VISIONS

March 2005

Staff Development Newsletter

Quinsigamond Community College

 

Editor: Erica Merrill

Layout & Design: Erica Merrill

This month's issue:

Special Feature: "Babies Born in QCC Dental Lab" by Karen Kaletski Dufault

"Yankee Dental Congress" by Joyce Cooney

"Fundamentals of Digital Imaging for Instructors & Faculty" by Linda LeFave

 

Questioning E.M. 71480

“Where lies poetry?” you ask so nonchalantly, 

while examining the dirt under your fingernails,

and ripping away that annoying little hangnail

by your left thumb.  “So, where lies poetry?” 

I don’t know.  In lots of things, I guess.

In your heart, in your head, in pleasure and in pain.

In love and laughter, tears of joy and sadness. 

In spoken words and awkward silence. 

Search your inner being; I know poetry lies there

with all your feelings and emotions,

your vivid imagination and real-life experiences.

Maybe poetry is in every human, everywhere.

Does that make sense?  No?  Fine! 

Let me pick your brain (while you pick someone else’s).

There’s something poetic about good and evil, right?

Am I right?  Or am I crazy?

But there’s poetry in insanity, too, right?

“Much madness is divinest sense.”*

Right?  Am I right?  Or am I wrong?

No matter.  Where was I?  Oh right!

Do you want to find where poetry lies?

Go out into nature.  Go look under a rock,

or in the sky, see fluffy bunny shapes in the clouds.

Kiss a golden butterfly’s wings as it lands on a flower.

Look directly at the blinding light of the sun,

(but don’t kill your corneas),

or try to catch a moonbeam in your hand.

Roll around in the muddy grass.  It’s fun – really!

Go climb a tree by the side of the road;

pretend you’re one of the Von Trapp children

from The Sound of Music.

Then, watch the autumn leaves falling all around you, swirling in a dizzying dervish,

or just stand completely still in a moment.

I know poetry lies there.

Or get some exercise.

Chase a falling star.  Go jump in a lake.

Dive into the ocean.  Wade through a river.

Listen to the babbling of a brook.

Or listen to my own babbling,

(I know poetry lies there).

Or keep cleaning the dirt from your fingernails,

And keep ripping away those pesky hangnails,

(I know poetry lies there).

What was that?  Oh, you don’t think that

I answered your question.

Then go ask a poet.  (Oh wait, you just did).

Then fine, go jump in a lake.  Find poetry there.

Answer your own . . . question.

 

Happy Spring, everyone!

 

*Note to English Professors – you may resume your sniggering now at this loony girl’s obsession with E.D.

 

Special Feature

Babies Born in QCC Dental Lab

By: Karen Kaletski Dufault

A day in the life of a respiratory therapist is never dull.  In my twenty-five years in this business called Respiratory Care, I have worn many hats.  I have worked in both the adult and neonatal critical care arenas.  I even mastered the intricacies of sleep disordered breathing when I specialized in sleep medicine.  I have managed airways, used a variety of highly sophisticated equipment to support ventilation, obtained arterial blood gas samples, and have even had the opportunity to save premature infants as part of a Neonatal Intensive Care Team.  Some of my Respiratory Care colleagues are employed by smoking cessation programs, sleep laboratories, asthma clinics and pulmonary rehabilitation facilities.  Respiratory Therapists are the unsung heroes of the medical profession . . . they are the specialists who are sometimes called upon to save a life . . . or two.

Monday, March 21st started off routinely enough.  We had just returned from spring break and a group of staff and faculty had gathered in Krista Lajoie’s office to chitchat about our vacations.  As part of this conversation, Jane Gauthier, Coordinator of Dental Hygiene, announced that kittens had been born in the lab.  Apparently, an open window lured an inquisitive, pregnant cat that hoped to find a cozy area to give birth.  Being a curious lot, Jane June, Jane Gauthier, Denise Urella, Krista and I decided to check out the new arrivals.  What we expected to find was a female cat, content, warm and comfortable in a box, surrounded by beautiful, suckling kittens.  Unfortunately, what we found was far from the serene sight we had so mistakenly pictured.

