP 8 91P15 SM TG Performance Measures 11 Placed the appropriate identification marker on the cassette 12 Placed the lead apron across the patient s lap 13 Gave proper pre post exposure instructions 14 Made the exposure 15 Processed the film Evaluation Guidance Score each soldier according to the performance measures in the eva
333. onds to the image Touch double edged box ACCEPT SELECTION amp PROCEED TO PRE SCAN g Touch double edged box READY FOR REPROCESS DAD Touch ENTER on keypad 3 210 STP 8 91P15 SM TG Performance Steps 16 Touch double edged box READY FOR SCAN 17 Touch START button after prompt on ELTP 18 When the plan is complete the boxes will return on ELTP Touch SELECT SCAN MODE 19 Touch ENTER on keypad 20 Touch double edged box READY FOR SCAN 21 Press START button after prompt on ELTP 22 Repeat for each plan Performance Measures GO 186 1 Touched anatomical area of the spine the body icon on the ELTP Electroluminescent Touch Panel 2 Touched the lumbar box 3 Touched PROCEED WITH NEW STUDY Pressed ENTER TEXT key keyboard a Typed patient information on display monitor b Pressed F1 Save Data Positioned patient for pilot scan Touched double edged box PROCEED TO PRE SCAN Touched double edged box READY FOR PILOT Pressed START button for Pilot After pilot image appeared pressed F8 PLAN STUDY a Positioned red cursor for first slice and pressed F1 FIRST Used theta ring to angle cursor if necessary b Positioned red cursor for last slice and pressed F2 LAST c Pressed F8 SAVE PLAN Oo N 10 scanning through each disc space used theta ring for tilt and repeated steps 9a and 9b for ea
334. one BTLS FOR PARAMEDICS EMERGENCY CARE 3 45 STP 8 91P15 SM TG MEASURE A PATIENT S PULSE 081 831 0011 Conditions You will need a watch stethoscope and appropriate forms Standards Counted a patient s pulse for 1 full minute Identified any abnormalities in the pulse rate rhythm and strength Performance Steps 1 Position the patient so that the pulse site is accessible 2 Palpate the pulse site a Place the tips of your index and middle fingers on the pulse site NOTE You must use a stethoscope to monitor the apical site b Press the fingers using moderate pressure to feel the pulse 3 Count for 1 full minute and evaluate the pulse NOTE To detect irregularities you must count for 1 full minute a Pulse rate 1 Normal adult rate 60 to 100 beats per minute 2 Infants and Children a Adolescent 11 14 years 60 to 105 0 School age 6 10 years 70 to 110 c Preschooler 3 5 years 80 to 120 d Toddler 1 3 years 80 to 130 e Infant 6 12 months 80 to 140 f Infant 0 5 months 90 to 140 g Newborn 120 to 160 3 Bradycardia less than 50 beats per minute WARNING When a patient presenting with bradycardia the medic must consider the physical condition of the patient For example the patient is an athlete and their normal at rest pulse rate is between 40 to 50 beats per minute 4 Tachycardia more than 100 beats per minute b Pulse rhythm 1 Regular a Usually easy to find b Has a regula
335. onsibility for domestic disaster assistance 1 3 Relationship of Soldier Training Publications STPs to Battle Focused Training The two key components of enlisted STPs are the Trainer s Guide TG and Soldier s Manual SM The TG and SM give leaders important information to help in the battle focused training process The TG relates soldier and leader tasks in the MOS and SL to duty positions and equipment It provides information on where the task is trained how often training should occur 1 1 STP 8 91P15 SM TG to sustain proficiency and who in the unit should be trained As leaders go through the assessment and planning stages they should use the TG as an important tool in identifying what needs to be trained The execution and evaluation of soldier and leader training should rely on the Armywide training objectives and standards in the SM task summaries The task summaries ensure that soldiers in any unit or location have the same definition of task performance and that trainers evaluate the soldiers to the same standard 1 4 Task Summaries Task summaries contain information necessary to conduct training and evaluate soldier proficiency on tasks critical to the MOS A separate task summary is provided for each critical task These task summaries are in effect standardized training objectives which ensure that soldiers do not have to relearn a task on reassignment to a new unit The format for the task summaries included in this
336. oom b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Give the patient a gown if necessary c Explain the procedure if applicable d Assist the patient onto the X ray table e Take a scout radiograph f Show the radiograph to the radiologist NOTE The radiologist will determine if the procedure will be performed by viewing the radiograph 7 Notify the radiologist the patient is ready for fluoro CAUTION Inform the radiologist of any patient allergies handicaps or other conditions that may affect the study 8 Assist the radiologist as directed 9 Prepare the equipment for follow up radiographs 3 191 STP 8 91P15 SM TG Performance Steps a Measure the body part through the entry exit site of the central ray b Set the control panel 1 Consult the technique chart 2 Set the appropriate mAs and kVp on the control panel c Use the appropriate cassettes based on the view 1 Use a 14 x 17 for the AP PA oblique and lateral decubitus views 2 Use a 10 x 12 for the AP axial and the lateral rectum d Place the cassettes in the bucky lengthwise 10 Place the letter marker on the film 11 Position the overhead tube a Set the tube angle 1 Place the tube vertical perpendicular for the AP PA oblique and lateral rectum 2 Place the tube angle 30 to 40 degrees cephalad for the
337. opriate forms Standards Recorded the patient s temperature to the nearest 0 2 F Performance Steps 1 Determine which site to use a Take an oral temperature if the patient is a conscious adult or a child who can follow directions and can breathe normally through the nose CAUTION Do not take an oral temperature when the patient Has had recent facial or oral surgery Is confused disturbed or heavily sedated Is being administered oxygen by mouth or nose Is likely to bite down on the thermometer Has smoked chewed gum or ingested anything hot or cold within the last 15 to 30 minutes b Tympanic method can be used with conscious or unconscious patients and is preferred temperature if the patient has recently had something to eat or drink CAUTION Do not take a tympanic temperature if the patient has had recent facial or aural surgery or has cerumen ear wax c Take a rectal temperature if the oral or tympanic site is ruled out by the patient s condition CAUTION Do not take a rectal temperature on a patient with a cardiac condition diarrhea a rectal disorder such as hemorrhoids or recent rectal surgery Do not take a rectal temperature on an infant unless directed to by medical guidance Take an axillary temperature if the patient s condition rules out using the other methods 2 Select the proper thermometer a Tympanic thermometer b An oral thermometer has a blue tip and may be labeled Oral c
338. ort Information screen 1 Console displays the commander s exception report and the commander s financial transaction listing on the monitor 2 Printer generates a hardcopy of the commander s exception report and the commander s financial transaction listing and deletes the records Select the Console option 1 View the commander s exception report a Document number Nomenclature Sub HR number j k Press any key to view the commander s financial transaction listing 2 View the commander s financial transaction listing a Document number 6 Nomenclature c Sub HR number Extended price Fund code i APC a b 0 f 9 Exit to the Request Processes Menu Printer option if printer option was selected 1 Verify the printer is online 2 Print the report Review written reports Exit to the Request Processes Menu Forward the written reports to the commander for review and authentication as required STP 8 91P15 SM TG Performance Steps 17 Send request transactions to SOS IAW ULLS S4 EM para 4 11 p 4 49 4 68 a Select the Supply Menu from the S4 Main Menu screen b Select the Request Processes Menu c Select the Send Supply Transactions to SOS Menu Select Transactions for the Sign On Current Transactions option 1 from the Send Supply Transactions to SOS Menu 1 Send transactions via floppy diskett
339. osage over a 3 hour period Determine the total IV dosage the patient is to receive by checking the doctor s orders Example The patient is to receive 1000 cc of IV fluid c Check the IV tubing package to determine the number of drops of IV fluid per cc the set has been designed to deliver Example The set is designed to give 10 drops of IV fluid per cc 10 gtts cc d Multiply the total hours step 15a by 60 minutes to determine the total minutes over which the IV dosage is to be administered Example 3 hours X 60 min 180 min Divide the total IV dosage step 15b the total minutes over which the IV dosage is to be administered step 15d to determine the cc of fluid to be administered per minute Example 1000 180 min 5 5 cc min f Multiply the cc min step 15 by the number of drops of IV fluid per cc delivered by the tubing step 15c to determine the number of drops per minute to be administered Example 5 5 cc min X 10 drops cc 55 drops min NOTE Always round drops per minute off to the nearest whole number If drops per minute equal 5 round up to the next whole number 16 Prepare and place the appropriate label a Dressing 1 Print the information on a piece of tape a Date and time the IV was started 6 Initials of the person initiating the IV 2 Secure the tape to the dressing b IV solution container 1 Print the information on a piece of tape a Patient s identification 6
340. osition NOTE The average patient will be rotated 30 to 40 degrees from the lateral position 4 Central ray directed to mid vertebral border of scapula perpendicular to film NOTE A fracture of the body of the scapula is best demonstrated by the lateral view 10 Place the appropriate identification marker on the cassette 11 Place the lead apron across the patient s lap NOTE Secure the lead apron across the patient s lap for the lateral view 12 Tell the patient STOP BREATHING AND DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Process the film Performance Measures GO Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through coracoid process Set the control panel Selected the proper size cassette Placed the cassette the bucky lengthwise Positioned the overhead tube N O A Positioned the scapula a AP view b Lateral view 10 Placed the appropriate identification marker on the cassette 3 102 STP 8 91P15 SM TG 11 Placed the lead apron across the patient s lap 12 Gave proper pre post exposure instructions 13 Made the exposure 14 Processed the film Evaluation Guidance Score each soldier accor
341. osition b Place a soft rolled dressing or similar material in the patient s hand and close the hand c Wrap the entire hand snugly with a flexible gauze bandage Kerlix Kling 3 38 STP 8 91P15 SM TG Performance Steps d Secure the bandage with tape not clips CAUTION Remove and replace mitts at least every 8 hours Clean the skin and perform range of motion exercises 3 Apply sheet restraints NOTE This procedure requires the assistance of another person a Litter or stretcher 1 Unfold a sheet Hold it at opposite corners and fold it lengthwise 2 Twirl the sheet into a tight roll 3 Place the patient on his or her stomach on a litter Turn the head to the side WARNING Check the patient frequently because he or she may suffocate while in the prone position 4 Place the middle of the rolled sheet diagonally across the patient s upper back and one shoulder 5 Bring both ends of the sheet under the litter cross the ends and bring the ends up over the other shoulder and upper back Tie snugly in the middle of the upper back 6 Secure one wrist to the litter parallel to the thigh using a wrist restraint 7 Secure the other wrist above the head by attaching it to the nearest litter handle using a wrist restraint CAUTION Use litter or stretcher restraints only as a temporary restraint for a patient who is combative or uncontrollable b Bed 1 Fold a sheet in half lengthwise 2 Tuck approximately
