Preparation for the procedure

2. Mobile X-ray equipment & Image detector

Prior to undertaking the mobile X-ray examination, the radiographer / RT must select an appropriate mobile X-ray unit and image receptor.  Most radiology departments will utilise either digital radiography (DR) or computed radiography (CR) systems.  In some jurisdictions mobile radiography may still be undertaken using film-screen based systems but these are likely to be a relatively limited number of decreasing cases.  Selection of the most appropriate X-ray unit and image receptor will depend on several factors.  These will include equipment availability, location, infection control issues and local protocols. Where available mobile radiography should ideally be undertaken using a DR unit, this will allow review of the resultant image at the patient’s bedside and the opportunity for immediate repeat imaging.  Such repeats could be due to technical reasons or the relocation of medical devices, for example endotracheal or nasogastric tubes (Figure 3).  Prior to undertaking a mobile X-ray examination, it is important to ensure that the mobile machine is adequately charged, fully functioning, contains the necessary ancillary items and has been cleaned to locally accepted standards.  A full list of items required for undertaking mobile examinations can be found in Table 3.  As a result of the COVID-19 pandemic it is likely that mobile X-ray units will be segregated for COVID-19 and non-COVID-19 cases.  This may require relocation of units to different parts of the hospital.  In such circumstances it is important to minimise the movement of X-ray equipment between segregated areas.

Table 3. Ancillary equipment required for mobile radiography
Full length lead rubber apron or equivalent (x2)
DR detector OR CR imaging cassette OR X-ray film cassette (of correct size)
Protective covers for the image receptor / mobile X-ray unit
Key or password to access mobile machine
Lead lined backstop
Appropriate cleaning wipes
Additional PPE, this may be provided on access to clinical areas

Figure 3.Mobile AP semi-erect chest X-ray in a COVID-19 patient with a misplaced naso-gastric tube (NGT). In the centre of the image the NGT can be seen looped within the oesophagus. When using mobile DR units, such systems can allow the referrer to immediate relocate the NGT prior to removal of the image receptor or the radiographer / RT leaving the ward. Image courtesy of Dr Nick Woznitza, London.