Presence of a localising marker in radiography for presence of foreign bodies.
The correct identification and localisation of a foreign body in a soft tissue wound can be difficult [1,2,3 ]. Several factors help with their identification on radiographs. One of these is the presence of an opaque localising marker placed adjacent to the site of injury, so as to be visible on the radiograph.
The Cycle
All radiographs that are obtained in order to identify a possible soft tissue foreign body should have a localising marker adjacent to the site of injury / puncture wound.
100%
Assess local practice
Percentage of radiographs which have a localising marker adjacent to the site of injury /puncture wound.
- Use RIS/PACS to identify films performed for localisation of a foreign body
- For each radiograph, record whether or not an opaque localising marker is visible
The last 100 radiographs for which the clinical request was for the identification of a possible soft tissue foreign body.
- Present the audit results to radiographers and radiologists, discuss technique and circulate written recommendations on methods
- Ensure there is a copy in the ED Radiology Department
- Make sure suitable opaque markers are available within the department
- Carry out the subsequent audit with the assistance and involvement of the radiography staff and referring Emergency Department Physicians and Emergency Nurse Practitioners.
• RIS-PACS for Radiograph requests • Image review
• Radiographers and audit staff
• Radiologists (or radiographers): 4 hours total
Royal College of Radiologists. RCR iRefer Making the Best Use of Clinical Radiology, 8th edition. London: RCR, 2017. https://www.irefer.org.uk/
Remedios D et al. Imaging foreign bodies. Imaging 1993;5:171–9.
Raby N, Berman L, de Lacey G. Accident and Emergency Radiology. A Survival Guide. London: WB Saunders, 1995:208–15.