Set Up..

Patient set-ups are all pretty similar out here and easily picked up. 

So, the staff will tell the patient to enter the room and then give them a few minutes before entering again. ive been told two reasons for this, one because of the radiation protection and the other because of patient dignity. The patient will get on the bed by themselves, sometimes struggling and I've seen blind people with little assistance trying to get on. They all have to lay their individual kanga's on the bed for their treatments before getting on. 

Sometimes they are moved to make sure that they are straight but they are mostly just given directions as to what to do to get themselves in the right position. Sometimes I disagree with what they are doing because they can move their ankles and legs after the field has been positioned, altering the position of the field possibly. 

For cervix patient anatomical surface markers are used for the set up on every patient; as I blogged in my last post. 

For other patients most of them have plaster markings around the edges of the field so that their is some guidance as to where to go. Although this is a good idea, the plasters are often put on by nurses outside of the treatment room. This means that the field light is not on the area and the patient is in a different position, therefore it can be non-representative of the actual treatment field. Another issue is that they do not stay on very well after washing etc. so if they fall off and patients re-position them (like they often do) it is hard to know where the exact place is. For patients having lateral fields treated the field is only marked on one side so this too can make the positioning hard as the bed can be unreliable with the measurements and movements. Obviously no movements are made from these plasters as they represent the actual field that needs to be treated. 

The accuracy is better than what I thought it would be, even if it is a bit dubious sometimes! Most of the time I feel comfortable to set up and switch on with the set-up they have done as it is all that can be achieved with their equipment. To start using tattoos would require a large change in the department and a lot of time and money; but hopefully in the future.