Radiographic Procedures 2 (155) Mobile Radiography

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Chapters 20 Mobile Radiography

34 Terms

1

Mobile radiography

  • use of transportable x-ray equipment to bring imaging services to the patient

  • commonly performed in:

    • patient rooms

    • ER

    • ICU

    • OR

    • PACU

    • nursery and NICU

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Mobile units

  • not as sophisticated as stationary units

  • typical unit has controls for setting kVp and mAs

    • mAs controls automatically adjusts mA and time

    • typical mAs range: 0.04-320

    • kVp: 40-130

  • power varies between 15-25 kW

  • anatomic programs (APRs)

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Digital Mobile units

  • mobile units with direct digital capability

    • acquire image within seconds after exposure

    • uses a flat-panel detector

    • wirelessly transfer images to PACS

    • lower radiation doses possible

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Technical considerations

  • grid, anode heel effect, source-to-image receptor distance (SID)

  • exposure technique charts are essential to optimize exams

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Grid considerations

  • sensitivity of CR imaging plates to scatter radiation leads to image degradation

  • optimum performance:

    • level: use of grid on unstable surface may cause “off level” grid cutoff

    • centered to CR: midline of a grid more than 1-1½ inches off transversely from the CR causes “off level” grid cutoff

    • used at recommended focal distnace or radius: exposures outside the recommended focal range may produce cuttoff on the lateral margins

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Anode heel effect

  • causes decreased image density under the anode side of the x-ray tube

  • more pronounced with:

    • short SID

    • larger field sizes

    • small anode angles

  • short SID and large field sizes are common in mobile

  • proper placement of anode-cathode axis with anatomy is essential

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Source to image distance (SID)

  • should be maintained at 40 inches (102 cm)

  • standardized distance ensures consistent images

  • longer SIDs:

    • requires increased mAs resulting in longer exposure times

    • increased risk of motion artifacts

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Radiation safety in mobile x-ray

  • produces some of the highest occupational radiation exposure to radiographers

  • protection for self, patient, and other personnel:

    • wearing a lead apron

    • standing as far away from patient, tube, and beam as possible

      • recommended minimal distance is 6ft

      • standing at a right angle (90 degrees) to the primary beam

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Mobile x-ray in isolation

  • two types of patients in isolation:

    • those who have contagious infectious microorganisms

    • those who must be protected from exposire to infectious microorganisms (reverse isolation)

  • wear all required protective apparel for specific situation

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Equipment used in mobile

  • IR

  • grid

  • protective covers

  • tape

  • caliper

  • markers

  • positioning blocks

  • lead

  • requisition

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Initial mobile x-ray procedure

  • preliminary steps for the radiographer prior to performing mobile radiography:

    • announce presence to nursing staff

    • ask for assistance if needed

    • confirm patient identity

    • introduce yourself to patient and family

    • explain the examination

    • observe medical equipment in room and move if necessary

    • ask family members and visitors to step out of the room

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Mobile unit placement

  • supine position: middle of bed

  • seated upright position: foot of the bed

  • lateral and decubitus positions: parallel or perpendicular to bed

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Patient considerations

  • assessment of patient condition

    • altertness

    • respiration

    • ability to cooperate

    • limitations to procedure

  • patient mobility

    • never move a patient or part without assessment of ability to move or ability to tolerate movement

    • check with nursing staff or physician to obtain assistance and permission to move a part that has had surgery or is fractured

    • inappropriate movement can further injure the patient

  • fractures

    • various fractures and fracture types

    • patient ability to assist

    • key is to be cautious and gentle for both patient safety and comfort

    • work in accordance with the patient’s condition and pain tolerance

  • interfering devices

    • orthopedic beds, fracture frames, tube, and wiring produce artifacts

    • some objects can be moved and some require procedure modification to obtain the image

