“ DIAGNOSTIC RADIOGRAPHY “

CLINICAL PRACTICE STUDENT LOG-BOOK

STUDENT NAME: _________________________________________________

ID NUMBER: _______________________________________________________

Prepared By:
Mrs. Jawaher Khalid Almaimani ..

Approved by: Dr. Jehad S. Felemban, Chairman, Diagnostic Radiography Technology Department

Clinical Practice Student Log-book

❖ GENERAL X-RAY
Date : ……………………………………………………………………………………………………………………………………………………………………………
- Clinical Site: (Outpatient - Inpatient - ER - Portable).
- Patient MRN: ……………………………………………………………………………………………………………………………………………………..…
- X-RAY FOR: ………………………………………………………………………………………………………………………………………………….………
- Clinical Indication: “Please mention any Important Abbreviation”

______________________________________________________________________________________________________________
➢ Patient Position : ⎔ Supine ⎔ Prone ⎔ Erect ⎔ Other _________________________________
➢ Projections : ⎔ AP ⎔ PA ⎔ Lateral ⎔ Oblique
➢ Modified Projection: ______________________________________________________________________________
➢ CP: ________________________________________________________________________________________________
➢ CR: ⎔ Perpendicular ⎔ Angulation ____________________________________________________________
➢ SID / Grid : ⎔ Green (100cm) ⎔ Yellow (180cm)
⎔ RED ⎔ Blue
➢ Area of Interest / FOV: ____________________________________________________________________________
➢ Radiation Protection: ⎔ Thyroid Collar ⎔ Gonad shield
⎔ Lead Aprons ⎔ Other _________________________________________
• Comments: ______________________________________________________________________________________________

❖ GENERAL X-RAY
Date : ……………………………………………………………………………………………………………………………………………………………………………
- Clinical Site: (Outpatient - Inpatient - ER - Portable).
- Patient MRN: ……………………………………………………………………………………………………………………………………………………..…
- X-RAY FOR: ………………………………………………………………………………………………………………………………………………….………
- Clinical Indication: “Please mention any Important Abbreviation”

______________________________________________________________________________________________________________
➢ Patient Position : ⎔ Supine ⎔ Prone ⎔ Erect ⎔ Other _________________________________
➢ Projections : ⎔ AP ⎔ PA ⎔ Lateral ⎔ Oblique
➢ Modified Projection: ______________________________________________________________________________
➢ CP: ________________________________________________________________________________________________
➢ CR: ⎔ Perpendicular ⎔ Angulation ____________________________________________________________
➢ SID / Grid : ⎔ Green (100cm) ⎔ Yellow (180cm)
⎔ RED ⎔ Blue
➢ Area of Interest / FOV: ____________________________________________________________________
➢ Radiation Protection: ⎔ Thyroid Collar ⎔ Gonad shield
⎔ Lead Aprons ⎔ Other _________________________________
• Comments: ______________________________________________________________________________________
J. Almaimani

Approved by: Dr. Jehad S. Felemban, Chairman, Diagnostic Radiography Technology Department

Clinical Practice Student Log-book

❖ FLOROSCOPY :

❑ Outpatient
❑ Inpatient

- Date: ……………………………………………………………………
- Patient MRN: ………………………………………………

- Name of the Study: ……………………………………………………………………………………………………………………………………………...

• Reason of the Exam: “Please mention any Important Abbreviation”

______________________________________________________________________________________________________________

• Patient Preparation:
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________

• Preparing for the Procedure :

⎔ Catheter ---------------------- ⎔ Saline ⎔ Needles
⎔ Contrast Media ⎔ Gauze ⎔ Syringe
⎔ Sterile Gloves ⎔ Basins & Cups
⎔ Others____________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
➢ Patient Position : ⎔ Supine ⎔ Prone ⎔ Erect ⎔ Other _______________________________
➢ Projections : ⎔ AP ⎔ PA ⎔ Lateral ⎔ Oblique ⎔ Other _________________
o Aim of each projection: __________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
➢CP:
_____________________________________________________________________________________________________
➢ CR: ⎔ Perpendicular ⎔ Angulation _____________
➢ Coverage Area/ FOV: ____________________________________________________________________________

