Recommendations on Standards for the Design of Medical Diagnostic Equipment for Adults with Disabilities, Advisory Committee Final Report

4.3.5 Patient Positions During Diagnostic Imaging

Finally, the vast majority of diagnostic imaging exams are conducted while patients are supine, prone, or side-lying on the table. Hence, the Committee focused much of its attention on the M301 standard (see Table 1.3.1(a)). However, given the enormous diversity of imaging equipment and the broad range of diagnostic objectives they seek to achieve, recommendations addressing M302 (diagnostic equipment used by patients in seated positions), M303 (diagnostic equipment used by patients seated in a wheelchair), and M304 (diagnostic equipment used by patients in standing position) are also relevant and were considered by the Committee.

Some nuclear medicine (NM) equipment has a unique design created for convenience: in this design, the table pivots out of the way to allow a scan of a patient seated in a chair or wheelchair. An experienced radiologist who presented to the Committee (see Section 3.3.3) indicated that in some circumstances examinations of equivalent quality may be obtained by patients who are supine on NM tables rather than sitting in chairs. Several Committee members and some radiologists expressed concerns that performing scans of patients while they remain in a wheelchair is not always appropriate and does not always produce images of equivalent quality as those obtained when patients are positioned properly on an imaging device. Therefore, the Committee used only the M301 criteria in making recommendations concerning NM accessibility standards.

Specialized MR and imaging devices using other modalities are designed specifically to scan upper and lower extremities (arms and legs). These specialized devices seat patients in chairs rather than positioning them on tables. The Committee agreed that, for these devices, the chair in which patients are seated should comply with the MDE accessibility standards recommended for chairs.

Certain X-ray exams are performed with patients asked to stand against a wall-like apparatus. In these situations, recommendations relating to M304 would apply (Section 5). Industry representatives on the Committee suggested that the standing supports would likely need to be an accessory or a mounting in the room. Additionally, these supports may also need to serve the diagnostic purpose of properly positioning the patient for the imaging tests. In these circumstances, recommendations relating to M305.3 may require adjustment to maintain diagnostic efficacy.