    • some procedures have to be performed with the object in the image

    • get assistance if unsure an object can be moved

  • positioning and aspesis

    • warn patietn of potential discomfort of IR

    • IR can damage skin of older patient

    • protect Ir from contamination by use of cover

    • disinfect IR for asepsis and infection control

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AP chest

  • patient position:

    • dependent on condition

    • seated upright, semi upright, or supine

      • greatest upright angle the patient can tolerate, whenever possible

      • use the supine position for critically ill or injured patients

  • part position:

    • center MSP to IR

    • top of IR 2 inches above relaxed shoulders

    • internally rotate patient’s arms (if not contraindicated)

    • no leaning or rotation of upper torso

  • CR:

    • perpendicular to long aixs of sternum and center of IR

    • enters approximately 3 inches below jugular notch at level of T7

  • respiration:

    • inspiration, unless otherwise requested

    • if respiration assistance is provided, watch patient’s chest to determine inspiratory phase

  • collimation:

    • 14 × 17 in

<ul><li><p>patient position:</p><ul><li><p>dependent on condition</p></li><li><p>seated upright, semi upright, or supine</p><ul><li><p>greatest upright angle the patient can tolerate, whenever possible</p></li><li><p>use the supine position for critically ill or injured patients</p></li></ul></li></ul></li><li><p>part position:</p><ul><li><p>center MSP to IR</p></li><li><p>top of IR 2 inches above relaxed shoulders</p></li><li><p>internally rotate patient’s arms (if not contraindicated) </p></li><li><p>no leaning or rotation of upper torso</p></li></ul></li><li><p>CR: </p><ul><li><p>perpendicular to long aixs of sternum and center of IR</p></li><li><p>enters approximately 3 inches below jugular notch at level of T7</p></li></ul></li><li><p>respiration:</p><ul><li><p>inspiration, unless otherwise requested</p></li><li><p>if respiration assistance is provided, watch patient’s chest to determine inspiratory phase</p></li></ul></li><li><p>collimation: </p><ul><li><p>14 × 17 in</p></li></ul></li></ul><p></p>
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AP chest image criteria

  • structures shown:

    • anatomy of thorax:

      • heart

      • trachea

      • ribs

      • diaphragmatic domes

      • entire lung fields

      • vascular markings

    • evaluation criteria:

      • no motion; well-defined diaphragmatic domes and lung fields

      • lung fields in their entirety including costophrenic angles

      • pleural markings

      • ribs and thoracic intervertebral disk spaces faintly visible through heart shadow

      • no rotation; medial portion of clavicles and alteral border of ribs equidistant from vertebral column

<ul><li><p>structures shown:</p><ul><li><p>anatomy of thorax:</p><ul><li><p>heart</p></li><li><p>trachea</p></li><li><p>ribs</p></li><li><p>diaphragmatic domes</p></li><li><p>entire lung fields</p></li><li><p>vascular markings</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>no motion; well-defined diaphragmatic domes and lung fields</p></li><li><p>lung fields in their entirety including costophrenic angles</p></li><li><p>pleural markings</p></li><li><p>ribs and thoracic intervertebral disk spaces faintly visible through heart shadow</p></li><li><p>no rotation; medial portion of clavicles and alteral border of ribs equidistant from vertebral column</p></li></ul></li></ul></li></ul><p></p>
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AP/PA chest lateral decubitus

  • patient position:

    • right or left lateral recumbent

      • affected side down for fluid levels

      • unaffected side down for air levels

    • remain for 5 minutes for air/fluid levels

    • knees flexed

    • place firm support under body to elevate 2-3 inches

    • raise arms over head or out of anatomy of interest

    • protect patient from rolling off bed

  • part position:

    • ensure lateral position without rotation

    • IR behind patient and below support

    • top of IR 2 inches above relaxed shoulders

  • CR:

    • horizontal and perpendicular to IR

    • enters approx. 3 inches below jugular notch at level of T7

  • respiration:

    • inspiration unless otherwise requested

  • collimation:

