X-Ray Technologist Skills Checklist

Personal Information

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Candidate Name

Email of Recruiter / POC

Select Submission Date

SSN (Last 4 digits)

Proficiency Scale & Legend

1 No Experience

2 Need Training

3 Able to perform with supervision

4 Able to perform independently

Communication

Organize written and oral communication in a logical manner

Use correct radiologic and medical terminology

Communicate effectively with patients, families, nurses, physicians, radiologists and other technologists

Use good listening skills and verify patient understanding

Obtain pertinent clinical history and mechanism of injury

Communicate effectively with non-English speakers and patients with communication/cognitive impairments

Provide clear instructions for breath-hold, positioning, swallowing and movement requirements

Communicate urgent patient-care concerns to the appropriate clinician

Patient Identification / Order Verification

Verify patient identity using two identifiers

Verify examination order/prescription and correct body part

Confirm laterality and clinical indication

Review relevant medical history, prior imaging and precautions

Verify correct patient, procedure, positioning and imaging protocol before exposure

Confirm allergies and relevant medication/contrast history when applicable

Screen for pregnancy/pregnancy possibility according to facility policy

Confirm informed consent requirements for applicable procedures

Patient Care / Assessment

Assess patient condition before and during examination

Assess mobility, fall risk, pain level and ability to cooperate

Perform safe bed-to-table and wheelchair transfers

Use immobilization and support devices appropriately

Monitor patients during procedures and recognize changes in condition

Obtain and document vital signs when required by facility/procedure

Provide appropriate patient positioning while protecting lines, tubes and drains

Provide age-appropriate care for pediatric, adult and geriatric patients

Provide appropriate care for trauma, postoperative, isolation and critically ill patients

Respond appropriately to medical emergencies and activate emergency response

Perform CPR/BLS/ACLS duties within current certification and facility scope, when required