When we entered the lab, mom cat was nowhere to be found.  What we did see were four small, kittens in the bottom of a cabinet, on a cold, hard, tile floor.  Although three of these babies were fairly vigorous and screaming loudly, another lay lifeless next to her siblings.  The respiratory therapist in me jumped into action.  I politely moved the Dental Hygiene staff aside (as they stood with hands on hips, sadly shaking their heads, announcing that one of the babies appeared to be dead), and immediately assessed the situation at hand.  Although I did not see any respiratory effort, I did see a slight move of her tongue and realized that this smallest kitten was still alive.  My adrenaline kicked in and I remembered my days as a therapist in the Neonatal Intensive Care Unit.  After all, cats are mammals too.  How different could it be??  AIRWAY! BREATHING! CIRCULATION!  These were the words that kept running through my head as I picked up this cold, lifeless feline.  Since I knew that hypothermia could be deadly, I did the best I could to warm her stiff body (had rigor mortis already set in?).  I gently opened her mouth with my finger, and began to vigorously rub her torso, hoping that this tactile stimulation would get her to take some breaths.  My plan had worked.  She was breathing!  She was also beginning to move around.  At this point, I handed the tiny kitten over to Charlotte Santimaw, the clinic manager.  “Here . . . try to keep her warm . . . and keep rubbing her . . . that will stimulate her to breathe.”  I became a woman possessed and on a mission.  I needed to check the cabinet floor for more babies.  My hunch paid off.  When I removed an egg crate mattress, another lifeless kitten fell to the ground.  Once again, I put my resuscitation skills to work and after a few minutes, this baby also began to breathe.

Now we were challenged to find the means to keep these newborns alive and warm.  As we tried to brainstorm ways to produce heat (eliminating the obvious ones like using the microwave . . . who suggested that anyway???), an astute Dental Hygiene student suggested that we fill rubber gloves with warm water.  Genius!  Why hadn’t I thought of that??  We combined several of these water-filled medical gloves to make a giant hot water bottle for our new charges.  It did the trick!  All five responded beautifully.  Their breathing stabilized and they became more active, letting us know by their boisterous meows that they were very, very hungry.

With a team effort, led by Krista and Denise, the mother cat was captured with a Have-A-Heart trap, which was donated by the local Animal Rescue League.

These kittens, two males and three females, all double-pawed, have been affectionately named Floss, Flora, Chip, Rooter and Gumby in honor of their place of birth.  They will be spayed/neutered, dewormed, vaccinated and available for adoption by May 16th.  If you are interested, please call Jen at the Gardner Animal Care Center, 978-632-7110.

Perhaps when these kittens are older, our dental hygienists can volunteer to clean their teeth, but for now, at least two of these felines are lucky that a respiratory therapist was there to give them a jump-start on life.

Have you hugged your Respiratory Therapist today?  You never know when you may need one!

 

Yankee Dental Congress

By: Joyce Cooney

I attended the Yankee Dental Congress, YDC30, in Boston on Friday, January 28th and Saturday, January 29th.  The Yankee Dental Congress is one of the premier dental meetings in the country.  It is truly an outstanding educational meeting for dental professionals.  Along with viewing the thousands of exhibits and informational booths at the Hynes Exhibit Hall, I also took a course in radiology.

The course objectives included ways to minimize patient and operator radiation exposure, technique principles for patient management, and reducing exposure and placement errors.

The course was divided into 4 sections.  At the first section, the presenters covered intraoral techniques, and also panoramic radiography was stressed.  This was a very informative section of the course.  The content that was covered included optimal techniques for panoramic images, criteria for a diagnostic panoramic, information about the focal trough, patient positioning, patient preparation, and processing procedures.

The third part of the course included panoramic errors such as midsagittal, anteroposterior, and occlusal plane.  Also, this section, which I found very helpful, covered patient preparation errors, exposure errors, and processing errors.

The fourth section of the course was very informative and useful, as it was a hands-on activity.  They had x-ray machines that were used by the participators to practice their techniques and view x-ray boxes to identify common technique errors.

On the whole I found the course to be very informative and interesting.  However, I was disappointed that the presenters did not offer a hands-on experience in the panoral technique.

 

Fundamentals of Digital Imaging for Instructors & Faculty

By: Linda LeFave, RT(R)(M)(QM)

The profession of radiologic technology has exploded in recent years, owing to the equally dramatic growth in technology, computer information systems, and the Internet.  Just as photography has moved away from the use of film as its primary medium towards the more versatile digital format, so too has much of radiologic technology. 