    • 14 × 17 in

<ul><li><p>patient position:</p><ul><li><p>right or left lateral recumbent</p><ul><li><p>affected side down for fluid levels</p></li><li><p>unaffected side down for air levels</p></li></ul></li><li><p>remain for 5 minutes for air/fluid levels </p></li><li><p>knees flexed</p></li><li><p>place firm support under body to elevate 2-3 inches</p></li><li><p>raise arms over head or out of anatomy of interest</p></li><li><p>protect patient from rolling off bed</p></li></ul></li><li><p>part position:</p><ul><li><p>ensure lateral position without rotation</p></li><li><p>IR behind patient and below support</p></li><li><p>top of IR 2 inches above relaxed shoulders</p></li></ul></li><li><p>CR:</p><ul><li><p>horizontal and perpendicular to IR</p></li><li><p>enters approx. 3 inches below jugular notch at level of T7</p></li></ul></li><li><p>respiration:</p><ul><li><p>inspiration unless otherwise requested</p></li></ul></li><li><p>collimation:</p><ul><li><p>14 × 17 in</p></li></ul></li></ul><p></p>
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AP/PA chest lateral decubitus image criteria

  • structures shown:

    • anatomy of thorax

    • air or fluid levels

  • evaluation criteria:

    • no motion or rotation

    • affected side in its entirety

      • upper lung for free air

      • lower lung for fluid

    • arms out of region of interest

<ul><li><p>structures shown:</p><ul><li><p>anatomy of thorax </p></li><li><p>air or fluid levels</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>no motion or rotation</p></li><li><p>affected side in its entirety</p><ul><li><p>upper lung for free air</p></li><li><p>lower lung for fluid</p></li></ul></li><li><p>arms out of region of interest</p></li></ul></li></ul><p></p>
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AP abdomen

  • patient position:

    • supine

    • adjust bed in horizontal position

  • part position:

    • place grid under body centered to MSP and level of iliac crests

      • for upper abdomen, center grid 2 inches above iliac crests

    • use draw sheet to roll patient and as barrier between skin and IR

    • ensure grid does not tip to prevent cutoff

    • align shoulders and hips in same plane

    • place arms out of anatomy of interest

  • CR:

    • perpendicular to center of grid

    • enters at MSP at level of iliac crests or 10th rib laterally

  • respiration:

    • expiration

  • Collimation:

    • 14 × 17 inches

<ul><li><p>patient position:</p><ul><li><p>supine</p></li><li><p>adjust bed in horizontal position</p></li></ul></li><li><p>part position:</p><ul><li><p>place grid under body centered to MSP and level of iliac crests</p><ul><li><p>for upper abdomen, center grid 2 inches above iliac crests</p></li></ul></li><li><p>use draw sheet to roll patient and as barrier between skin and IR</p></li><li><p>ensure grid does not tip to prevent cutoff</p></li><li><p>align shoulders and hips in same plane</p></li><li><p>place arms out of anatomy of interest</p></li></ul></li><li><p>CR: </p><ul><li><p>perpendicular to center of grid</p></li><li><p>enters at MSP at level of iliac crests or 10th rib laterally</p></li></ul></li><li><p>respiration:</p><ul><li><p>expiration</p></li></ul></li><li><p>Collimation:</p><ul><li><p>14 × 17 inches</p></li></ul></li></ul><p></p>
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AP abdomen image criteria

  • structures shown:

    • inferior margin of liver

    • spleen

    • kidneys

    • psoas muscles

    • calcifications

    • evidence of tumor masses

    • size and shape of liver if upper abdomen and diaphragm included

  • evaluation criteria:

    • no motion

    • outlines of abdominal viscera

    • abdominal region including ppubic symphysis or diaphragm

    • vertebral cloumn centered

    • psoas muscles, lower margin of liver, and kidney margins

    • no rotation

      • symmetric appearance of vertebral column and iliac wings

<ul><li><p>structures shown:</p><ul><li><p>inferior margin of liver</p></li><li><p>spleen</p></li><li><p>kidneys</p></li><li><p>psoas muscles</p></li><li><p>calcifications</p></li><li><p>evidence of tumor masses</p></li><li><p>size and shape of liver if upper abdomen and diaphragm included</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>no motion</p></li><li><p>outlines of abdominal viscera</p></li><li><p>abdominal region including ppubic symphysis or diaphragm</p></li><li><p>vertebral cloumn centered</p></li><li><p>psoas muscles, lower margin of liver, and kidney margins</p></li><li><p>no rotation</p><ul><li><p>symmetric appearance of vertebral column and iliac wings</p></li></ul></li></ul></li></ul><p></p>
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AP/PA abdomen left lateral decubitus

  • patient position:

    • left lateral recumbent position

    • flex knees for stability

    • place firm support under patient to elevate body

    • raise both arms out of anatomy of interest

    • ensure patient cannot roll out of bed

    • leave in position for 5 minutes to allow air to rise and fluid to settle

  • part position:

    • true lateral without rotation

    • place vertical grid centered at 2 inches above iliac crests to demonstrate diaphragm

    • ensure patient has been in position for at least 5 minutes to allow air to rise and fluid to settle

  • CR:

    • horizontal and perpendicular to center of grid

    • enters at MSP at level 2 inches above iliac crests

  • respiration:

    • expiration

  • collimation:

    • 14 × 17 inches

<ul><li><p>patient position:</p><ul><li><p>left lateral recumbent position</p></li><li><p>flex knees for stability</p></li><li><p>place firm support under patient to elevate body</p></li><li><p>raise both arms out of anatomy of interest</p></li><li><p>ensure patient cannot roll out of bed</p></li><li><p>leave in position for 5 minutes to allow air to rise and fluid to settle</p></li></ul></li><li><p>part position: </p><ul><li><p>true lateral without rotation</p></li><li><p>place vertical grid centered at 2 inches above iliac crests to demonstrate diaphragm</p></li><li><p>ensure patient has been in position for at least 5 minutes to allow air to rise and fluid to settle</p></li></ul></li><li><p>CR: </p><ul><li><p>horizontal and perpendicular to center of grid</p></li><li><p>enters at MSP at level 2 inches above iliac crests</p></li></ul></li><li><p>respiration:</p><ul><li><p>expiration</p></li></ul></li><li><p>collimation:</p><ul><li><p>14 × 17 inches</p></li></ul></li></ul><p></p>
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AP/PA abdomen left lateral decubitus image criteria

  • structures shown:

    • air or fluid levels

    • right border of the abdominal region must be visualized

  • evaluation criteria:

    • no motion

    • well-defined diaphragm and abdominal viscera

    • air or fluid levels

    • right and elft abdominal wall and flank structures

    • no rotation

      • symmetric appearance of vertebral column and iliac wings

<ul><li><p>structures shown:</p><ul><li><p>air or fluid levels</p></li><li><p>right border of the abdominal region must be visualized</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>no motion</p></li><li><p>well-defined diaphragm and abdominal viscera</p></li><li><p>air or fluid levels</p></li><li><p>right and elft abdominal wall and flank structures</p></li><li><p>no rotation </p><ul><li><p>symmetric appearance of vertebral column and iliac wings</p></li></ul></li></ul></li></ul><p></p>
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AP pelvis

  • patient position:

    • supine

    • adjust bed to horizontal

    • move arms out of anatomy of interest

  • part position:

    • place grid under pelvis

      • centered to MSP at level midway between ASIS and pubic symphysis

    • no rotation of pelvis

    • rotate legs medially approx. 15 degrees, when not contraindicated

  • CR:

    • perpendicular to IR center

    • enters patient at MSP at 2 inches above pubic symphysis and 2 inches below ASIS

  • respiration:

    • suspended

  • collimation:

    • 14 × 17 inches

<ul><li><p>patient position:</p><ul><li><p>supine</p></li><li><p>adjust bed to horizontal</p></li><li><p>move arms out of anatomy of interest</p></li></ul></li><li><p>part position:</p><ul><li><p>place grid under pelvis</p><ul><li><p>centered to MSP at level midway between ASIS and pubic symphysis</p></li></ul></li><li><p>no rotation of pelvis</p></li><li><p>rotate legs medially approx. 15 degrees, when not contraindicated</p></li></ul></li><li><p>CR:</p><ul><li><p>perpendicular to IR center</p></li><li><p>enters patient at MSP at 2 inches above pubic symphysis and 2 inches below ASIS</p></li></ul></li><li><p>respiration:</p><ul><li><p>suspended</p></li></ul></li><li><p>collimation:</p><ul><li><p>14 × 17 inches</p></li></ul></li></ul><p></p>
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AP pelvis image criteria

  • structures shown:

    • pelvis with both hip bones

    • sacrum and coccyx

    • proximal femora including head, neck, and trochanters

  • evaluation criteria:

    • entire pelvis, including proximal femora and hip bones

    • no rotation

      • symmetric appearance of iliac wings and obturator foramina

      • femoral necks no foreshortened

      • greater trochanters in profile

<ul><li><p>structures shown:</p><ul><li><p>pelvis with both hip bones</p></li><li><p>sacrum and coccyx</p></li><li><p>proximal femora including head, neck, and trochanters</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>entire pelvis, including proximal femora and hip bones</p></li><li><p>no rotation</p><ul><li><p>symmetric appearance of iliac wings and obturator foramina</p></li><li><p>femoral necks no foreshortened</p></li><li><p>greater trochanters in profile</p></li></ul></li></ul></li></ul><p></p>
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AP femur

  • patient position:

    • supine

    • patient generally has limited mobility

  • part position:

    • carefully place grid lengthwise under femur

    • centered to midline of femur

    • distal end of grid low enough to include fracture site, pathology, and knee joint

    • ensure grid aligned parallel with CR and femoral condyles

  • CR:

    • perpendicular to long axis of femur and center of grid

    • CR and grid must be aligned to prevent cutoff

  • respiration:

    • suspended

  • collimation:

    • top of ASIS for hip, bottom at tibial tuberosity for knee, 1 inch on side of the shadow of the femur, and 17 inches in length

<ul><li><p>patient position:</p><ul><li><p>supine</p></li><li><p>patient generally has limited mobility</p></li></ul></li><li><p>part position:</p><ul><li><p>carefully place grid lengthwise under femur</p></li><li><p>centered to midline of femur</p></li><li><p>distal end of grid low enough to include fracture site, pathology, and knee joint</p></li><li><p>ensure grid aligned parallel with CR and femoral condyles</p></li></ul></li><li><p>CR:</p><ul><li><p>perpendicular to long axis of femur and center of grid</p></li><li><p>CR and grid must be aligned to prevent cutoff</p></li></ul></li><li><p>respiration:</p><ul><li><p>suspended</p></li></ul></li><li><p>collimation:</p><ul><li><p>top of ASIS for hip, bottom at tibial tuberosity for knee, 1 inch on side of the shadow of the femur, and 17 inches in length</p></li></ul></li></ul><p></p>
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AP femur image criteria

  • structures shown:

    • distal 2/3 of femur

    • knee joint

  • evaluation criteria:

    • most of femur including knee joint for distal

    • no rotation of knee

    • adequate penetration

    • orthopedic appliance in its entirety

<ul><li><p>structures shown:</p><ul><li><p>distal 2/3 of femur</p></li><li><p>knee joint</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>most of femur including knee joint for distal</p></li><li><p>no rotation of knee</p></li><li><p>adequate penetration</p></li><li><p>orthopedic appliance in its entirety</p></li></ul></li></ul><p></p>
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Lateral femur

  • patient position:

    • dorsal decubitus

  • part position:

    • use either mediolateral or lateromedial projection

    • mediolateral projection preferred because it provides more visualization of proximal femur

    • mediolateral projection:

      • place vertical grid along lateral aspect of femur

      • distal edge of grid low enough to include knee joint

      • support unaffected leg with patient’s support or support block

      • elevate unaffected leg until femur is near vertical

    • lateromedial projection:

      • place vertical grid along medial aspect of femur (between patient’s legs)

      • make sure knee joint is included

      • ensure grid is perpendicular to the epicondylar plane

  • CR:

    • perpendicular to long axis of femur

    • centered to femur

    • CR and grid must be aligned to prevent cutoff

  • respiration:

    • suspended

  • collimation:

    • radiation field at top of ASIS for hip, bottom at tibial tuberosity for knee, 1 inch on side of the shadow of the femur, and 17 inches in length

<ul><li><p>patient position:</p><ul><li><p>dorsal decubitus</p></li></ul></li><li><p>part position:</p><ul><li><p>use either mediolateral or lateromedial projection</p></li><li><p>mediolateral projection preferred because it provides more visualization of proximal femur</p></li><li><p>mediolateral projection:</p><ul><li><p>place vertical grid along lateral aspect of femur</p></li><li><p>distal edge of grid low enough to include knee joint</p></li><li><p>support unaffected leg with patient’s support or support block</p></li><li><p>elevate unaffected leg until femur is near vertical </p></li></ul></li><li><p>lateromedial projection:</p><ul><li><p>place vertical grid along medial aspect of femur (between patient’s legs)</p></li><li><p>make sure knee joint is included</p></li><li><p>ensure grid is perpendicular to the epicondylar plane</p></li></ul></li></ul></li><li><p>CR:</p><ul><li><p>perpendicular to long axis of femur</p></li><li><p>centered to femur</p></li><li><p>CR and grid must be aligned to prevent cutoff</p></li></ul></li><li><p>respiration:</p><ul><li><p>suspended</p></li></ul></li><li><p>collimation:</p><ul><li><p>radiation field at top of ASIS for hip, bottom at tibial tuberosity for knee, 1 inch on side of the shadow of the femur, and 17 inches in length</p></li></ul></li></ul><p></p>
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Lateral femur image criteria

  • structures shown:

    • distal 2/3 of femur

    • knee joint

    • no superimposition of opposite thigh

  • evaluation criteria:

    • most of femur with knee joint

    • patella in profile

    • superimposition of femoral condyles

    • oppposite femur and soft tissue out of area of interest

    • adequate penetration of proximal femur

    • orthopedic appliance if present

<ul><li><p>structures shown:</p><ul><li><p>distal 2/3 of femur</p></li><li><p>knee joint</p></li><li><p>no superimposition of opposite thigh</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>most of femur with knee joint</p></li><li><p>patella in profile</p></li><li><p>superimposition of femoral condyles</p></li><li><p>oppposite femur and soft tissue out of area of interest</p></li><li><p>adequate penetration of proximal femur</p></li><li><p>orthopedic appliance if present</p></li></ul></li></ul><p></p>
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Lateral C-spine

  • patient position:

    • right or left dorsal decubitus

    • arms extended alongside of body

    • do not remove any immobilization device without physician consent

  • part position:

    • no rotation of upper torso, cervical spine, and head

    • grid lengthwise on right or left side, parallel to neck

    • top of grip approx. 1 inch above external acoustic meatus (EAM) and centered to C4

    • raise chin slightly, if not contraindicated

    • relax shoulders and reach for feet, if possible

  • CR:

    • horizontal and perpendicular to center of grid

    • enters level of C4

    • increased OID; SID of 60-72 inches recommended to show C7

  • respiration:

    • full expiration for depression of shoulders

  • collimation:

    • radiation feild at top of ear attachment (TEA), bottom to jugular notch, and 1 inch on the sides of the neck

