Quality Improvement Neonatal Radiology

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Quality ImprovementNeonatal Radiology
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Introducing NeoRayTMThe first FDA approved
Portable X-Ray System Specifically Optimized for
Neonatal Application
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Improving Quality Careof Neonates and X-Rays

• Provide acute care in a timely fashion
• Immediate results - X-Ray images displayed in 5
  seconds of less
• X-Ray images displayed on 19 monitor at
  incubator
• Less radiation dose 50 to 70 less than CR
  technology
• Early identification of new diagnosis or
  necessary intervention
• Cost Savings
• No need for additional personnel
• No waiting for X-Ray images
• No charges for unacceptable exposures
• No need to repeat X-Rays (repeat order, phone
  call, return of radiology technician)
• No film/cassettes - to change after each X-Ray
  exposure

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Procedures That Would Benefit from NeoRayTM

• Umbilical Catheterization (UAC UVC)
• Peripherally inserted central catheter
• Chest tube placement
• Needle aspiration
• ECMO cannulation
• Broviac placement
• Surgical placement of abdominal drains
• Endotracheal intubations
• Duodenal tubes
• Esophageal tube for hypothermia treatment

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Diagnosis Benefits from utilizing NeoRayTM

• Early diagnosis of life threatening illnesses
• Pneumothorax, pneumomediastinum,
  pneumopericardium
• NEC/ Bowel perforation
• Congenital Diaphragmatic Hernia

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Personnel Benefits

• Neonatologists
• Nurse Practitioners
• Nursing
• Residents

• Pediatric Surgeons
• Cardiovascular Surgeons
• Neurological Surgeons

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Example of Cost/Time Saving Benefit

• Decrease in nursing time
• PICC insertion
• Proper placement verified immediately versus
  multiple x-rays for readjustment of lines as well
  as multiple sterile dressing changes
• Relief of stress/responsibility of radiology
  technician
• Technician may have to return multiple times for
  repeat X-Rays occupying their time which may be
  needed elsewhere in the Hospital.

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NeoRayTM

• Highly portable
• Battery powered
• Outstanding Image quality
• User friendly
• Low X-Ray Dose
• Small focal spot X-Ray tube
• Low KW X-Ray Generator
• Compact and light weight
• Flat panel image receptor with integrated full
  function workstation

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Workstation Features

• Auto image Optimization
• Automatic shutters
• Image annotation
• Measuring tools
• Image enhancement tools
• PACS Worklist
• PACS network for storage
• DICOM complaint

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Highly Portable

• Can be moved from incubator to incubator easily
• Light weight - weights 8 times less than other
  battery powered portable X-Ray systems
• Compact - X-Ray head fits under lid of giraffe
  when in open position
• Small foot print

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Image Receptor Panel

• High resolution images
• Less radiation
• Compact size
• Protected by outer case
• Model Varian PaxScan 2520E
• Receptor Type Amorphous Silicon
• Conversion Screens CsI
• Pixel Area 19.5 x 24.4 cm
• Resolution 3.94 lp/mm
• Scan Type Progressive
• Data Interface Gigabit Ethernet
• A/D Depth 14 Bit
• Light weight Magnesium housing, shock and water
  resistant

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Generator

• Class HF Resonant Inverter
• Battery Power App. 30 exposures
• A/C Line Power 115 volts
• kVp Range 40-80 kVp, adjustable in
• one kVp
  increments
• mAs Range 0.1 30.0
• mA Range 10 mA fixed Closed
• Loop
  Regulation

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X-Ray Tube

• Anode Type Stationary Anode
• Filtration 2.7 mm al Minimum
• Target Material Tungsten
• Focal Spot 0.5mm
• Anode Capacity 20,000 HU Storage
• Target Angle 15 degrees

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Workstation Hardware

• CPU Intel DuoCore 3.0G
• Hard Drive 10,000 RPM SAT 150G
• DICOM Format DICOM 3.0
• Storage Media CD-R, DVD-R, USB
• Display 19 LCD Flat Screen
• OS Platform Windows XP Pro
• Image Processing Auto Collimation
• Annotation Tool
• Flip/Rotate/Invert
• Image Enhance

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Collimation

• Type Multileaf Adjustable
• SID Indicator Tape Measurer
• Angle Indicator Inclinometer
• Positioning Device Laser

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Support

• Free software upgrade
• National Dealer network
• Online technical support
• 24 hour technical support

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Benefits to Neonates

• Less stress
• Decreased manipulation times due to repeat films,
  dressing changes, re-taping of ETTs
• Decreased interrupted skin integrity due to
  multiple dressing changes and tape removal
• Eliminating additional dressing changes on
  central lines will eliminate the possibility of
  accidental removal of the line
• Ability to receive immediate care during acute
  phases of their illness examples
• Air leak diagnosis and immediate evacuation to
  include re-evaluation of therapies
• Bowel perforation diagnosis followed by
  evacuation via needle aspiration and/or placement
  of drainage tubes by surgeon followed by
  re-evaluation of therapy

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Benefits to Medical/Nursing Staff

• Immediate results permitting adjustment in
  treatment modalities faster
• Decrease nursing time for
• Re-entry of orders in computer
• Re-positioning infant for repeat X-Rays
• Repeated dressing out (sterile) for sterile
  procedures/dressing changes

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Liability Benefits

• Immediate results
• minimizing adverse effects of a treatment (i.e.
  malpositioned central line)
• No time delay in diagnosing acute changes or new
  diagnoses
• Ability to repeat X-Rays immediately due to
  exposure problems or positioning, thereby
  minimizing time for an acceptable image
• Less radiation than conventional x-rays

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Problems with NeoRay

• Only one problem identified to date
• Digital receptor is protected by a solid cover
  and will not fit in isolette film tray
• Digital detector must be placed directly under
  infant.

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Ultimate Goal

• Provide the highest standard of care possible to
  your neonates
• Improve your neonates outcomes and enhance early
  discharge
• Minimize procedure costs to hospital patients