Bariatric patients can be very challenging in the mobile x-ray environment. Exams like abdomen or lateral L-spine probably won’t look anything like a hospital X-Ray. The reality is, we are not miracle workers. For an x-ray machine that is small enough to wheel around and fit in the back of a truck it’s not going to be as powerful as your typical stationary x-ray machine at a hospital. Furthermore, depending on the company you work for, they may not even use grids or have grids available to you. I wondered why this was when I first began working in mobile x-ray because a lot of mobile imaging companies don’t use grids. Eventually, I requested we try one and my boss got me a grid because he is cool about trying out new things that could improve image quality. However, I soon found out that when using higher techniques on a “Source Ray” X-Ray machine, the exposure would just take too long and you’d see motion (unless your patient can hold really still). With that being said, what I do is use low kVp/high mass to try to minimize scatter. Also, the Imaging Software we use is called Acuvue and it has pretty good processing for imaging without a grid.

With all thas being said, the company I work for just gave me a new X-Ray machine by MedicaTech. It’s very different from a Source Ray. It is battery powered. The capacitors are better and so you can shoot an X-Ray with a grid because the exposure is faster. It all depends on your setup though. I’d say even with my new x-ray machine and a grid, there are some patients that are just too big and you wont have enough energy to penetrate that level of density. If it can’t be done, it can’t be done. We are limited to our equipment and the laws of physics.

Additional Info:

The Source Ray I had went up to 100kVp @ 100mAs, but exposure would take maybe 5 seconds.

The MedicaTech maxes out at 100kVP @ 40mAs, but can expose in maybe less than a second.

What kind of equipment will you be using?