Maintain patient dignity, privacy, comfort and confidentiality

Radiographic Positioning — Chest / Thorax

PA chest

AP chest

Lateral chest

Portable AP chest

Lordotic chest

Decubitus chest

Ribs — AP/PA and oblique

Sternum — RAO/lateral

Apices / lung apices

Chest for line/tube placement

Chest for foreign body evaluation

Chest for airway or aspirated/ingested foreign body, when applicable

Chest imaging with respiratory/clinical modifications

Radiographic Positioning — Abdomen

AP supine abdomen / KUB

AP upright abdomen

Decubitus abdomen

Acute abdominal series

Left lateral decubitus abdomen

Abdomen for foreign body evaluation

Abdomen for nasogastric/enteric or orogastric/enteric tube placement

Abdomen for line/tube placement

Portable abdominal radiography

Radiographic Positioning — Upper Extremity

Hand — PA, oblique, lateral

Finger/thumb — AP/PA, oblique, lateral

Wrist — PA, oblique, lateral

Scaphoid/navicular views

Forearm — AP and lateral

Elbow — AP, lateral and oblique

Radial head / capitellum views

Humerus — AP and lateral

Shoulder — AP/internal-external rotation

Shoulder — scapular Y

Shoulder — axillary/modified axillary

Clavicle — AP and AP axial

AC joints — with/without weights per protocol

Scapula — AP and lateral

Trauma / nonstandard upper-extremity projections

Radiographic Positioning — Lower Extremity

Foot — AP, oblique, lateral

Toe — AP, oblique, lateral

Calcaneus — axial and lateral

Ankle — AP, mortise, lateral

Tibia/fibula — AP and lateral

Knee — AP, lateral, oblique

Patella / sunrise or tangential view

Femur — AP and lateral

Hip — AP and lateral / cross-table lateral

Pelvis — AP

SI joints — oblique

Trauma / nonstandard lower-extremity projections

Weight-bearing studies when ordered and safe

Radiographic Positioning — Spine

Cervical spine — AP, lateral, odontoid

Cervical spine — oblique

Cervical flexion/extension when ordered

Swimmer\'s / cervicothoracic junction

Thoracic spine — AP and lateral

Lumbar spine — AP and lateral

Lumbar spine — oblique

Lumbar flexion/extension when ordered

Lumbosacral junction / L5-S1 spot

Sacrum — AP/axial and lateral

Coccyx — AP/axial and lateral

Trauma cervical spine / cross-table lateral

Thoracolumbar spine studies when ordered

Skull / Facial Bones / Sinuses

Skull — AP/PA and lateral

Towne / AP axial skull

Facial bones — PA/Waters and lateral

Orbits — dedicated views

Zygomatic arches

Nasal bones

Mandible — AP/PA, oblique and lateral

TMJ studies when applicable

Paranasal sinuses — appropriate views

Trauma facial-bone positioning and immobilization

Pediatric Radiography

Use pediatric-specific exposure techniques

Use age-appropriate communication and distraction

Use pediatric immobilization/support devices safely

Minimize repeats and radiation exposure

Apply Image Gently principles when applicable

Adapt positioning for infants and young children

Perform pediatric chest and abdomen

Perform pediatric extremity and skeletal imaging

Perform pediatric trauma imaging

Perform pediatric line/tube placement imaging

Trauma / Emergency Radiography

Portable imaging in emergency department

Portable imaging in ICU/CCU

Trauma chest and abdomen

Cross-table lateral hip

Cross-table lateral cervical spine

Trauma extremity imaging without unnecessary patient movement

Spine trauma imaging with immobilization

Post-reduction imaging

Foreign-body imaging

Prioritize STAT/emergency examinations

Protect lines, drains, tubes and immobilization devices during imaging

Portable / Mobile Radiography

Operate portable/mobile X-ray unit

Transport and position mobile equipment safely

Verify patient and room before exposure

Select portable exposure factors

Use appropriate portable SID and positioning

Perform portable chest/abdomen imaging

Perform portable extremity imaging

Perform portable trauma imaging

Use appropriate infection-control precautions between patients

Minimize radiation exposure to staff and bystanders

Manage portable detector and accessories safely

Radiographic Equipment / Technical Factors

Operate fixed X-ray generator

Operate radiographic table

Operate wall stand/Bucky

Operate tube stand and tube angulation controls

Operate collimator/light field

Select kVp

Select mAs

Select mA and exposure time

Select focal spot

Use AEC chambers appropriately

Select appropriate SID

Control OID when clinically possible

Select appropriate grid/grid ratio when applicable

Use digital detector correctly

Use technique charts/anatomic programs

Perform tube warm-up procedures

Recognize equipment malfunction and remove unsafe equipment from service

Perform basic equipment readiness checks

Digital Radiography / Image Production

Operate DR detector/receptor

Handle wireless detector safely

Position detector correctly for anatomy

Select appropriate exposure field/collimation

Evaluate exposure indicator/deviation index

Recognize exposure creep and overexposure/underexposure

Evaluate image contrast

Evaluate spatial resolution/detail

Evaluate recorded detail and distortion

Evaluate noise/quantum mottle

Recognize saturation and detector limitations

Recognize grid cutoff

Recognize motion artifact

Recognize rotation and positioning errors

Recognize clipping/anatomy cutoff

Recognize processing and stitching artifacts

Use post-processing appropriately without masking errors

Use electronic masking/cropping/shuttering according to facility policy

Verify exposure indicator data has not been improperly altered

Pacs / Ris / Dicom / Informatics

Enter and verify patient demographics

Select correct exam/procedure in RIS

Use PACS to review images

Verify image orientation and laterality

Verify correct body part and exam series

Send images to PACS

Correctly associate images with the intended patient/exam

Recognize and resolve common worklist errors

Use DICOM information appropriately

Maintain security and confidentiality of imaging information

Use teleradiography/image transmission workflow when applicable

Recognize downtime procedures for RIS/PACS

Document and escalate data integrity problems

Radiation Safety

Apply ALARA principles

Minimize patient exposure while maintaining diagnostic quality

Use appropriate collimation

Select exposure factors to minimize repeats

Use appropriate shielding/protective devices according to current facility policy