342. ositioned the patella Immobilized the body part as required Placed the appropriate identification marker on the cassette 12 13 14 15 Placed the lead apron across the entire pelvic area Gave patient pre post exposure instructions Developed exposed cassette s evaluation guide Unless otherwise stated task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 140 STP 8 91P15 SM TG References Required Related None BONTRAGER KENNETH L 3 141 STP 8 91P15 SM TG Subject Area 6 General Radiography Trunk X RAY THE PELVIS 081 823 0124 Conditions You have a request for a radiological examination of the pelvis You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sand bags lead shielding letter makers and various positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Sandbags b Lead apron gonadal shielding c Letter markers d Calipers 3 Pr
343. osure Processed the film 3 Evaluated the film lt Verified the test tool dots Checked the radiation field 4 Reported unacceptable results to the appropriate authority Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 290 STP 8 91P15 SM TG DEVELOP A STANDING OPERATING PROCEDURE DOCUMENT FOR A RADIOLOGY SECTION 081 823 0274 Conditions You must develop a standing operating procedure document for your radiology section service or department You will need Accreditation Manual for Hospitals AR 11 9 AR 40 66 DA Pam 611 21 and Title 21 Code of Federal Regulations Standards Developed a functional standing operating procedure document for your radiology section service or department Performance Steps 1 Identify the purpose of the SOP a What is it intended to accomplish b What is the reason for its existence 2 Identify the applicability of the SOP a Staff b All personnel c Civilian personnel d Enlisted personnel e Outside visitors 3 Identify the personnel responsibilities a List the individual responsibilities and procedures by position function within the radiology service 1 OIC responsi
344. ow the inventory is to be conducted 5 Inventory the required items with hand subhand receipt holders 6 Make a visual check of the condition of the property 7 Check end items for completeness 8 Verify the serial number on the item with the serial number on the hand subhand receipt 6 Conduct a change of PBO inventory This inventory is taken when the PBO of an organization is replaced The inventory is conducted jointly by the incoming and outgoing PBO Property not issued on hand receipt must be inventoried d The outgoing PBO will 1 Make sure all completed transactions have been posted to the property records 2 Make the property book and related files available to the incoming PBO for review 3 Assist the incoming PBO in the review of the property records e The incoming PBO will 1 Compare the Modified Table of Allowances MTOE Table of Distribution and Allowances TDA or Joint Table of Allowance JTA with the property book 2 Check the property book and document register to determine the authorized quantity of the MTOE TDA or JTA are on hand or on request 3 Review the property book document register and document file to judge the condition of the records 4 Ensure hand receipt holders are in the unit that is assigned the property 5 Compare hand receipts with the property book to find the items not issue 6 Verify that there is a property book page for each property book item listed on th
345. patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown patient as necessary c Explain the procedure to the patient d Assist the patient onto the table 6 Notify the radiologist the patient is ready for fluoro CAUTION Inform the radiologist of any patient allergies handicaps or other conditions which may affect the study or the patient s safety 7 Assist the radiologist as directed 8 Measure the body part from the entry exit site of the central ray 9 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control pane 10 Position the overhead tube a Set the tube vertical perpendicular to the cassette bucky b Set the source to image distance SID to 40 inches 101 cm 3 183 STP 8 91P15 SM TG Performance Steps c Center the tube to the cassette d Adjust the conefield to 10 x 17 lengthwise 11 Place the cassette in the bucky lengthwise NOTE Use 14 x 17 for all views 12 Place the identification marker on the film NOTE Make sure the letter marker is within the conefield 13 Place the lead shielding across the patient s lap 14 Position the patient a PA view 1 Place the patient in the prone position 2 Position the midsagittal plane to the midline of the table cassette 3 Place the acromion processes 2 below the upper film border NOTE Patient s knees maybe flexed with soles of feet flat on the table for
346. permitted to remain in service because the part demonstrated is generally in the middle of the radiograph Performance Measures GO 1 Gathered the necessary materials and supplies 2 Set the control panel Bg 3 Placed the cassette the table top with the wire mesh on top of the 4 Positioned the overhead tube 5 6 Developed the exposed film 3 281 STP 8 91P15 SM TG Performance Measures GO 7 Placed the film on the illuminator 8 Checked the cassette for any signs of poor screen film contact Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BUSHONG STEWART C 3 282 STP 8 91P15 SM TG TEST FOR SECONDARY SCATTER RADIATION 081 823 0266 Conditions You have to conduct a scatter radiation test You have the assistance of additional personnel if required You will need a properly equipped X ray exposure with cassettes in various sizes letter markers lead shielding sandbags and positioning sponges Standards Placed the cassettes at proper distances to determine the amount of scatter radiation
347. plete the task These actions are listed in a GO NO GO format for easy evaluation Each evaluation guide contains a feedback statement that indicates the requirements for receiving a GO on the evaluation e References This section identifies references that provide more detailed and thorough explanations of task performance requirements than that given in the task summary description Additionally some task summaries include safety statements and notes Safety statements danger warning and caution alert users to the possibility of immediate death personal injury or damage to equipment Notes provide a small extra supportive explanation or hint relative to the performance measures 1 2 STP 8 91P15 SM TG 1 5 Soldier s Responsibilities Each soldier is responsible for performing individual tasks which the first line supervisor identifies based on the unit s METL The soldier must perform the tasks to the standards listed in the SM If a soldier has a question about how to do a task or which tasks in this manual or she must perform it is the soldier s responsibility to ask the first line supervisor for clarification The first line supervisor knows how to perform each task or can direct the soldier to the appropriate training materials 1 6 NCO Self Development and the Soldier s Manual Self development is one of the key components of the leader development program Itis planned progressive and sequential program followed by l
348. posed film with the patient s identification STP 8 91P15 SM TG GO performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 85 STP 8 91P15 SM TG X RAY THE WRIST 081 823 0109 Conditions You have a formal request for a radiologic examination of the wrist You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure the patient s jewelry is removed as necessary 2 Ensure the patient s sleeve is rolled up as necessary c Explain the procedure if applicable d Seat the patient facing the X ray table 4 Place the lead apron across the patient s
349. possible wrist trauma before routine series has been completed to evaluate for possible fractures of distal forearm and or wrist 1 Center the wrist to the appropriate 1 2 of the cassette 2 Flex the elbow 90 degrees 3 Ensure that shoulder elbow and wrist are on the same horizontal plane 4 Position the styloids parallel to the cassette and ulnar flex hand towards the ulna 5 Central ray directed towards the scaphoid 3 4 inch medial and 3 4 inch distal to the lateral styloid c Oblique view 1 Center the wrist on the appropriate 1 2 of the cassette 2 Flex the elbow 90 degrees 3 Ensure that shoulder elbow and wrist on the same horizontal plane 4 Adjust the metacarpal and styloid plane to form a 45 degree angle to the cassette 5 Central ray directed to midcarpal region d Lateral view 1 Center the wrist on the appropriate 1 2 of the cassette 2 Flex the elbow 90 degrees 3 Ensure that shoulder elbow and wrist are on the same horizontal plane 4 5 O Ensure the epicondyles are perpendicular to the cassette Supinate the hand 5 degrees to place the styloid processes perpendicular to the cassette 6 Central ray directed to midcarpal region 11 Immobilize the body part by placing a sandbag over the forearm if needed 12 Place the appropriate letter marker on the cassette 13 Tell the patient DO NOT MOVE 14 Make the exposure 15 Tell the patient RELAX and remove immobiliz
350. pressor and ventilator simultaneously switch positions g New Ventilator Check the casualty s carotid pulse for 5 seconds If present state There is a pulse and perform rescue breathing If not present state No pulse Tell the new compressor to give chest compressions New compressor Position the hands to begin chest compressions as directed by the ventilator h Ventilator Continue to give two breaths on each 15th upstroke of chest compressions and ensure that the chest rises Compressor Continue to give chest compressions at the rate of 100 per minute NOTE lf signs of gastric distension are noted do the following 1 Recheck and reposition the airway 2 Watch for the rise and fall of the chest 3 Ventilate the casualty only enough to cause the chest to rise CAUTIONS 1 Do not push the abdomen 2 If the casualty vomits turn the casualty the side clear the airway and then continue CPR NOTE lf the patient is intubated the ratio of breaths to compressions becomes asynchronous Give 100 compressions per minute with a ventilation rate of approximately 10 to 12 per minute 3 20 STP 8 91P15 SM TG Performance Steps 12 Continue to perform CPR as stated in the task standard NOTE The rescuer doing rescue breathing should recheck the carotid pulse every 3 to 5 minutes 13 When the pulse and breathing are restored continue to evaluate the casualty If the casualty s condition permits place him or he
351. push the X RAY button on the fluoro tower console to expose the film Performance Measures GO 86 1 Turned the console a Flipped the circuit breaker to the on position b Pushed the MAINS button on the power console 2 Properly set up the console for fluoroscopy a Pushed the button on the power console 3 252 STP 8 91P15 SM TG Performance Measures GO l b Pushed the SPOT FILM button on the power console c Selected the appropriate density according to the patient s size by pushing the corresponding DENSITY button on the power console Pushed the RESET AUTOTIMER button on the power console to reset the autotimer to zero e Selected the mA level by pushing the 200 LARGE SPOT button on the power console 3 Selected the appropriate fluoro time 4 Placed the table bucky at one end of the table 5 Rotated the conventional X ray tube away from the table and to the opposite side of the fluoro tower 6 Pulled the fluoro tower out by releasing the stop lock button and pulling towards self 7 Selected the proper film format on the fluoro tower console 8 Adjusted the digital fluoro screen so that the digital image could be viewed properly 9 Pushed the PREPARE button on the fluoro tower console to make exposure 10 Placed film in fluoro tower bucky and pushed the X RAY button on
352. quipment You will need radiography unit several sizes of radiographic cassettes loaded with digital imaging plates exam terminal computer computer terminal digital image plate processor and IP reader Standards Instructed new personnel on the use of computed radiography equipment without error Performance Steps 1 Show and discuss imaging plates IPs IPs replaced the film IPs are loaded automatically into the cassette by the image processor Minimize handling of imaging plates to prevent damage IPs must be loaded into the cassette so the bar code shows through the cassette bar code window This will match the plate s tube side with the cassette s tube side e Do not bend IPs f The IPs do not get exposed with light only radiation 2 Show discuss imaging plate holders cassettes a IP holders are built with the same dimensions as old film holders b IP holders do not have intensifying screens of any kind c Do not bend IP holders or place heavy weight pressure on them d Warped cassettes will not be accepted by the image processor 3 Demonstrate use of IP holders a Acquire the examination request for the next routine patient b Perform the examination as per routine 4 Demonstrate the use of the exam terminal computer a Using the mouse select worklist exams for today b Enter last four digits of the patient ID number SSN c Double click on the patient current examination d
