I Can No Longer Tell Left From Right
Just over three years ago, in a lecture shortly before our first clinical placement, we were given three vital radiographical items: our uniforms, a dose badge, and a set of markers. Three weeks into my first post, and I’m now devoid of all three.
My uniform is currently on order, and may not arrive for a few months (some staff members have been waiting since August) so I’m still mooching around in my student tunics; luckily there are no Portsmouth students at Trogdor’s so it doesn’t look too awful. My dose badge (this measures the amount of radiation we’re exposed to) is also on its way. And yesterday, I made a terrible mistake which has led to a painful loss…
An essential part of any radiographer’s inventory is a set of markers. X-ray images are 2D representations of 3D structures, and as such it isn’t always possible to be 100% certain what orientation the image is supposed to be in; looking at a chest x-ray you could be fairly sure that the heart is on the left hand side, but conditions such as dextrocardia remove any certainty. Extremity images (such as knees, hands, feet etc) can be very easily flipped by the processing software, making distinguishing left and right nearly impossible. This has huge medical and legal implications (you may have heard horror stories about surgeons amputating the wrong leg; improperly reported x-rays can contribute to these disasters) and as such, it is a legal requirement to physically denote which side of the body is which. We do this using markers: a simple L and R made out of metal which can be placed on the patient or the imaging cassette.
My markers and I went through a lot together, and as such we were parted several times, but until yesterday we were always reunited. My R frequently visited many a ward after being taped to an in-patient, and I once had a patient return to the department after discovering my L stuck to her hip whilst getting into her car. For these reasons (and others) I stopped using tape to secure my markers, and instead I chose to attach them to each end of a disposable tournequet; some people use ribbon but I personally find this a bit grim as it’s difficult to clean and ribbon is quite slippery, a problem when you’re hanging it over a wall stand. The tournequet is rubbery so it stays put, can be wiped down in between patients, and can be easily replaced when it gets soiled.
But yesterday I made a mistake. It was my first day in theatre so I wore scrubs instead of my tunic; and at the end of the day I was tired and had broken my routine so I put the scrubs into the laundry bin and went home, forgetting that my precious markers were in the pocket. This morning upon opening my locker the terrible realisation dawned on me… But it was too late.