Maintain distance and use barriers appropriately

Stand in appropriate position during exposures

Protect other patients and staff in the imaging area

Use personnel dosimeter/TLD according to policy

Follow pregnancy-related radiation safety procedures

Apply Image Wisely principles when applicable

Apply Image Gently principles for pediatric patients when applicable

Recognize and report radiation-safety violations

Follow state/federal/institutional radiation regulations

Fluoroscopy

Prepare fluoroscopy room and equipment

Operate fluoroscopy controls within scope

Assist radiologist/physician with fluoroscopic procedures

Perform positioning for fluoroscopic examinations

Apply radiation protection during fluoroscopy

Monitor patient during fluoroscopic procedure

Prepare required supplies and accessories

Document fluoroscopy-related information as required

Assist with image capture/spot imaging

Recognize and respond to equipment or patient safety concerns

Contrast / Medication-related Skills

Verify contrast/medication order and indication

Screen for relevant allergy/adverse-reaction history

Verify required patient preparation

Verify IV access when required and within scope

Perform venipuncture when authorized and competent

Prepare contrast administration supplies

Administer contrast/medications only when legally authorized and within facility scope

Operate injector/power injector when authorized

Recognize mild, moderate and severe contrast reactions

Respond to contrast reaction according to emergency protocol

Maintain emergency equipment readiness

Document contrast/medication administration and reaction information

Dispose of contaminated sharps and supplies appropriately

Gi / Genitourinary / Special Fluoroscopic Procedures

Esophagram / barium swallow

Upper GI series

Small bowel series / follow-through

Modified barium swallow assistance, when applicable

Contrast enema / lower GI examination

Voiding cystourethrogram assistance, when applicable

Retrograde urethrogram assistance, when applicable

Retrograde pyelogram assistance, when applicable

Hysterosalpingography assistance, when applicable

Fistulogram/sinogram assistance, when applicable

Contrast injection and image acquisition under physician direction

Post-procedure patient monitoring and instructions

Arthrography / Myelography / Interventional Assistance

Assist with arthrogram procedures

Assist with joint injection/aspiration imaging procedures when applicable

Assist with myelography

Assist with lumbar puncture/epidural injection imaging procedures when applicable

Prepare sterile supplies for applicable procedures

Maintain sterile technique when required

Perform fluoroscopic positioning for spine/joint procedures

Assist with specimen/supply handling according to facility policy

Monitor patient and communicate changes in condition

Operating Room / C-arm

Operate C-arm/mobile fluoroscopy unit when authorized

Perform C-arm setup and room preparation

Position C-arm for AP, lateral and oblique views

Maintain sterile-field awareness

Use appropriate radiation protection in the OR

Coordinate with surgeon, anesthesia and OR staff

Perform orthopedic C-arm imaging

Perform spine C-arm imaging

Perform pain-management procedure imaging when applicable

Perform line/tube placement imaging when applicable

Handle C-arm safely around sterile equipment and personnel

Complete image transfer/documentation after procedure

Quality Assurance / Quality Control

Perform required daily equipment checks

Recognize detector artifacts and equipment drift

Participate in repeat/reject analysis

Monitor repeat rates and identify causes

Verify exposure indicator/deviation index trends

Participate in image-quality improvement

Follow equipment QC schedules

Document QC results accurately

Report equipment problems for service

Follow preventive maintenance and calibration requirements

Infection Control / Environmental Safety

Perform hand hygiene correctly

Use appropriate PPE

Clean and disinfect equipment between patients

Follow isolation precautions

Clean portable detectors and accessories appropriately

Dispose of sharps and contaminated materials correctly

Manage bodily-fluid contamination safely

Follow hazardous-material and spill procedures

Maintain imaging room cleanliness and readiness

Professional Practice / Documentation

Maintain HIPAA/privacy and confidentiality

Document procedures accurately

Document contrast/medication administration when applicable

Document patient tolerance and relevant events

Follow facility protocols and scope of practice

Maintain required credentials and continuing education

Recognize limits of practice and seek assistance appropriately

Practice within state law and facility policy

Participate in quality improvement

Use ethical judgment and advocate for patient safety

Maintain professional relationships and teamwork

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency.