Module 4.1: Patient Interaction and Positioning

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Module 4.1Patient Interaction and Positioning
Sara Siavoshi Wendy Tanamai Beckman Laser
Institute University of California, Irvine
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Overview

• Patient Etiquette
• Patient Orientation/Positioning
• Marking the Measurement Area
• Holding the Probe

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Patient Etiquette

• Conversation
• Helps relax patient and reduce nervousness.
• Great conversation starters Food, job, kids
• You are not the doctor
• Do not comment on strange data to patientcan
  scare them
• Do not attempt to diagnose. If needed, refer to
  physician
• Remember HIPAA
• Only individuals on the protocol are to know
  specifics about a patient. Otherwise, refer to
  patient by subject , not by name.
• Do not make the patient wait
• Instrument warm-up and making sure instrument is
  working properly should happen before patient
  arrives

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Patient Orientation/Position

• Patient Position should allow for optimal DOS
  measurement
• Arm should be raised over head if
• Lower quadrants of the breast are going to be
  measured
• Lesion will become more palpable
• Position should not be uncomfortable
• All position adjustments should be made before
  measurement beginsposition should not change
  during measurement.
• If needed, Place pillow behind the subjects
  head, back, or arm.
• To reduce error in DOS measurements, position
  should stay consistent for all follow-up
  measurements
• Record exact arm position and pillow placement

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Breast Mapping

• Methods of mapping the breast include
• - Quadrants
• - Clock
• - Coordinates
• Quadrants and Clock positions are used in
  diagnostic reports
• Coordinates are used in FDPM breast measurements

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Quadrants
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Clock
1200
1200
300
300
900
900
600
600
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Coordinates
(-30, 20) LN030P020 (30, 30) LP030P030
(10, -20) LP010N020
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Marking Measurement Area

• Identify your region of interest.
• No Lesion Draw grid over your region of interest
  (ROI).
• Lesion
• Check diagnostic reports and ask patient where
  lesion is.
• Palpate it yourself, note the size and location
  of the mass as you palpate it (e.g. 2x2cm mass
  located at Left breast (30,20)).
• Draw grid to completely cover lesion and
  surrounding normal tissue

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Marking Measurement Area

• Grid
• Either square or rectangle (Cannot make an image
  out of a circle/cross/ovaletc.)
• Should cover entire lesion along with some
  surrounding normal tissue
• Mirror the grid onto contra-lateral breast
• Drawn with surgical marker

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Marking Measurement Area

• Some Important Notes
• Grids are drawn differently for each patient
  depending on breast size, type of measurement,
  lesion location, lesion sizeetc.
• If the lesion area coincides with an area of
  bruising, scarring, or the areolar region, do NOT
  avoid these areas. The grid can overlap into
  these areas.
• Exact coordinates of lesion, areola, bruising, or
  scarring should be recorded
• If measuring a patient several times within one
  week, you may ask patient to try to keep dots on
  by not scrubbing over the area when showering.

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Holding the Probe

• Probe placement should allow for optimal source
  and detector contact with the skin
• Place probe over Extreme points (Points at the
  outer edges of the grid)
• Determine which probe orientation would
  accommodate these points best
• Position dot should be situated between the
  source and the detector fibers.
• Using light pressure, make sure that the source
  and detector fibers are in contact with the skin.
• The same probe placement should be used
• Throughout the whole measurement
• For all subsequent measurements on the same
  patient.