353. r 1 full minute and evaluated the pulse 8 Recorded the rate rhythm strength and significant deviations from normal on the appropriate forms 5 Reported any significant pulse abnormalities to the supervisor immediately Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 48 STP 8 91P15 SM TG MEASURE A PATIENT S RESPIRATIONS 081 831 0010 Conditions You will need a watch and appropriate forms Standards Counted a patient s respirations for 1 full minute Identified any abnormalities in respiration rate depth rhythm pattern and quality Performance Steps 1 Count the number of times the chest rises in 1 minute Normal respirations for each age group are as follows NOTE The patient should not be aware that respirations are being counted If the patient is aware he or she often becomes tense and an accurate count becomes extremely difficult Adult and adolescent 11 14 years old 12 20 School age 6 10 years old 15 30 Preschooler 3 5 years old 20 30 Toddler 1 3 years old 20 30 Infant 6 12 months old 20 30 Infant 0 5 months old 25 40 g
354. r and Inventory DA FORM 581 Request for Issue and Turn In of Ammunition DA FORM 581 1 Request for Issue and Turn In of Ammunition Continuation Sheet Department of Army Pamphlets DA PAM 350 59 Army Correspondence Course Program Catalog 1 October 2002 Field Manuals FM 25 101 Battle Focused Training 30 September 1990 FM 4 25 11 First Aid for Soldiers 23 December 2002 FM 7 0 Training the Force 22 October 2002 Other Product Types DD FORM 1348 6 DOD Single Line Requisition System Document Manual Long Form DD FORM 792 Twenty Four Hour Patient Intake and Output Worksheet Soldier Training Publications STP 21 1 SMCT Soldier s Manual of Common Tasks Skill Level 1 1 October 2001 STP 21 24 SMCT Soldier s Manual of Common Tasks SMCT Skill Levels 2 4 1 October 2001 Special Texts Suggested Reading BASIC NURSING Rosdahl Textbook of Basic Nursing Edition Lippincott 1 August 1997 BONTRAGER KENNETH L Textbook of Radiographic Positioning and Related Anatomy 3rd Edition Mosby Year Book Inc 1 January 1993 BTLS FOR PARAMEDICS Campbell Basic Trauma Life Support for Paramedics and Other Advanced Providers 4th Edition Prentice Hall 1 August 1999 BUSHONG STEWART Radiologic Science for Technologists Physics Biology and Protection 5th Edition V Mosby Co 1 January 1993 CUSWORTH RITA J Quality Assurance in Diagnostic Radiology An Eight Step Methodology Multi Medial Pub Inc 1 January 1983 References 2
355. r in the recovery position See task 081 831 0018 CAUTION During evacuation CPR or rescue breathing should be continued en route if necessary When pulse and breathing are restored the casualty should be watched closely Evaluation Preparation Setup For training and evaluation a CPR mannequin must be used Place the mannequin face up on the floor One rescuer CPR two rescuer CPR or a combination of both see NOTE after step 10e can be evaluated If two soldiers are involved they will be designated as rescuer 1 and rescuer 2 Rescuer 1 will start in the chest compression position and will be the only one scored during performance of the task The evaluator will ensure that all aspects of the task are evaluated by indicating whether pulse is present and when the rescuers should change positions Brief soldier If two soldiers are involved tell them about their roles as rescuer 1 and 2 Ask rescuer 1 on what kind of surface the casualty should be positioned Then tell the soldier s to perform one rescuer or two rescuer CPR as appropriate Performance Measures GO 1 Positioned the casualty on a hard flat surface Properly positioned the hands during chest compressions Administered the correct number of chest compressions Gave the chest compressions the rate of 80 to 100 minute Administered the correct number of breaths Gave the breaths at the correct rate N O A
356. r rate and rhythm c Varies with the individual 2 Irregular intermittent any change from a regular beating pattern NOTE If a peripheral pulse is irregular or intermittent you should take a second pulse at the carotid femoral or apical site See Figure 3 2 3 46 STP 8 91P15 SM TG Performance Steps Temporal Carotid Apical Brachial Popliteal Posterior Dorsalis pedis tibial Figure 3 2 c Pulse strength 1 Strong or full pulse a Easy to find 0 Has even beats with good force 2 Bounding a Easy to find 0 Exceptionally strong heartbeats which make the arteries difficult to compress 3 Weak thready a weak and thin b difficult to find 4 Record the rate rhythm strength and any significant deviations from normal on the appropriate forms 5 Report any significant pulse abnormalities to the supervisor immediately 3 47 STP 8 91P15 SM TG Evaluation Preparation Setup While the soldier is palpating a pulse site you must palpate the corresponding site Specify which site the soldier is to palpate If the apical site is chosen either a double stethoscope or separate stethoscopes may be used A tolerance of plus or minus two beats will be allowed Brief soldier Tell the soldier to count evaluate and record the patient s pulse Performance Measures GO 1 Positioned the patient so that the pulse site is accessible Palpated the pulse site Counted fo
357. r use during inventory d Verify availability of facilities for layout equipment e Determine the date time and place of inventory f Identify personnel to assist in the inventory 2 Conduct a physical inventory IAW DA PAM 710 2 1 a Perform the following general actions for all inventories 1 Check with the next higher headquarters for any special instructions 2 Verify inventory by using DA Pam 25 30 that the current publications are available for use during inventory 3 Visually count and verify serial numbers of each item 4 Inform commander of inventory results 5 Report discrepancies to the accountable officer 6 Provide a copy of memorandum of inventory results to higher headquarters as required b Perform the following specific types of inventories 1 Conduct a receipt and issue of property inventory a Make sure the items are for your unit 0 Check the item to make sure it matches the description on the receipt document c Make sure the quantity received agrees with quantity recorded on the receipt document d Check end items for completeness e Check the serial numbers when items with serial numbers are received f Make a visual check of the condition of the items g Notify the PBO when serviceability of an item is questionable h Sign the receipt document after actions a through g above have been completed 3 310 STP 8 91P15 SM TG Performance Steps i When property is issued on hand su
358. ral projection the tube angle will be perpendicular to the film or cassette b Set the source to image receptor SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to full film coverage 1 2 of an 8 x 10 10 Position the calcaneus 3 121 STP 8 91P15 SM TG Performance Steps a Plantodorsal Axial projection 1 Patient supine or seated on the table 2 Leg fully extended 3 Center ankle joint to portion of cassette being used with the long axis of leg 4 Dorsiflex foot so the plantar surface is near perpendicular to the film NOTE Loop gauze then the belt around the foot and ask the patient to pull gently but firmly on the belt to bring the plantar surface as near perpendicular as possible 5 Direct central ray to the base of 3rd metatarsal 6 Angle central ray 40 degrees towards the heel b Lateral view 1 Patient in lateral recumbent position affected side down 2 Flex knee of affected limb about 45 degrees NOTE Place the opposite leg behind the injured limb 3 Adjust cassette to center calcaneus to portion of cassette being used with the long axis of the foot parallel to long axis of the film 4 Place support under knee and leg as needed to keep the plantar surface perpendicular to the film 5 Position ankle and foot for a true lateral which places the lateral malleolus about 15 20 degrees posterior to the medial malleolus 6 Dorsiflex foot so plantar surface is at r
359. rder c Decubitus view NOTE Place a positioning sponge below the patient 1 Patient in a lateral recumbent position with their back firmly against the film holder 2 Raise both arms above the patient s head to clear the lung fields 3 Flex the knees slightly and ensure that the coronal plane is parallel to the film with no body rotation 4 Adjust the height of the film holder to center thorax to the film 5 Adjust the patient to center midsagittal plane and T 7 to the central ray NOTE Acromion processes about 2 3 inches below the upper film border 6 Central ray horizontal perpendicular directed to the center of the film 11 Immobilize the patient as required 12 Place the appropriate letter marker on the cassette 13 Tell the patient TAKE IN A FULL BREATH BLOW IT OUT TAKE IN ANOTHER FULL BREATH AND HOLD IT 14 Make the exposure 15 Tell the patient RELAX AND BREATHE NORMALLY 16 Develop the exposed film with the patient s identification Performance Measures GO 1 Selected the required view s based on the request 2 Gathered the necessary materials and supplies Bg 3 Prepared the patient 3 145 STP 8 91P15 SM TG Performance Measures N A 10 11 12 13 14 15 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Me
360. res to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 218 STP 8 91P15 SM TG DISPLAY IMAGES FROM DIGITAL ARCHIVES 081 823 0177 Conditions You must display an examination that has been archived digitally in the Optical Disk Jukebox You will need on line computed radiography work station connected on line with an Optical Disk Jukebox and DIN PACS operating instructions Standards Displayed the correct examination and completed patient demographic information IAW DIN PACS Performance Steps 1 Open the Folder selection Menu Select appropriate Folder from the Folder menu Click on a Query Input field that applies to your search Type your search criteria in the Query Input field Select the off line examination oa A N Select Fetch Exam from the Images menu Performance Measures GO 1 Opened the Folder selection Menu Selected appropriate Folder from the Folder menu Clicked on a Query Input field that applies to the search Typed correct search criteria in the Query Input field Selected the off line examination eg Selected Fetch Exam from the Images menu Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the sol
361. rid ratios and screen cassettes Standards Calculated the exposure factors without error Performance Steps 1 Obtain the exposure factors including the grid ratios from the factor chart 2 Determine what grid ratio if any will be used 3 Calculate the correct factors if the grid ratio to be used is not the same as on the factor chart by using the appropriate formula See Figure 3 4 Grid Nongrid Conversion Formulas Ratio Nongrid to Grid 5 1 Add 8 kVp 1 5 mAs 6 1 Add 12 kVP or 2 0 mAs 8 1 Add 20 or 3 0 mAs 12 1 Add 23 kVP or 3 5 mAs 16 1 Add 25 kVp or 4 0 mAs Figure 3 4 Performance Measures 1 Obtained the exposure factors including the grid ratios from the factor chart 2 Determined what grid ratio if any will be used 3 Calculated the correct factors if the grid ratio to be used is not the same as on the factor chart by using the appropriate formula Grid to Nongrid Subtract 8 kVp Subtract 12 kVp Subtract 20 kVp Subtract 23 kVp Subtract 25 kVp 86 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 60 STP 8 91P15 SM TG DETERMINE EXPOSURE LIMITATION 081 823 0106 Conditions You have an
362. rned to the side 3 Position restraints to avoid causing further injury to a wound or interfering with IV lines catheters and tubes a Adjustable limb holders cuff and strap 1 Clean and powder the skin around the wrists and ankles if possible 2 Pad the limb with ABD pads or similar material 3 Position the restraint cuff over the padded limb 4 Thread the strap through the loop on the cuff Pull the straps snugly enough to restrict free movement of the limb NOTE If two fingers can be comfortably inserted under the cuff the restraint is snug enough The patient however must not be able to wiggle his or her hand out of the cuff 5 Wrap the strap around the bedframe 6 Lock the buckle and position it facing the outside of the bedframe for quick access 7 Repeat steps 1a 2 through 1a 6 for each limb NOTE The keys to the locked restraints must be readily available b Improvised restraints 1 Clean and powder the skin around the wrists and ankles if possible 2 Pad the limb with any soft cloth such as towels gauze cravats clean handkerchiefs or clothing 3 Secure the restraining material gauze or roller bandage to the limb with a clove hitch 4 Pull the knot to fit the limb snugly 5 Using a bow knot tie both free ends to the bedframe in a location inaccessible to the patient 6 Repeat steps 1b 2 through 1b 5 for each limb 2 Apply mitt restraints a Place the patient s hand in a naturally flexed p