➢Radiation Protection: ⎔ Thyroid Collar ⎔ Gonad shield

⎔ Lead Aprons ⎔ Other _____________

➢Type of CM : ⎔ Telebrix ⎔ Xenetix ⎔ Other __________

➢Rote of CM : ⎔ Oral ⎔ IV ⎔ Rectum ⎔ Other __________

➢Patient After Care : _______________________________________________________________________________________

___________________________________________________________________________________________________
•Comments:
______________________________________________________________________________________________________________
J. Almaimani

Approved by: Dr. Jehad S. Felemban, Chairman, Diagnostic Radiography Technology Department

Clinical Practice Student Log-book

❖ COMPUTED TOMOGRAPHY

- Date : …………………………………………………..……………………………………………………………………………………………………………………
- Patient MRN: …………………………………………………………………………………………………………………………………………………..……
- Name of the Study: ………………………………………………………………………………………………………………………………………………

• Reason of the Exam: “Please mention any Important Abbreviation”

______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

•Preparing for CT Scan:

⎔ Saline ⎔ Needles ⎔ Contrast Media ⎔ Gauze
⎔ Syringe ⎔ Gloves
⎔ Others____________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

➢ Scout ( Topogram ) : ⎔ Coronal ⎔ Sagittal ⎔ Axial ⎔ Other __________

➢ Patient Position : ⎔ Supine ⎔ Prone ⎔ Other ____________________________

➢ Scan Direction : ⎔ Head First ⎔ Feet First ⎔ Other ____________________________

➢ CP: ______________________________________________________________________________________________

➢ Coverage Area / FOV: ___________________________________________________________________________

➢ Type of CM : ⎔ Telebrix ⎔ Xenetix ⎔ Other ___________________________

➢Rote of CM : ⎔ Oral ⎔ IV ⎔ Rectum ⎔ Other___________

• Comments:
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

J. Almaimani

Approved by: Dr. Jehad S. Felemban, Chairman, Diagnostic Radiography Technology Department

Clinical Practice Student Log-book

❖ ULTRASOUND, - Date : …………………………………………………..………………………………………
- Clinical Site: (Outpatient / Inpatient )
- Patient MRN: …………………………………………………………………………
- Name of the Study: ……………………………..……………….

• Reason of the Exam: “Please mention any Important Abbreviation”

…………………………………………………………………………………………………………………………………………………………………………………..……
• Type of Transducer used: ⎔ Linear Array ⎔ Convex Array
⎔ Sector Array ⎔ Other --------------
❑ Renal US:
o Kidney Size : RT …………………. cm , LT ……………………. cm
o Echogenicity : RT : ⎔ Normal ⎔ Hyperechoic ⎔ Hypoechoic ⎔ anechoic
LT : ⎔ Normal ⎔ Hyperechoic ⎔ Hypoechoic ⎔ anechoic
o Collecting system : RT: ⎔ Normal ⎔ Other ………………………………………
LT: ⎔ Normal ⎔ Other ………………………………………
o Bladder Volume: Prevoid ………………… cc , Postvoid ………………… cc
• Comments:………………………………………………………………………………………………………………………………………………………………
……………………………………….…………………………………………………………………………………………………………………………………………..

❑ Abdomen US:
o Aorta ……………………….. cm
o IVC …………………………… cm
o Liver :
- Size: ⎔ Normal …………….. cm ⎔ Abnormal ………………. cm
- Echogenicity: ⎔ Normal ⎔ Hyperechoic ⎔ Hypoechoic ⎔ anechoic
o PV ……………………….. cm , CBD ……………………….. cm
o GB ⎔ Normal …………….. cm ⎔ Abnormal ………………. cm [……………….....……]
o Pancreas ⎔ Normal ⎔ Abnormal [……………….....……]
o Kidney Size : RT …………………. cm , LT ……………………. cm
o Spleen ……………………….. cm
• Comments:………………………………………………………………………………………………………………………………………………………………
……………………………………….…………………………………………………………………………………………………………………………………………..