<ul><li><p>patient position:</p><ul><li><p>right or left dorsal decubitus</p></li><li><p>arms extended alongside of body </p></li><li><p>do not remove any immobilization device without physician consent</p></li></ul></li><li><p>part position:</p><ul><li><p>no rotation of upper torso, cervical spine, and head</p></li><li><p>grid lengthwise on right or left side, parallel to neck</p></li><li><p>top of grip approx. 1 inch above external acoustic meatus (EAM) and centered to C4</p></li><li><p>raise chin slightly, if not contraindicated</p></li><li><p>relax shoulders and reach for feet, if possible</p></li></ul></li><li><p>CR: </p><ul><li><p>horizontal and perpendicular to center of grid</p></li><li><p>enters level of C4</p></li><li><p>increased OID; SID of 60-72 inches recommended to show C7</p></li></ul></li><li><p>respiration:</p><ul><li><p>full expiration for depression of shoulders</p></li></ul></li><li><p>collimation:</p><ul><li><p>radiation feild at top of ear attachment (TEA), bottom to jugular notch, and 1 inch on the sides of the neck</p></li></ul></li></ul><p></p>
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Lateral C-spine image criteria

  • structures shown:

    • seven cervical vertebrae

    • base of skull

    • soft tissue of neck

  • evaluation criteria:

    • all seven cervical vertebrae

    • neck extended when possible, so mandibular rami are no superimposing C1 or C2

  • C4 centered

  • superimposed posterior margins of each vertebral body

<ul><li><p>structures shown: </p><ul><li><p>seven cervical vertebrae</p></li><li><p>base of skull</p></li><li><p>soft tissue of neck</p></li></ul></li><li><p>evaluation criteria:</p><ul><li><p>all seven cervical vertebrae</p></li><li><p>neck extended when possible, so mandibular rami are no superimposing C1 or C2</p></li></ul></li><li><p>C4 centered</p></li><li><p>superimposed posterior margins of each vertebral body</p></li></ul><p></p>
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Best practices

  • speed

  • knowledge

  • positioning accuracy

  • practice standard precautions

  • immobilizations

  • equipment

  • attention to detail

  • attention to department protocol and scope of practice

  • professionalism

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AP chest/abdomen neonate

  • infant is supine

  • move arms out of anatomy of interest

  • bring legs down

  • leave head rotated to avoid advancing endotracheal tube too far

  • collimate closely

  • shield gonads

  • CR is perpendicular to IR

  • infant respirations are rapid

<ul><li><p>infant is supine</p></li><li><p>move arms out of anatomy of interest</p></li><li><p>bring legs down</p></li><li><p>leave head rotated to avoid advancing endotracheal tube too far</p></li><li><p>collimate closely</p></li><li><p>shield gonads</p></li><li><p>CR is perpendicular to IR</p></li><li><p>infant respirations are rapid</p></li></ul><p></p>
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32

AP chest/abdomen neonate image

knowt flashcard image
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33

Lateral chest/abdomen neonate

  • obtained using dorsal decubitus position

  • elevate infant on blcok wrapped in soft cover

  • place IR lengthwise and vertical beside infant and immobilize

  • center infant’s chest and abdomen to IR

  • have nurse hold arms and legs out of collimated field

  • CR is horizontal and perpendicular to IR

    • enters on MCP

  • exposure made on inspiration

<ul><li><p>obtained using dorsal decubitus position</p></li><li><p>elevate infant on blcok wrapped in soft cover</p></li><li><p>place IR lengthwise and vertical beside infant and immobilize</p></li><li><p>center infant’s chest and abdomen to IR</p></li><li><p>have nurse hold arms and legs out of collimated field</p></li><li><p>CR is horizontal and perpendicular to IR</p><ul><li><p>enters on MCP</p></li></ul></li><li><p>exposure made on inspiration</p></li></ul><p></p>
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34

Lateral chest/abdomen neonate image

knowt flashcard image
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