363. ry the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 220 STP 8 91P15 SM TG ARCHIVE IMAGES TO OPTICAL DISK SYSTEM 081 823 0203 Conditions You must archive previously acquired images to optical disk storage for later necessary retrieval You will need on line digital work station optical disk storage system and DIN PACS operating instructions Standards Archived necessary images to optical disk storage without error IAW DIN PACS operating instructions Performance Steps 1 Open the Acquisition Folder from the Main selection menu Select Unarchived Images from the Folder menu Select a Query Input field that applies to your unarchived image search Type search criteria in the Query Input field Select image file intended for archival Select Save from menu Select intended folder to archive file for future acquisition N O A Verify newly archived is correct folder and available for acquisition Performance Measures GO 1 Opened the Acquisition Folder from the Main selection menu Selected Unarchived Images from the Folder menu Selected a Query Input field that applies to the unarchived image search Typed search criteria in the Query Input field Selected image intended for archival Selected Save from menu Selected inten
364. ry to obtain an accurate reading Performance Measures GO 1 Explained the procedure to the patient if necessary Selected the proper size of sohygmomanometer cuff Checked the equipment Positioned the patient Placed the cuff just tightly enough to prevent slippage fF Positioned the stethoscope if used 3 52 STP 8 91P15 SM TG Performance Measures GO 7 Inflated the cuff until the gauge read least 140 mm Hg 10 mm Hg higher than the usual range that patient if known 8 Determined the blood pressure 9 Recorded the blood pressure on the appropriate forms 10 Evaluated the blood pressure 11 Reported any abnormal readings to the supervisor Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 53 STP 8 91P15 SM TG MEASURE A PATIENT S TEMPERATURE 081 831 0013 Conditions You have performed a patient care handwash You will need disinfected mercury oral and rectal thermometers or an electronic thermometer canisters marked used water soluble lubricant gauze pads a watch and appr
365. s 9 Position the lumbar spine a AP view 1 Place the patient supine with the median plane perpendicular to and over the centerline of the table 2 Flex the knees with the soles of the feet flat on the table 3 Center the iliac crests to the cassette b Lateral view 1 Place the patient laterally recumbent with the knees flexed and arms at right angles to the body 2 Adjust the coronal plane perpendicular to and over the centerline of the table 3 Place radiolucent material under the lower dorsal region to bring the long axis of the spine parallel to the table 4 Center the iliac crests to the cassette c Lateral L 5 S 1 view 1 Place the patient laterally recumbent with the knees flexed and arms at right angles to the body 2 Adjust the coronal plane perpendicular to and over the centerline of the table 3 Place radiolucent material under the lower dorsal region to bring the long axis of the spine parallel to the table 4 Central ray directed to a point midway between the superior prominence of the iliac crest and the ASIS 10 Place the appropriate letter marker on the cassette 11 Place the lead apron across the patient s lap 12 Tell the patient STOP BREATHING AND DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the exposed film with the patient s identification Performance Measures GO Selected the required view s based on request
366. s You have a request for an X ray examination of the temporomandibular joints You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrate the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead apron c Letter markers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient is dressed in a gown if necessary c Explain the procedure if applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use an 8 X 10 cassette 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Angle the tube 25 to 30 degrees caudad b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassett
367. s None 3 262 STP 8 91P15 SM TG OPERATE CR PLATE READER 081 823 0327 Conditions You are a staff technologist in a radiology section and are required to operate a CR plate reader You will need a fully operational and on line CR plate reader Standards Prepared and operated CR plate reader for image plate processing IAW manufacturer directions and department SOP Performance Steps 1 Power on the CR plate reader a Ensure that the power light on the local panel is on b Wait for the processor to perform self diagnostic test and begin warm up cycle c Observe local panel to display Ready NOTE Images be acquired during warm up period but no printing will occur until ready message is displayed 2 Load image plate cassette into the CR reader NOTE Most CR plate readers will indicate when ready to process image plates on most cassette doors will open automatically a If the cassette door is not already open press the Open Door button on the local panel b Cassette door should open c Feed image plate cassette into the CR reader 1 Push cassette firmly but gently into the cassette entry door far enough for the cassette door to close behind the cassette or the feeding mechanism to grasp the IP cassette 2 Once the CR reader has processed the imaging plate the cassette door should open and the originally loaded cassette should be ready for removal and re use 3 Remove cassette from the CR reader Perfor
368. sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Tape Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary 3 Use a drape sheet to cover the patient as needed c Explain the procedure as applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size film cassette NOTE Use a 10 X 12 cassette for the sacrum views and 8 X 10 cassette for the coccyx views 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film except for the following views 1 AP sacrum
369. screens and cassettes were properly cleaned and reloaded with film Performance Steps 1 Lay out the cassettes to be cleaned on a table 2 Visually inspect the screens for cracks damage visible particles or anything that shouldn t be there NOTE Cassettes should be cleaned in a dust free environment and should be cleaned every quarter unless the amount of use is higher than normal Then cassettes may need to be cleaned monthly 3 Using a dust free cloth and screen cleaner carefully wipe the screens clean 4 Place the cleaned cassettes on their sides and allow 20 30 minutes for drying depending on the outside temperature NOTE The type of cleaner used should be recommended by the manufacturer and it would be very beneficial to have a cleaner that has an antistatic compound inherent in the solution 5 Once the screens are dry and free from particles and dirt reload the cassettes ina darkroom 6 Clean the outside of the cassettes with a cloth and cleaning solution The solution should have an antibacterial compound in it 7 Allow the outsides of the cassettes to dry before using them for a procedure Performance Measures GO 1 Laid out the cassettes to be cleaned on a table 2 Visually inspected the screens for cracks damage visible particles or anything that shouldn t have been there 3 Used a dust free cloth and screen cleaner and carefully wiped the screens clean 4 Placed
370. sing terminal Ensure that the processing terminal is on line and ready Scan the patient information barcode or select patient information from the acquisition work list to enter patient s imaging information Check the patient information to ensure that the correct plate is registered to the performed examination Register imaging plate information using plate barcode and scanner Insert radiographic cassette into plate reader Remove freshly loaded cassette Verify operation by selecting patient s exam at the examination workstation to validate complete image and information transfer from the acquisition work list to enter patient s imaging information Checked the patient information to ensure that the correct plate is registered to the performed examination Registered imaging plate information using plate barcode and scanner Inserted radiographic cassette into plate reader Removed freshly loaded cassette Verified operation by selecting patient s exam at the examination workstation to validate complete image and information transfer 3 261 STP 8 91P15 SM TG Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly Reference
371. sk summary the soldier must pass all Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette in the bucky lengthwise Positioned the overhead tube Positioned the temporomandibular joints Placed the appropriate identification marker on the cassette Placed the lead apron across the patient s lap 12 13 14 Gave the patient the pre post exposure instructions Made the exposure Developed exposed cassette s PTT TTT TTT Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly 3 75 STP 8 91P15 SM TG References Required Related None BONTRAGER KENNETH L 3 76 STP 8 91P15 SM TG X RAY THE ZYGOMATIC ARCHES 081 823 0142 Conditions You have a request for an X ray examination of the zygomatic arches You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performan
372. soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 91 STP 8 91P15 SM TG X RAY THE ELBOW 081 823 0111 Conditions You have a formal request for a radiologic examination of the elbow You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure the patient s jewelry is removed as necessary 2 Ensure the patient s sleeve is rolled up as necessary c Explain the procedure if applicable d Seat the patient facing the X ray table
373. st enter N for NMCS or E for ANMCS 12 Card column 65 66 Enter the proper advice code b Complete identification data section of DD Form 1348 6 Request for Issue for non NSN item 1 Block 6 Enter the type number date and page number of the authorizing publication 2 Block 7 Enter one or two words that describe the item requested 3 Block 8 Enter complete item description 4 Block 9 Enter end item application and other information if available c Record the DD Form 1348 6 in the appropriate document register d File one copy of DD Form 1348 6 in the due in status file e Forward the completed 1348 6 to the supporting SSA SOS 7 Prepare DD Form 1348 6 as a request for issue for an NSN item IAW DA Pam 710 2 1 a Complete the card column section of DD Form 1348 6 as a request for issue for an NSN item 1 Card column 8 20 Enter the NSN of the item requested 2 Card column 23 24 Enter the unit of issue 3 Card column 25 29 Enter the quantity requested 4 Card column 30 35 Enter the unit DODAAC 5 Card column 36 39 Enter the Julian date 6 Card column 40 43 Enter the serial number 7 Card column 44 Enter the demand code 8 Card column 54 56 Enter the proper EIC 9 Card column 57 59 Enter project code if assigned 3 298 STP 8 91P15 SM TG Performance Steps 10 Card column 60 61 Enter the priority designator 11 Card column 62 64 Enter RDD 12 Card column 65 66 Enter the proper a
374. st medium is being used and verify the expiration date 5 Prepare the equipment for fluoroscopy 6 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary c Explain the procedure if applicable d Assist the patient onto the X ray table e Take a scout radiograph f Show the radiograph to the radiologist NOTE The radiologist will determine if the procedure will be performed by viewing the radiograph CAUTION Inform the radiologist of any patient allergies handicaps or other conditions that may affect the study 7 Assist the radiologist as directed 8 Prepare the equipment for follow up radiographs a Measure the body part through the entry exit site of the central ray b Set the control panel 3 194 STP 8 91P15 SM TG Performance Steps 1 Consult the technique chart 2 Set the appropriate mAs and kVp on the control panel c Use a 14 X 17 cassette for all the views d Place the cassette in the bucky lengthwise e Place the identification marker on the film f Position the overhead tube 1 Set the tube angle 2 Set the FFD 3 Center the tube to the film 4 Adjust the conefield to 10 X 17 lengthwise g Verify the exposure factors 9 Position the patient for the follow up radiographs
