Rational Use of Bedside Mobile DR and the Practical Dilemmas It Faces

 Bedside mobile DR (Digital Radiography) was originally designed to provide essential imaging services for critically ill patients or those who truly cannot be transported. By enabling examinations to be completed at the bedside, it helps avoid the risks associated with moving vulnerable patients.

However, in recent years, driven by healthcare reforms that have lowered prices and simplified application procedures, the use of bedside mobile DR has increased significantly. As a result, some patients who could easily undergo examinations with fixed, large-scale DR systems are now indiscriminately requesting bedside imaging. This trend has led to resource waste, increased labor burden, and new safety concerns.

1. Differences Between Mobile DR and Fixed DR

Fixed large-scale DR systems offer standardized imaging environments and superior image quality, making them the best choice for the majority of patients. Mobile DR systems, constrained by ward space and inherent equipment limitations, still cannot match the imaging quality of fixed DR.

Therefore, as long as a patient can be safely transported—by walking, wheelchair, or stretcher—the examination should preferentially be performed using fixed DR, reserving mobile DR resources for truly critical patients.

2. Increasingly Evident Overuse

In daily practice, technologists may push a mobile DR unit to the ward only to find the patient walking around the room or even going downstairs for meals. Some patients are able to undergo CT, MRI, or bone densitometry on the same day, yet do not take the opportunity to have a DR exam along the way. In other cases, after imaging has been completed, a physician may adjust an implanted tube one or two hours later and then request a “free repeat scan.”

Such practices divert mobile DR from its original purpose of emergency and critical care, occupying opportunities that should be reserved for severely ill patients. At the same time, imaging technologists are left constantly rushing—urgent requests from one department followed by emergency calls from another, moving back and forth across different buildings and floors.

3. Radiation Protection Challenges in the Ward

One of the biggest technical challenges of bedside imaging in wards is radiation protection. Ward spaces are limited and cannot provide the same level of comprehensive shielding as fixed DR rooms. Nearby patients and family members often need to be evacuated in advance, and some may refuse to cooperate due to misunderstanding or discomfort.

Technologists must explain radiation protection principles while simultaneously moving equipment and adjusting patient positioning and detector plates. This process is time-consuming and increases psychological stress. In some cases, family members may even question: “Why take X-rays in the ward? Will it expose others to radiation?” These communication costs and emotional frictions are rarely encountered during fixed DR examinations.

4. Suggestions for Improvement

Establish a usage data tracking and reporting mechanism
Imaging departments should regularly collect and analyze data on bedside mobile DR usage, including the proportion of patients who are clearly mobile or can be safely transported, as well as departmental distribution. The results should be reported to medical affairs or management departments to support process optimization.

Prioritize fixed DR and reserve mobile DR for those who truly need it
As long as patients can be safely transported by wheelchair or stretcher, fixed large-scale DR should be the first choice, reducing radiation protection challenges in the wards.

Encourage cooperation from patients and families
For critically ill or mobility-limited patients, caregivers should assist technologists with detector placement and positioning adjustments. This not only reduces physical strain on staff but also facilitates smoother examinations.

Optimize radiation protection workflows
Hospitals can designate temporary imaging areas in wards or install lead screens to minimize interference with other patients, improving the safety and acceptance of bedside imaging.