1	Quality Improvement Neonatal Radiology
2	Introducing NeoRayTM The first FDA approved Portable X-Ray System Specifically Optimized for Neonatal Application
3	Improving Quality Care of 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
4	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
5	Diagnosis Benefits from utilizing NeoRayTM Early diagnosis of life threatening illnesses Pneumothorax, pneumomediastinum, pneumopericardium NEC/ Bowel perforation Congenital Diaphragmatic Hernia
6	Personnel Benefits Pediatric Surgeons Cardiovascular Surgeons Neurological Surgeons Neonatologists Nurse Practitioners Nursing Residents
7	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.
8	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
9	Workstation Features Auto image Optimization Automatic shutters Image annotation Measuring tools Image enhancement tools PACS Worklist PACS network for storage DICOM complaint
10	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
11	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
12	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
13	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
14	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
15	Collimation Type Multileaf Adjustable SID Indicator Tape Measurer Angle Indicator Inclinometer Positioning Device Laser
16	Support Free software upgrade National Dealer network Online technical support 24 hour technical support
17	Benefits to Neonates Less stress Decreased manipulation times due to repeat films, dressing changes, re-taping of ETT’s 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
18	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
19	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
20	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.
21	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