Social distancing with portable chest radiographs during the covid-19 pandemic: Assessment of radiograph technique and image quality obtained at 6 feet and through glass

Abstract

Purpose: To develop a technique that allows portable chest radiography to be performed through the glass door of a patient’s room in the emergency department. Materials and Methods: A retrospective review of 100 radiographs (50 [mean age, 59.4 years 6 17.3; range, 22–87 years; 30 women] performed with the modified technique in April 2020, randomized with 50 [mean age, 59 years 6 21.6; range, 19–100 years; 31 men]) using the standard technique was completed by three thoracic radiologists to assess image quality. Radiation exposure estimates to patient and staff were calculated. A survey was created and sent to 32 radiography technologists to assess their perceptions of the modified technique. Unpaired t tests were used for numerical data. A P value < .05 was considered statistically significant. Results: The entrance dose for a patient with a body mass index in the 50th percentile was the same between techniques, measuring 169 µGy. The measured technologist exposure from the modified technique assuming a 50th percentile patient and standing 6 feet to the side of the glass was 0.055 µGy, which was lower than standard technique technologist exposure of 0.088 µGy. Of the 100 portable chest radiographs evaluated by three reviewers, two reviewers rated all images as having diagnostic quality, while the other reviewer believed two of the standard images and one of the modified technique images were nondiagnostic. A total of 81% (26 of 32) of eligible technologists completed the survey. Results showed acceptance of the modified technique with the majority feeling safer and confirming conservation of personal protective equipment. Most technologists did not feel the modified technique was more difficult to perform. Conclusion: The studies acquired with the new technique remained diagnostic, patient radiation doses remained similar, and technologist dose exposure was decreased with modified positioning. Perceptions of the new modified technique by frontline staff were overwhelmingly positive.