375. sternum c Center the tube to the cassette d Adjust the conefield to full film coverage 9 Position the sternum NOTE Patient position can be erect or semi prone a RAO view 1 Place the patient in a semi prone position with right arm down by their arm 2 Oblique patient to their right side between 15 to 20 degrees 3 Align long axis of sternum to midline of x ray table and film 3 150 STP 8 91P15 SM TG Performance Steps 4 Place the cassette about 1 5 inches above the jugular notch 5 Center ray directed to center of film NOTE Midway between the jugular notch and the xiphoid process 6 Collimate to area of sternum b Lateral view 1 Patient will be erect standing or seated with shoulders and arms brawn back as far as possible 2 Place the median plane parallel to the wall bucky 3 Central ray midway between the jugular notch and xiphoid process 4 Collimate to four sides of the sternum 10 Place the appropriate letter marker on the cassette 11 Place the lead shielding around the patient s waist 12 Provide the breathing instructions a RAO view PLEASE DO NOT MOVE will continue normal breathing Lateral view IN DEEP BREATH HOLD IT AND DO NOT MOVE 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the exposed radiograph s with the patient s identification Performance Measures GO Selected the required view s based on t
376. stricting band NOTE When placing the constricting band ensure that the tails of the tubing are turned away from the proposed site of venipuncture 3 Apply the constricting band tight enough to stop venous flow but not so tightly that the radial pulse cannot be felt 4 Tell the patient to open and close his or her fist several times to increase circulation CAUTION Do not leave the constricting band in place for more than 2 minutes b Select a prominent vein NOTES 1 Wet the area with germicide to facilitate palpation of the vein with the fingertips Touch the distended vein with the fingertips and estimate tissue support 2 If the vein rolls select another vein c Tell the patient to close his or her fist and keep it closed until instructed to open the fist d Clean the skin over the selected area with 70 alcohol or betadine using a firm circular motion from the center outward e Allow the skin to dry and discard the gauze f Put on gloves for self protection against transmission of contaminants 6 Prepare to puncture the vein a Pick up the assembled needle and remove the protective cover with the other hand 1 Ensure the needle is bevel up 2 Place the forefinger on the needle hub to guide it during insertion through the skin and into the vein b Position yourself so as to have a direct line of vision along the axis of the vein to be entered 7 Puncture the vein 3 26 STP 8 91P15 SM TG Performance Steps CAUTI
377. sure there is no rotation to the head 6 Center cassette to acanthion 7 Collimation will be full film coverage b Lateral bilateral view 1 Place the patient in the prone position 2 Rest the lateral side of head against the table NOTE The side of interest should be place closest to the cassette 3 Position the nasal bone centered on the portion of the unused cassette 4 Adjust head into a true lateral position NOTE Oblique body as needed for patient s comfort Placing a positioning underneath the patient s torso help them maintain the position 5 Align midsagittal plane parallel to the tabletop Align interpupillary line IPPL perpendicular to the tabletop Position the infraorbitomeatal line perpendicular to the front edge of the cassette Center the central ray 1 2 inch inferior and posterior to the nasion Collimation will be 4 x 4 inch conefield 2 YS DB a 6 7 8 9 11 Place the appropriate identification marker on the cassette 12 Tell the patient DO NOT BREATHE OR MOVE 13 Make the exposure 14 Tell the patient RELAX AND BREATHE NORMALLY 15 Develop the exposed film with the proper patient identification Performance Measures GO 1 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the
378. t the drive Verify that the printer is online when the message prompt Ensure printer is online is displayed then press key Select Y or N to the message prompt Commander s Report Should Be Run Before Sending Transactions To Source of Supply Do You Wish To Continue 1 Selecting N returns you to the Send Transactions screen where you can then return to the Request Processes Menu to run the Commander s Reports 2 Selecting Y allows you to continue the process f Label a diskette g Insert the diskette into A drive h Format the diskette i Select the diskette volume label i 1 6 j Select Y or N to format another disk k Process the transactions Review the Send Supply Transactions Report m Process transactions for each DSU if necessary 4 Send transactions via communications a Select Send Trans Via Communications 6 Verify that the printer is online c Process the transactions d Review the Send Supply Transactions Report e Return to the Send Supply Transactions screen f Make disposition to the SSA 3 307 STP 8 91P15 SM TG Performance Measures GO 86 1 Determine authorization documents required to request supplies IAW AR 71 32 and AR 710 2 2 Select correct request form or method IAW DA Pam 710 2 1 and the ULLS 5 4 para 4 2 and 4 3 4 4 4 17 3 Process DA
379. t the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size film cassette NOTE Use 10 X 12 cassette for both views 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle vertical perpendicular to the film if the patient is supine or horizontal perpendicular if the patient is erect b Set the source to image receptor distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Position the scapula 3 101 STP 8 91P15 SM TG Performance Steps a AP view 1 Place the patient supine or erect with the arm of the side of interest abducted 90 degrees and hand supinated 2 Center the coracoid process over the centerline of the table 3 Place the posterior surface of shoulder in direct contact with tabletop without rotation of thorax 4 Position the patient so that the center point of the film is to mid scapula area which is 2 inferior to the coracoid process b Lateral view 1 Stand the patient upright facing the table 2 Place the arm of the affected side across the front of the body with the palm resting on the opposite shoulder 3 Palpate borders of scapula and rotate patient until the scapula is in a true lateral p
380. t to the index finger of the first hand e Remove the first hand from the notch and place it on top of the hand on the sternum so that both hands are parallel to each other NOTE You may either extend or interlace your fingers but keep the fingers off the casualty s chest 3 Position your body a Lock your elbows with the arms straight b Position your shoulders directly over your hands 4 Give 15 compressions a Press straight down to depress the sternum 1 5 to 2 inches b Come straight up and completely release pressure on the sternum to allow the chest to return to its normal position The time allowed for release should equal the time required for compression CAUTION Do not remove the heel of your hand from the casualty s chest or reposition your hand between compressions c Give 15 compressions in 9 to 11 seconds at a rate of 100 per minute 5 Give two full breaths a Move quickly to the casualty s head and lean over b Open the casualty s airway See task 081 831 0018 c Give two full breaths 1 5 to 2 seconds each 6 Repeat steps 2 through 5 four times 7 Assess the casualty a Check for the return of the carotid pulse for 3 to 5 seconds 1 If the pulse is present continue with step 7b 2 If the pulse is absent continue with step 8 3 19 STP 8 91P15 SM TG Performance Steps b Check breathing for 3 to 5 seconds 1 If breathing is present monitor breathing and pulse closely 2 If breathi
381. tal line IOML parallel to the table 5 Center the midpoint of the IOML to the cassette Ob b lique axial bilateral view TWHA 3 77 STP 8 91P15 SM TG Performance Steps 9 10 11 12 13 14 15 16 Performance Measures GO N oO A N 12 13 14 Selected the required view s based on the request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size cassette Placed the cassette in the bucky crosswise Positioned the overhead tube Positioned the zygomatic arches Placed the appropriate identification marker on the cassette Placed the lead apron across the patient s lap 1 Place the patient seated with back against the upright table 2 Adjust the vertex of the skull in contact with the table 3 Turn the head 15 degree towards the side to be examined Adjust the median plane to form a 15 degree angle to the table 4 Adjust the IOML parallel to the table 5 Center the midpoint of the IOML of the side nearest the table to the cassette Place the appropriate identification marker on the cassette Place the lead apron across the patient s lap Verify the exposure factors Tell the patient DO NOT BREATHE OR MOVE Make the exposure Tell the patient BREATH
382. tandards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free of artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Lead shielding c Letter markers d Cassette holder e Calipers 3 Prepare patient a Bring patient into room b Ensure the patient is dressed in a gown if necessary NOTE Remove all items from around the patient s neck as well as any removable dental work CAUTION Ensure that no movement of the cervical spine and head occurs while removing items c Explain the procedure to the patient 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Use the proper size cassette NOTE Use a 10 X 12 lengthwise grid cassette for the lateral and AP views 7 Place the cassette into the grid cap 8 Position the overhead tube a Set the tube perpendicular to the cassette NOTE Angle the tube 15 degrees cephalic for the AP view and horizontal perpendicular for the lateral view b Set the source to image receptor SID to 40 inches NOTE Increase SID to 60 72 inches for the lateral view if equipment and room space permits c Center the tube to the cassette d Adjust the conefield t
383. ter clean stethoscope and appropriate forms Standards Measured a patient s blood pressure and recorded the measurement on the appropriate forms Performance Steps 1 Explain the procedure to the patient if necessary a The length of time the procedure will take b The site to be used c The physical sensations the patient will feel 2 Select the proper size of sohygmomanometer cuff NOTE The cuff width should be two thirds of the upper arm length if using the brachial artery and two thirds of the upper leg if using the popliteal artery 3 Check the equipment a Ensure that the cuff is deflated completely and fully retighten the thumbscrew b Ensure the sohygmomanometer gauge reads zero NOTE Steps 2 3 and 4 describe the procedure for taking the blood pressure at the brachial site If the brachial site cannot be used measure the blood pressure using a larger cuff applied to the thigh The patient should be lying down preferably on the stomach otherwise on the back with one knee flexed Apply the cuff at mid thigh and place the stethoscope over the popliteal artery The remainder of the procedure is the same as for the brachial artery site 4 Position the patient a Place the patient in a relaxed and comfortable sitting standing or lying position NOTE A reading obtained from a standing position will be slightly higher b Place the patient s arm palm up at approximately heart level Support the arm so that it is r
384. the casualty on a long spine board NOTE If a spine board is not available utilize a standard litter or improvised litter made from a board or door A hard surface is preferable to one that gives with the casualty s weight a The log roll technique 1 Place the spine board next to and parallel with the casualty 2 Immobilize the casualty s head and neck using manual stabilization a Place your hands on both sides of the casualty s skull with the palms over the ears 0 Support the jaw mandible with the fingers c Maintain manual stabilization until the casualty has been placed on the spine board 3 Apply a cervical collar if available or improvise one See steps 2b 1 through 2b 5 4 Brief each of the three assistants on their duties and instruct them to kneel on the same side of the casualty with the spine board on the opposite side of the casualty a First assistant Place the near hand on the shoulder and the far hand on the waist 0 Second assistant Place the near hand on the hip and the far hand on the thigh c Third assistant Place the near hand on the knee and the far hand on the ankle 5 On your command and in unison the assistants roll the casualty slightly toward them Turn the casualty s head slightly keeping it in a straight line with the spine 6 Instruct the assistants to reach across the casualty with one hand grasp the spine board at its closest edge and slide it against the casua