The introduction of computer systems to collect data (in the form of transmitted radiation, to then be reconstructed into an electronic image and eventually stored in an electronic format) occurred as recently as the 1970’s with the arrival of the CAT scanner – a short lived name which remains popular with the general public owing to the animal reference, but which is more correctly termed a CT scan by imaging professionals.  This technology allowed physicians to view human anatomy in a more detailed manner and to visualize structures not readily apparent on traditional radiographic images.  Astounding improvements to this imaging tool since its arrival has enabled more difficult patient conditions to be diagnosed and treated than could be managed previously. 

At the same time, other imaging modalities such as nuclear medicine, sonography and radiation therapy also implemented computer assistance and extended their abilities to more clearly demonstrate human tissues. 

New technologies were presented in the 1980’s and 1990’s, including MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography), and the ability to perform interventional vascular procedures, as well as create 3-D reconstructed anatomical images.  It is only common sense to realize that with each new decade, significant change and advances will occur and medical imaging will continue to evolve.

Although these tremendous changes were occurring in areas refereed to as “advanced imaging modalities,” routine radiography continued to plod along with film as the typical image medium.  The ability to acquire electronic images with traditional radiographic equipment developed more slowly and with less urgency. 

However, the day has finally come and upgrades to conventional radiography have become the priority for any imaging facility interested in staying competitive.  Various methods have been developed to convert the traditional analog image data to a digital format, as well as attempts at direct digital data acquisition. 

Several factors exist which complicates the acceptance of electronic images, including the need for excellent spatial resolution in order to accurately image and view small anatomical structures or changes in anatomy for reliable diagnosis, the need to keep radiation exposure low, adequate storage media to permit manipulation and archiving of vast quantities of digital data, privacy and security issues regarding medical data, and expense of purchasing new or trying to retrofit radiographic equipment. 

Locally, the establishment of the Worcester Medical Center enabled the construction of the new St. Vincent Hospital, which includes a “filmless” imaging department, meaning all medical images (except mammograms) are acquired, viewed, interpreted, shared and archived electronically.  Existing radiology services in other health care facilities will introduce this technology as they make planned upgrades to their equipment and services. 

It is expected that nearly all health care facilities in Worcester County will convert or upgrade to digital imaging by the end of this decade.  The overall benefit will be improved image quality, more timely completion of a radiologic procedure, including having the interpretation by the radiologist and report available to referring physicians, leading to a quicker response in treatment for patients.  The images will be available on specialized picture archiving and communications system (PACS) networks which associates a patient’s images with relevant textual data contained in the department radiology information system (RIS), and then links with the hospital information system (HIS). 

Once implemented, radiologic technologists are required to become familiar with the new technology and learn the appropriate modifications that must be made to the usual exam protocols to create high quality images within appropriate ranges of radiation exposure.  Generally, little formal training is available for technologists and each manufacturer has specific features to be learned.  It is readily apparent that radiologic technology programs need to educate future radiographers to be competent with current imaging technology; it was for this reason that I attended this two-day conference.

The basics necessary for understanding the principles of computer systems and digital imaging were presented to approximately 75 attendees, most of whom are radiologic technology program or clinical educators from across the country.  As educators, there was much interest in being able to break down the technical information in order to present students with a foundation on which to build throughout their professional careers.  Additionally, attempts were made to compare and contrast the specifics of traditional imaging principles with those associated with digital imaging, discuss criteria to use for evaluating student competency in terms of image quality critique and acceptable dose determination, and learn outcomes to expect of students at this time. 

As always the best part of meeting with fellow educators is the opportunity to learn and share what others are doing, and what impediments to expect, as well as receive recommendations for valuable resources.  The seminar presentations and group discussions answered many questions and supported how this information is currently being presented to the students in the QCC Radiologic Technology program, but also raised new questions and issues to consider for future curricula. 

The profession of radiologic technology is dynamic and continuing developments must be expected, thereby verifying the importance of continued education for graduate radiographers and educators; along with this, regular adjustments to program course content are needed to ensure students are provided with current information to become competent radiographers with a foundation for professional growth.