❑ Thyroid US :
o RT Lobe size: ………………………………………….. cm
o LT Lobe size: ………………………………………….. cm
o Isthmus …………………………………………………….. cm
• Comments:………………………………………………………………………………………………………………………………………………………………
……………………………………….………………………………………………………………………………………………………………………………….………
…………………………………………………………………………………………………………………………………………………………………………………..

J. Almaimani

Approved by: Dr. Jehad S. Felemban, Chairman, Diagnostic Radiography Technology Department

Clinical Practice Student Log-book

❖ ULTRASOUND, - Date : …………………………………………………..……………………………………
- Clinical Site: (Outpatient / Inpatient / OB- GYN)
- Patient MRN: …………………………………………………………………………
- Name of the Study: ……………………………..……………….

• Reason of the Exam: “Please mention any Important Abbreviation”

…………………………………………………………………………………………………………………………………………………………………………………..……
• Type of Transducer used: ⎔ Linear Array ⎔ Convex Array
⎔ Sector Array ⎔ Other --------------
❑ Pelvic US:
o Uterus Size : ………………………….…………………………………………………………..
o Endometrium ; ……………………………………………….. mm
o RT Ovary Size ………………………………………………… cm
o LT Ovary Size ………………………………………………… cm
o Bladder Volume: Prevoid ………………… cc , Postvoid ………………… cc
o Comments:………………………………………………………………………………………………………………………………………………………………
……………………………………….…………………………………………………………………………………………………………………………………………..

❑ Other ……………………………………………… :
o Steps and Parts included in the scan:
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………
o ………………………………………………………

• Comments:………………………………………………………………………………………………………………………………………………………………
……………………………………….………………………………………………………………………………………………………………………………….………
…………………………………………………………………………………………………………………………………………………………………………………..

J. Almaimani

Approved by: Dr. Jehad S. Felemban, Chairman, Diagnostic Radiography Technology Department

Clinical Practice Student Log-book

❖ ANGIOGRAPHY, - Date : ___________________________________________________
- Name of the Procedure: ______________________________
- Patient MRN: __________________________________________

•Request of the Patient :

➢Reason of the Exam: “Please mention any Important Abbreviation”
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

•Preparing for the Procedure :

⎔ Angio Drape ⎔ Skin Prep Solution ⎔ Local Ansethia
⎔ Suture ⎔ Introducer Sheath ⎔ Peel away Sheath
⎔ Catheter ---------------------- ⎔ Heparin Saline ⎔ Saline
⎔ US probe cover ⎔ Needles ⎔ Scalpel
⎔ Contrast Media -------------- ⎔ Puncture Needle ⎔ Gauze
⎔ Guide wire -------------------- ⎔ Dilators ⎔ Syringe
⎔ Stent --------------------------- ⎔ Sterile Gowns & Gloves ⎔ Basins & Cups
⎔ Others____________________________________________________________________________________________________

➢Site of Puncture: ⎔ Femoral ⎔ Radial ⎔ Basilic Vein ⎔ Other ------------

➢Radiation Protection: ⎔ Thyroid Collar ⎔ Gonad shield ⎔ Lead Aprons
➢Dose Delivered Accumulation: __________________________
➢Comments:_______________________________________________________________________________________________
______________________________________________________________________________________________________________

• In case this procedure is cancelled, Explain the reason.

______________________________________________________________________________________________________________

❖ DOPPLER ULTRASOUND - Date: ____________________________________________

- Patient MRN: __________________________________
- Name of the Study: ____________________________

Reason OR Diagnosis: “Please mention any Important Abbreviation”

______________________________________________________________________________________________________________

• Type of Transducer used: ⎔ Linear Array ⎔ Convex Array ⎔ Sector Array

• ⎔ Negative Study OR ⎔ Positive Study
• Comments ______________________________________________________________________________________________

➢ In case of Lower Extremity Venous Doppler (DVT):

• ⎔ Negative Study OR ⎔ Positive Study
• DVT Diagnostic Features: ⎔ NO Color Filing ⎔ NO Compression
⎔ Echogenic clot ⎔ Other ---------------
• Comments:
______________________________________________________________________________________________________________

J. Almaimani

Approved by: Dr. Jehad S. Felemban, Chairman, Diagnostic Radiography Technology Department

Clinical Practice Student Log-book