385. the forearm You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sandbags lead shielding letter markers and various positioning sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies a Appropriate cassettes b Sandbags c Lead shielding d Letter markers e Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure the patient s jewelry is removed as necessary 2 Ensure the patient s sleeve is rolled up as necessary c Explain the procedure if applicable d Seat the patient facing the X ray table 4 Place the lead shielding across the patient s lap 5 Measure the body part through the entry exit site of the central ray 6 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 7 Select the proper size cassette NOTE Use 1 2 of a 14 x 17 cassette placing the AP and lateral views on the same cassette 8 Place the cassette lengthwise on the table 9 Position the overhead tube a Set the tube angle perpendicular to the film b Set the source to
386. the part 3 Adjust median plane perpendicular to the film 4 Fully extend the lower extremities with both feet and legs rotated 15 degrees internally 5 Place the sagittal plane 2 medial to the ASIS at its intersection with the transverse plane through the greater trochanter to the center of the film 6 Central ray perpendicular to the film b Axiolateral hip 1 Place the patient in a supine position 2 Shield gonads without obscuring the part 3 Flex and elevate unaffected leg to place thigh nearly vertical NOTE Ensure pelvis is not rotated 4 Place cassette in crease above the iliac crest and adjust parallel to femoral neck 5 Internally rotate the affected leg 15 20 degrees unless there is a possibility of fracture or pathology NOTE For the cassette to be parallel to the femoral neck there should be an angle of approximately 55 degrees between the cassette and the lateral aspect of the thigh 10 11 12 13 14 15 6 Central ray is horizontal perpendicular to the film Immobilize the body part as required Place the appropriate letter marker on the cassette Instruct the patient DON T MOVE AND DON T BREATHE Make the exposure Tell the patient RELAX AND BREATHE NORMALLY Develop the exposed cassette s with patient identification Performance Measures N O fF Selected the proper view s based request Gathered the necessary materials and suppl
387. the patient 3 Program scan parameters 4 Perform scan Performance Measures GO 1 Prepared scanner room 2 Positioned patient 3 Programmed scan parameters Bb 4 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References None 3 259 STP 8 91P15 SM TG OPERATE CR EXAMINATION TERMINAL 081 823 0325 Conditions You must operate examination terminal through the acquisition of digital computer images You will need on line digital work station and DIN PACS operating instructions Standards Operated examination station without error IAW DIN PACS operating instructions Performance Steps 1 oa Performance Measures GO N O A Opened the Folder acquisition selection Menu Selected appropriate search folder from the Folder menu Clicked a Query Input field that applies to the search Typed correct search the Query Input field Selected the off line examination Selected Fetch Exam from the Images menu Verified correct operation through the validation of correct image Open the Folder acquisition selection Menu Select appropriat
388. the patient study series or image to be sent with the left mouse button b Make sure the Zip drive is highlighted c Click on the flying envelope button to send the image s NOTE In the lower left part of the DI 2000 screen you will see Processing Image the Sending Image and then Done Sending Image NOTE When sending images to Zip drive remember that whatever you have highlighted in the patient window will be sent 3 265 STP 8 91P15 SM TG Performance Steps 6 Review images onto the laptop a Eject the Zip disk from the PC Zip drive b Take the Zip disk to the laptop and insert in Zip drive c Turn on the laptop NOTE The external Zip drive must be connected to the laptop via the USB port before turning on the laptop d To retrieve the images from the Zip drive left click the Dicom retrieve button and open the location for the Zip drive to select the image s NOTE The image s and patient data will transfer to the RV 2000 work list e Double click on the desired patient to view image s f Use the tools to manipulate the image s Performance Measures GO 1 Entered the new patient information 2 Scanned a plate 3 Reviewed the image s 4 Sent a patient study or series B 5 Reviewed image s on laptop Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier
389. the patient at least once every half hour for signs of distress and security of restraints WARNING The use of restraints has the following hazards 1 Tissue damage under the restraints 2 Development of pressure areas 3 Nerve damage 4 Injury or death in case of fire or other emergencies 5 Inability to effectively resuscitate a patient 6 Possibility of shoulder dislocations in combative patients or those with seizure activity 6 Change the patient s position at least once every 2 hours day and night Exercise the limbs through normal range of motion activities 7 Evacuate the patient if necessary Performance Measures GO 1 Applied wrist and ankle restraints as applicable Applied mitt restraints as applicable Applied sheet restraints as applicable Applied field expedient restraints as applicable Checked the patient Changed the patient s position Evacuated the patient if necessary FT Td tis N O A Did not cause further injury to the patient Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None EMERGENCY CARE 3 40 STP 8 91P15 SM TG TRANSPORT A CASUALTY WITH
390. the request for issue process 2 Class listing contains the repair part items that were requested through the request for issue process 3 Non expendable listing contains the non expendable items that were requested through the request for issue process 4 Listing of all records produces want list reports for the SSSC Class IX and non expendable items requested through the request for issue process Select any key after the message prompt Records Will Be Deleted If They Are Printed f Select console or printer at the Report Information screen 1 Select console in order to view the report on the monitor a View the desired want list report b Select lt ENTER gt to continue viewing the entire list report 1 2 3 4 U 5 6 7 3 ae es a 3 303 STP 8 91P15 SM TG Performance Steps g h 2 Select printer in order to generate a hard copy of the want list and to delete the printed records a Print the report 0 Review the report Exit to the Request Processes Menu Disposition instructions IAW local SOP 16 Produce the commander s report IAW ULLS S4 EM para 4 10 p 4 47 a 3 304 Select the Supply Menu from the 54 Main Menu screen b Select the Request Processes Menu C d Acknowledge system prompt Report May Never Be Rerun If Routed to Select the Commander s Report option Printer Select the method of output from the Rep
391. the system by switching the breakers on in the breaker box and pressing the power ON switch on the control panel 3 244 STP 8 91P15 SM TG Performance Measures 13 14 15 16 17 18 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Placed the foam pad on the table top Employing two people lifted the tube collimator transport fixture onto the head end of the table top Used the hex key to loosen and remove the transport brackets holding the vertical column to the column support Slid the vertical column toward the head end as far as it will go The column hinge should be at the bottom of the column Raised the tube column to the vertical position The tube column is hinged at the column base Installed the four bolts securing the base of the column to the longitudinal carriage Removed the four screws that fasten the column hinge to the longitudinal carriage Removed the small hinge securing screw Folded the hinge and secured it with the small screw Removed the eight screws that attach the two column transport supports to the base plate and removed the two column support Removed the tube arm mounting bolts from the vertical carriage Moved the column longitudinally toward the head end so that the transverse tube arm aligns with the vertical
392. the thermometer in place for the required time 1 Oral at least 3 minutes NOTE Leave digital thermometers in place until testing is complete The unit will normally have an audible tone 2 Rectal at least 2 minutes 3 Tympanic until an audible signal occurs and the patient s temperature appears on the digital display 4 Axillary at least 10 minutes 5 Remove the thermometer and wipe it down with a gauze square or discharge the protective plastic sheath 6 Read the scale 7 Put the thermometer in the proper used canister or dispose of the plastic sheath as appropriate 8 Record the temperature to the nearest 0 2 F the appropriate forms and report any abnormal temperature change immediately to the supervisor NOTES 1 The normal temperature range is Oral 97 0 to 99 0 F Rectal 98 0 to 100 0 F Axillary 96 0 to 98 0 F 2 Record an axillary temperature with an A on the patient s record Record a rectal temperature with an R on the patient s record Evaluation Preparation Setup To test step 1 for evaluation purposes create a scenario in which the patient s condition will dictate which site the soldier must choose Brief soldier Tell the soldier to measure evaluate and record a patient s temperature Performance Measures GO 1 Determined which site to use Selected the proper thermometer Explained the procedure and positioned the patient Measured the temperature
393. the waist up should be removed and the patient will wear a gown c Explain the procedure 4 Measure the body part at the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 14 X 17 cassette for both views 7 Place the cassette in an upright cassette holder lengthwise NOTE A moving or stationary grid may be used 8 Position the overhead tube a Set the tube angle horizontal perpendicular to the cassette b Set the source to image distance SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Place the lead shielding around the patient s waist 10 Position the decubitus chest 3 159 STP 8 91P15 SM TG Performance Steps a Lateral decubitus chest view NOTE Place a cardiac board or radiolucent pad under the patient 1 Place the patient in a lateral recumbent position with their back firmly against the film holder 2 Raise both arms above the patient s head to clear the lung fields 3 Flex the knees slightly and ensure that the coronal plane is parallel to the film with no body rotation 4 Adjust the height of the film holder to center thorax to the film 5 Adjust the patient to center midsagittal plane and T 7 to the central ray NOTE Acromion processes about 2 3 inches below the upper film border 6
394. tient into the X ray room b Ensure the patient removes all foreign objects 1 Glasses 2 Hair clips and or bows 3 Dentures c Explain the procedure d Seat the patient facing the upright X ray table or bucky 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use an 8 x 10 cassette for all views 7 Place the cassette in the bucky lengthwise for all views 8 Position the overhead tube a Set the tube angle perpendicular to the film NOTE Set tube angle 15 degrees caudad for the Caldwell view b Set the source to image receptor SID to 40 inches 101 cm c Center the tube to the cassette d Adjust the conefield to 6 x 6 coverage 9 Place the lead shielding around the patient s waist 10 Position the sinuses NOTE To allow free fluids and air to settle direct the patient to sit for several minutes a Caldwell view 1 Place the patient seated or standing with their nose and forehead in contact with the table or wall bucky 3 65 STP 8 91P15 SM TG Performance Steps 2 Place the median plane perpendicular to and over the centerline of the table 11 12 13 14 15 3 Adjust the orbitomeatal line OML perpendicular to the cassette 4 Project the nasion to the center of the cassette b Water s view 1
