When either a patient or an image receptor (IR) needs to be held, a

nurse or family member needs to hold. This keeps our dose as a

radiographer low and ensures that we follow rules. As radiographers,
we need to inform the public how they can keep our and their dose low.
We should not just give the IR to them, but explain how to hold it and
where they should stand to insure they are not radiated by primary
rays. Whenever someone needs to hold, regardless if it is us or someone
else, they MUST wear a lead apron.
Simply asking another person who is not exposed to radiation everyday
will ensure that we should never have to hold. It is our responsibility to
achieve the best image with the lowest possible dose.
According to the American Registry of Radiologic Technologists code of
ethics , number seven states (2016), The radiologic technologist uses
equipment and accessories, employs techniques and procedures, performs services
in accordance with an accepted standard of practice, and demonstrates expertise in
minimizing radiation exposure to the patient, self, and other members of the
healthcare team.
Realistically, a patient or family member may not always be available. In
this case, a technologist will have to hold. When this occurs, it is
essential to switch out technologists. The same technologists should not
hold every time. This is why it is imperative to always wear your
radiation badge, regardless if you are in lead or not.

This is NOT a proper way to hold an IR. The hand on the left side of the
image is a technologists hand. The proper way would to have the
patients hand on each side of the IR while you are not in the room.

This is how a patient should proper hold a cassette for a sunrise

projection of the knee.

This is also not the proper way to have a cassette be held. There should
be a grid holder utilized instead.

This is a grid holder that should be properly utilized during an

axiolateral hip or an axillary shoulder.

In conclusion, in order to guarantee that technologists never have to

hold, we must be comfortable with IR holders and explanations to
patients. We must inform them why we cannot hold, how we will protect
them, and what their risks are. If we create a rapport with the patients
and others who will hold the IR, they will be more trusting and willing to
hold the IR. Remember, according to the NCRP technologists should
never hold unless it is a life or death situation!

References:
Johnston, J., Killion, J.B., Veale, B., & Comello, R. (2011). U.S.
technologists' radiation exposure perceptions and practices. Radiologic
Technology, 82(4), 311-320.

American Registry of Radiologic Technologists. (2016). Standards of

ethics. Retrieved from https://www.arrt.org/pdfs/GoverningDocuments/Standards-of-Ethics.pdf.