395. tion allowing the cuff to deflate slowly 3 Watch the gauge and remember the point at which the pulse returns systolic pressure NOTES 1 The diastolic pressure cannot be determined using this method 2 If the procedure must be repeated wait at least 1 minute before repeating steps 6 through 8 9 Record the blood pressure on the appropriate forms a Record the systolic reading over the diastolic reading for example 120 80 b Record the readings in even numbers 10 Evaluate the blood pressure reading by comparing it with one of the following a The patient s previous reading b An average of the patient s previous readings c The normal range 100 140 60 90 for males and 90 130 50 60 for females 11 Report abnormal readings to the supervisor Evaluation Preparation Setup A double stethoscope should be used if available A tolerance of 4mm Hg will be allowed If other methods are used such as independent measurements on different sites or at different times the evaluator must apply discretion in applying the 4 mm Hg standard You will allow the soldier to retake the blood pressure at least once if the soldier feels that it is necessary to obtain an accurate reading You will use discretion in allowing additional repetitions based upon the difficulty of obtaining a reading on the patient Brief soldier Tell the soldier to take a patient s blood pressure Tell the soldier that the blood pressure may be retaken if necessa
396. tion number and room ward number as appropriate c The infusion rate d The time and date the solution container was hung e Your initials 3 Place the label on the solution container 4 Prepare the timing label a Place a strip of adhesive tape vertically along the length of the solution container 0 Determine how long the solution container will last See task 081 833 0033 c Write on the tape the approximate times at which the solution level will reach the volume markings on the solution container d At the bottom of the label write the approximate time the solution container will be empty d Label the tubing 1 Place a strip of adhesive tape around the tubing leaving a tab 2 Write on the tab the date and time the tubing was changed e Record the information on the appropriate forms Nursing Notes Field Medical Card 1 The date and time the IV was initiated 2 The amount and type of solution 3 31 STP 8 91P15 SM TG Performance Steps 3 The infusion rate 4 The type and gauge of the needle catheter 5 The insertion site 6 The patient s condition 7 Your name f Record the amount of infusion on DD Form 792 if applicable 4 Replace the solution container only NOTE Change the solution container every 24 hours when running a slow infusion in which the container may not be depleted in 24 hours Perform a patient care handwash Select or prepare the new solution See task 081 8
397. to step 6 0 If the breath fails to go in go to step 4 d Bag valve mask BVM NOTE Supplemental oxygen can be given while using the BVM to increase oxygen concentration levels to 50 When BVM systems have a reservoir supply oxygen concentrations can reach almost 100 1 Insert an airway adjunct as needed 2 Select the proper size of mask 3 Position the mask on the casualty s face 4 Form around the ventilation port Use the third fourth and fifth fingers under the casualty s jaw to hold the mask in place NOTE The most difficult part of performing rescue breathing using a BVM is maintaining an adequate seal The American Heart Association recommends two rescuer BVM ventilation In this method one rescuer maintains a two hand seal while the other rescuer squeezes the bag 5 Squeeze the bag 6 Release pressure from the bag and allow the patient to exhale passively a If the chest rises and air goes in squeeze the bag again to give a second breath and then go to step 6 0 If the chest fails to rise go to step 4 e Flow restricted oxygen powered ventilation device CAUTION Use caution when using the FROPVD on patients with chest injuries Be careful not to force excess air into the stomach instead of the lungs This may cause gastric distention and vomiting Do not use on children 1 Follow the same steps to position and seal the mask as with the BVM 2 Push the trigger on the device once a If the chest ris
398. to the table 4 STP 8 91P15 SM TG Adjust the vertex of the skull even with the upper edge of the cassette Place the median plane perpendicular to and over the centerline of the table Adjust the orbitomeatal line OML perpendicular to the cassette Place the median plane perpendicular to and over the centerline of the table Adjust the infraorbitomeatal line IOML perpendicular to the front edge of the cassette 5 Place the midpoint between the external occipital protuberance EOP and the glabella over the centerline of the table 6 Adjust the vertex of the skull 2 inches below the upper edge of the cassette Place the appropriate letter marker on the cassette Place the lead apron across the patient s lap Tell the patient DO NOT BREATHE OR MOVE Make the exposure Tell the patient BREATHE NORMALLY AND RELAX Develop the exposed cassette s with patient identification for processing Performance Measures A Selected the required view s based on request Gathered the necessary materials and supplies Prepared the patient Measured the body part through the entry exit site of the central ray Set the control panel Selected the proper size of cassette Placed the cassette in the bucky lengthwise for the PA Chamberlain Towne CT views Position the cassette crosswise for the lateral view Positioned the overhead tube Positioned the skul
399. tral ray Set the control panel Used 14 17 cassette for both views Placed the cassette into the bucky lengthwise Positioned the overhead tube oOo ON DO Positioned the thoracic spine b Lateral view 10 Placed the appropriate identification marker on the cassette 11 Placed lead apron across the patient s lap 12 Gave the proper pre post exposure instructions 13 Made the exposure 3 172 STP 8 91P15 SM TG Performance Measures GO 86 14 Processed the film Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 173 STP 8 91P15 SM TG X RAY THE LUMBAR SPINE 081 823 0132 Conditions You have a formal request for a radiologic examination of the lumbar spine You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s wer
400. tral ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size cassette NOTE Use a 10 x 12 cassette 7 Place the cassette in the bucky crosswise 8 Position the overhead tube a Set the angle 15 to 30 degrees cephalad b Set the source to image receptor distance SID to 40 inches 101cm c Center the tube to the cassette d Adjust the conefield to full field coverage 9 Secure the lead shielding around the patient s waist 10 Position the clavicle for the AP view NOTE Patient can be erect or supine a Posterior surface of the shoulder be in contact with the tabletop without rotation of the body b Chin raised looking straight ahead c Center the clavicle to the center of cassette considering cephalic central ray angle 3 104 Performance Steps 11 12 13 14 15 Place the appropriate identification marker on the cassette STP 8 91P15 SM TG Tell the patient BLOW YOUR BREATH OUT AND HOLD IT OUT DON T BREATHE AND DON T MOVE Make the exposure Tell the patient RELAX AND BREATHE NORMALLY Develop the exposed cassette s with patient identification Performance Measures O N N i 12 13 14 Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must
401. try exit site of the central ray Set the control panel Selected the proper size of cassette Placed the cassette into the grid Positioned the overhead tube Placed lead apron across the entire pelvic area N A D Positioned the cervical spine PT TTT TT ITT Placed the appropriate identification marker on the cassette 3 166 STP 8 91P15 SM TG 12 Gave the proper pre post exposure instructions 13 Made the exposure 14 Developed exposed cassette s with the patient s identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all GO Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 167 STP 8 91P15 SM TG X RAY THE CERVICAL SPINE 081 823 0130 Conditions You have a formal request for a radiologic examination of the cervical spine You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with cassettes of various sizes sand bags letter markers and calipers Standards The radiograph s were of diagnostic quality and properly demonstrated
402. ty s nose while watching for the chest to rise and fall and listening and feeling for air to escape during exhalation NOTE may be necessary to open the casualty s mouth or separate the lips to allow air to escape 4 If the chest rises a Give a second full breath 0 Go to step 6 5 If the chest does not rise go to step 4 c Mouth to mask STP 8 91P15 SM TG Performance Steps NOTE The face mask is an important part of infection control to the rescuer Rescuer breaths are delivered to the casualty through the one way valve of the mask There is no direct contact with the casualty s mouth 1 Insert an airway adjunct as necessary 2 Place the mask on the casualty a Position the apex of the mask on the bridge of the nose 0 Place the base of the mask at the chin between the lower lip and the chin prominence 3 Create a seal while maintaining the airway a Place your thumbs over the top half of mask 0 Place your index and middle fingers over the bottom half of the mask c Use your fourth and fifth fingers to bring the jaw toward the mask 4 Take a deep breath and exhale into the mask NOTES 1 Remove your mouth from the valve to allow for exhalation 2 Some masks have oxygen inlets Providing supplemental oxygen significantly increases the concentration of oxygen delivered to the patient Oxygen concentrations can reach 50 when the flow is set to 15 LPM a If the breath goes in give a second breath and go
403. u f File reports IAW local SOP 3 302 STP 8 91P15 SM TG Performance Steps g Disposition instructions IAW local SOP 14 Prepare a request for issue post post IAW ULLS S 4 EM para 4 4 p 4 20 4 24 Select the Supply Menu from the S4 Main Menu screen Select the Request Processes Menu Select Post Post Request option Enter the NIIN Use FED LOG disk if item is not on the system catalog Add a catalog record if item is not on the system catalog or FED LOG NIIN FSC CAGE SCMC U PRICE Enter the SHRN Enter the component list number if applicable Enter the quantity Enter the ordinal Julian date Enter the document number sequence Enter the priority Complete the Request for Issue Higher Level Supply Data screen if required 1 Enter the RDD if not already completed 2 Complete all other entries as needed n Process the request o Post transactions to the appropriate document control register if the transaction is for manual posting Disposition instructions IAW local SOP 15 Produce want list reports IAW ULLS S4 EM para 4 5 p 4 25 4 26 a Select the Supply Menu from the S4 Main Menu screen b Select the Request Processes Menu c Select the Want List Report Option Menu d Select the desired want list report 1 SSSC listing contains the self service supply center items that were requested through
404. u will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Tape Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from the patient as necessary 2 Ensure the patient s clothing is removed as required NOTE Gown the patient as necessary 3 Use a drape sheet to cover the patient as needed c Explain the procedure as applicable d Assist the patient onto the X ray table 4 Measure the body part through the entry exit site of the central ray 5 Set the control panel a Consult the technique chart b Set the appropriate mAs and kVp on the control panel 6 Select the proper size film cassette NOTE Use a 14 X 17 cassette for both views 7 Place the cassette in the bucky lengthwise 8 Position the overhead tube a Set the tube angle perpendicular to the film b Set
405. uched anatomical area of the abdomen on the body icon on the Electroluminescent Touch Panel Touched the abdomen pel box Touched PROCEED WITH NEW STUDY Pressed ENTER TEXT key on keyboard 3 208 STP 8 91P15 SM TG Performance Measures a Typed patient information on display monitor b Pressed F1 Save Data Positioned patient for pilot scan Touched double edged box PROCEED TO PRE SCAN Touched double edged box READY FOR PILOT Pressed START button for Pilot After pilot image appeared pressed F8 PLAN STUDY a Positioned red cursor for first slice and pressed F1 FIRST Used theta ring to angle cursor if necessary b Positioned red cursor for last slice and pressed F2 LAST c Pressed F8 SAVE PLAN 10 Touched double edged box MOVE COUCH READY FOR SCAN 11 Pressed START after prompt on ELTP N 12 When plan is completed the boxes will return on the ELTP Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all GO l performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None CUSWORTH RITA J MOSS ALBERT A RADIOLOGY BRANCH SOP 3 209 STP 8 91P15 SM TG PERFORM COMPUTED TOMOGRAPHY CT EXAMINATION OF THE SPINE 081 823 0202 Conditions
406. uhl Germany Leadership 6H 300 A0630 AMSC Supt of Cbt Cas Humanitarian Missions 5 days SA TX Just in Time STP 8 91P15 SM TG e Determine risk assessment and identify safety concerns Analyze the risk involved in training a specific task under the current conditions at the time of scheduled training Ensure that your training preparation takes into account those cautions warnings and dangers associated with each task e Train each soldier Show the soldier how the task is done to standard and explain step by step how to do the task Give each soldier one chance to do the task step by step e Emphasize training in mission oriented protective posture MOPP level 4 clothing Soldiers have difficulty performing even the very simple tasks in an NBC environment The combat effectiveness of the soldier and the unit can degrade quickly when trying to perform in MOPP 4 Practice is the best way to improve performance The trainer is responsible for training and evaluating soldiers in MOPP 4 so that they are able to perform critical wartime tasks to standards under NBC environment conditions Check each soldier Evaluate how well each soldier performs the tasks in this manual Conduct these evaluations during individual training sessions or while evaluating soldier proficiency during the conduct of unit collective tasks This manual provides an evaluation guide for each task to enhance the trainer s ability to conduct year round hands on ev
407. ures GO 1 Selected the required view based on the request 2 Gathered the necessary materials and supplies 3 Prepared the patient 4 Measured the body part through the entry exit site of the central ray Bg 5 Set the control panel 3 116 N 10 11 12 13 14 15 Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all Selected the proper cassette size Positioned the overhead tube Positioned the foot a AP view b Oblique view c Lateral view Immobilized the body part as necessary STP 8 91P15 SM TG Placed the cassette on the table lengthwise Placed the appropriate letter marker on the cassette Placed the lead apron across the patient s lap Gave the proper pre post exposure instructions Made the exposure Developed the exposed film with the patient s identification GO Bg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related BONTRAGER KENNETH 3 117 STP 8 91P15 SM TG X RAY THE ANKLE 081 823 0118 Conditions You have a request for an X ray examination of the ankle You have the assistance of additional personnel if required You will need
408. valuation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None CUSWORTH RITA J MOSS ALBERT A RADIOLOGY BRANCH SOP 3 214 STP 8 91P15 SM TG PRINT CT IMAGES 081 823 0379 Conditions You have the requirement to print a computed tomography procedure You will need a fully equipped and functioning computed tomography suite Standards Printed CT images of diagnostic quality that properly demonstrated the body section requested The images were correctly identified and free from artifacts Performance Steps 1 Press F2 SEND from the Hyperlan Network Operations menu screen 2 Select study to be printed by pressing F3 SET MARK on study 3 Press F1 PROCEED to print Performance Measures GO 1 Pressed F2 SEND from the Hyperlan Network Operations menu screen 2 Selected study to be printed by pressing SET MARK on study 3 Pressed F1 PROCEED to print Bb Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly
409. w or different subhand receipt holder Select N if the modification request is not for a new subhand receipt holder Enter in a new priority if desired or accept the default priority Complete the Request for Modification Higher Level Supply Data screen if required 1 Enter the RDD if not already completed 2 Complete all other entries as needed i Complete other modification requests if required j Return to the Request Processes Menu 13 Prepare a request for follow up IAW ULLS S4 EM para 4 7 p 4 31 and 4 32 a Select the Supply Menu from the S4 Main Menu screen b Select the Request Processes Menu c Select the Request for Follow up Options Menu d Select the Manual Follow up option for individual document numbers 1 Enter in the document number the sign on DODAAC is filled in automatically 2 Verify that follow up action was completed Message prompt will state Follow up created or Document Number does not meet follow up requirements followed by an explanation why 3 Return to the Manual Follow up screen 4 Complete any additional follow up requests 5 Return to the Request for Follow up Options Menu e Select the Automated Follow up option 1 Review the results of the follow up process at the bottom of the Follow up Options Menu 2 Select Y or N to print the automated Follow up Report 3 Select Y to print the automated Follow up Report 4 Return to the Request Processes Men
410. with the table 3 Rotate the arms internally with the palms of the hands facing outwards resting on the hips 4 Place the acromion processes 3 below the upper edge of the cassette blique view above RPO LPO RAO and LAO 1 Place the patient upright 2 Rotate the coronal plane to form a 45 degree angle with the table 3 Move the arms away from the sides of the body 4 Center the point between the midsagittal plane and the lateral surface of the affected side of the body to the cassette 5 Place the acromion processes 3 below the upper edge of the cassette c AP view below 1 Place the patient upright with the median plane perpendicular to and over the centerline of the table 2 Place the back in contact with the table 3 Move the arms away from the side of the body 4 Place the iliac crests 1 above the lower edge of the cassette d Oblique view below RPO and LPO 1 2 3 4 b O Place the patient upright Rotate the coronal plane to form a 45 degree angle with the table Center the trunk to the table Place the iliac crests 1 above the lower edge of the cassette 10 Place the appropriate identification marker on the cassette 11 Place the lead shield around the patient s waist 12 Provide breathing instructions a Above the diaphragm TAKE IN A FULL BREATH AND HOLD IT DO NOT BREATHE OR MOVE b Below the diaphragm BLOW YOUR BREATH OUT AND HOLD IT DO NOT BREATHE OR MOVE
411. x MOVE COUCH READY FOR SCAN Press START after prompt on ELTP When plan is complete the boxes will return on the ELTP 185 ELTP Electroluminescent Touch Panel Pressed ENTER TEXT key on keyboard a Typed patient information on display monitor b Pressed F1 Save Data Positioned patient for pilot scan 3 206 Pressed START button for Pilot N STP 8 91P15 SM TG Touched double edged box PROCEED TO PRE SCAN Touched double edged box READY FOR PILOT After pilot image appeared pressed F8 PLAN STUDY a Positioned red cursor for first slice and pressed F1 FIRST Used theta ring to angle cursor if necessary b Positioned red cursor for last slice and pressed F2 LAST c Pressed F8 SAVE PLAN 9 Touched double edged box MOVE COUCH READY FOR SCAN 10 Pressed START after prompt on ELTP 11 When plan is completed the boxes will return on the ELTP Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all GO eg performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required None Related CUSWORTH RITA J MOSS ALBERT A RADIOLOGY BRANCH SOP 3 207 STP 8 91P15 SM TG PERFORM UNENHANCED COMPUTED TOMOGRAPHY
412. xit site of the central ray Set the control panel Selected the proper size film cassette Placed the cassette in the bucky lengthwise Positioned the overhead tube Positioned the abdomen N A D Placed the appropriate identification marker on the cassette Placed the lead shield across the patient s lap Gave patient the pre post exposure instructions PTT TTT TT Made exposure 3 154 STP 8 91P15 SM TG Performance Measures GO 86 14 Developed the exposed film with the patient s identification Evaluation Guidance Score each soldier according to the performance measures the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 155 STP 8 91P15 SM TG X RAY DECUBITUS ABDOMEN 081 823 0216 Conditions You have a formal request for a radiologic examination of the decubitus abdomen You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic qual
413. xposure 14 Processed the exposed film Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 111 STP 8 91P15 SM TG X RAY TRAUMA SHOULDER 081 823 0220 Conditions You have a formal request for a radiologic examination of the shoulder that has had serious trauma You have the assistance of additional personnel if required You will need a properly equipped X ray exposure room with various sizes of film in cassettes sandbags lead apron letter markers calipers and various sponges Standards The radiograph s were of diagnostic quality and properly demonstrated the requested body part The radiograph s were correctly identified and free from artifacts Performance Steps 1 Select the required view s based on the request 2 Gather the necessary materials and supplies Appropriate cassettes Radiographic film Sandbags Letter markers Positioning sponges Lead shielding Calipers 3 Prepare the patient a Bring the patient into the X ray room b Ensure the patient is properly dressed 1 Ensure foreign objects are removed from patient as necessary
414. y Prepared the patient Notified the radiologist the patient was ready for fluoro 6 7 8 Assisted the radiologist as directed 9 Prepared the equipment for follow up radiographs 0 10 Positioned the patient the follow up radiographs 3 187 STP 8 91P15 SM TG Performance Measures GO NO GO a PA view b Lateral view c RAO view 11 Gave the patient the pre post exposure instructions 12 Made the exposure 13 Developed the exposed film with the patient identification Evaluation Guidance Score each soldier according to the performance measures in the evaluation guide Unless otherwise stated in the task summary the soldier must pass all performance measures to be scored GO If the soldier fails any step show what was done wrong and how to do it correctly References Required Related None BONTRAGER KENNETH L 3 188 STP 8 91P15 SM TG ASSIST PHYSICIAN WITH SMALL BOWEL SERIES 081 823 0146 Conditions You have received a formal request for a small bowel series You have the assistance of additional personnel if required You will need a properly equipped radiographic fluoroscopic exposure room with the correct contrast medium and various sizes of film in cassettes Standards The radiographs will be of diagnostic quality and will properly demonstrate the requested body part The radiographs were correctly identified and free from artifacts Performan
415. y Training and Evaluation Program The Army s collective training program that establishes unit training objectives critical to unit survival and performance in combat They combine the training and the evaluation process into one integrated function The ARTEP is a training program and not a test The sole purpose of external evaluation under this program is to diagnose unit requirements for future training ARNG Army National Guard ARTEP Army Training and Evaluation Program ASI additional skill identifier ASIS anterior superior iliac spine AVPU alertness responsiveness to vocal stimuli responsiveness to painful stimuli unresponsiveness Battle focus A process to guide the planning execution and assessment of the organization s training program to ensure they train as they are going to fight BVM bag valve mask CBRNE chemical biological radiological nuclear and high yield explosive Chemical Corps cubic centimeter CF correction factor Glossary 1 STP 8 91P15 SM TG CIF central issue facility cm centimeter s Chemical Collective training Training either in institutions or units that prepares cohesive teams and units to accomplish their combined arms and service missions on the battlefield Common task A critical task that is performed by every soldier in a specific skill level regardless of MOS COMSEC communications security CONUS continental United States CPR cardiopulmon

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