Check-off Reminders

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Author:
nenyabrooke
ID:
108139
Filename:
Check-off Reminders
Updated:
2011-10-12 08:22:18
Tags:
Radiographic Positioning Procedures
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Description:
Brief reminders of key points for different projections
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  1. CXR (Chest X-Ray)
    -- PA Chest
    -- Left Lateral Chest

    Notes on PA Chest:
    • Erect position
    • 14x17 cassette length-wise, lead blocker above shoulders
    • SID 72"
    • roll 90°
    • lock tube longitudinally and transversely
    • collimate 14x17 (to match cassette)
    • center to T7:
    • female: 7" down from Vert. Prominens (hang ten)
    • male: 8" down from Vert. Prominens
    • center bucky so that IR and CR are in alignment
    • marker on top, closest to radiographer
    • Chin up, backs of hands on hips, elbows forward, shoulders down
    • breathing: expose on 2nd deep inspiration
  2. CXR (Chest X-Ray)
    -- PA Chest
    -- Left Lateral Chest

    Notes on Left Lateral Chest:
    • Erect position
    • 14x17 cassette length-wise, lead blocker above shoulders
    • SID 72"
    • roll 90°
    • lock tube longitudinally and transversely
    • collimate 14x17
    • patient's left side against IR
    • marker noting side touching IR (left)
    • center to T7:
    • female: 7" down from Vert. Prominens (hang ten)
    • male: 8" down from Vert. Prominens
    • center to mid-thorax (down the armpit)
    • patient holds arms up, as high as possible, chin up
    • check scapula/sternum for alignment
    • breathing: expose on 2nd deep inspiration
  3. CXR Wheelchair
    • 14x17 cassette crosswise (lengthwise in LAB only)
    • lead blocker above shoulder
    • SID 72" (measuring tape)
    • marker on the left (anatomical right)
    • CR centered to T7:
    • measure 4-5 inches down from manubrial notch (rock fingers)
    • adjust collimation manually (IR above shoulder)
    • tube angled 90° to IR (raise vertically, angle down)
    • chin lifted, backs of hands on hips, elbows forward, shoulders down
    • breathing: 2nd deep inspiration
  4. CXR Stretcher, Supine
    • 14x17 cassette crosswise under backboard/patient
    • top of cassette lined up with vertebral prominens
    • lead blocker on top
    • marker on top, noting anatomical side
    • check for cassette on both sides of patient
    • SID 72"
    • CR centered to T7:
    • measure 4-5 inches down from manubrial notch (rock fingers)
    • chin lifted, backs of hands on hips, elbows forward, shoulders down
    • breathing: 2nd deep inspiration
  5. CXR Stretcher, Semi-erect
    • 14x17 cassette crosswise placed behind patient
    • lead blocker above shoulder
    • marker on left (anatomical right)
    • SID: at foot of stretcher
    • center to T7:
    • measure 4-5 inches down from manubrial notch (rock fingers)
    • adjust collimation manually
    • tube angled 90° to IR (raise vertically, angle down)
    • chin lifted, backs of hands on hips, elbows forward, shoulders down
    • breathing: 2nd deep inspiration
    • extra: make sure shoulder shadow is on the IR
  6. Abdominal Series
    -- Erect
    -- Diaphragm
    -- Supine

    Notes on Erect:
    • everything from waist down removed
    • AP projection
    • 14x17 cassette lengthwise, lead blocker on bottom
    • marker at the top
    • 90° roll
    • SID 40"
    • lock tube transversely and longitudinally
    • collimate 14x17
    • CR centered to top of ilium (iliac crest)
    • mid-sagittal centered to xiphoid process
    • hands down by sides
    • breathing: 1st expiration
  7. Abdominal Series:
    -- Erect
    -- Diaphragm
    -- Supine

    Notes on Diaphragm:
    • AP projection
    • 14x17 cassette placed cross-wise
    • lead blocker on top
    • marker on top
    • SID 72 "
    • collimate 17x14
    • center CR and mid-sagittal to xiphoid process
    • arms down by sides
    • breathing: 1st inspiration
  8. Abdominal Series:
    -- Erect
    -- Diaphragm
    -- Supine

    Notes on Supine:
    • 14x17 cassette placed lengthwise
    • lead blocker on bottom
    • marker directly on top of lead blocker
    • SID 40" (table receptor SID)
    • tube locked in transversely
    • bucky lined up to CR
    • center patient on table
    • center CR across iliac crest (by moving table)
    • center mid-sag with xiphoid proc. (by moving table)
    • hands down by sides
    • breathing: 1st expiration
  9. Decubitus CXR

    Additive pathologies are imaged with the affected side down:
    • pneumonia
    • congestive heart failure
    • pleural effusion
    • hemothorax
    • hydrothorax
    • TB
  10. Decubitus CXR

    Destructive pathologies are imaged with the affected side up:
    • COPD (chronic obstructive pulmonary disease)
    • Emphysema
    • pneumothorax
  11. Left/Right Lateral Decubitus CXR
    • 14x17 cassette lengthwise to patient = crosswise
    • marker notes the elevated side, above the shoulder
    • SID 72"
    • lock tube transversely and longitudinally
    • center bucky to patient
    • patient on Left or Right side, according to pathology
    • 90° roll
    • collimate 17x14
    • both arms above head
    • line up bucky to the CR
    • center CR on T7 (using Vert. Prom. or Man. Notch)
    • move entire stretcher to line up, not tube
    • top of light lined up with top of cassette
    • lift chin
    • breathing: 2nd deep inspiration
    • extra: bi-lateral decubitus, 2 projections: right and left
  12. Dorsal Decubitus
    • 14x17 cassette lengthwise to patient = crosswise
    • marker placed to note the side touching the IR, above the patient (left in our LAB)
    • SID 72"
    • collimated 17x14
    • bucky centered to patient
    • patient flat on back, in one plane, arms raised up
    • CR centered on mid-thorax (armpit)
    • center to T7: 4-5 inches down from manubrial notch
    • chin up
    • breathing: 2nd deep inspiration
  13. Decubitus Abdomen
    -- to include bladder
    -- to include diaphragm

    Notes on including bladder:
    • 14x17 cassette lengthwise to patient = crosswise
    • lead blocker on bottom
    • right anatomical marker, to mark the elevated side
    • SID 40"
    • collimate 17x14
    • patient lays on left shoulder, both arms up
    • top of light lined up with top of cassette
    • CR centered to spine and the top of the iliac crest
    • breathing: 1st expiration
  14. Decubitus Abdomen
    -- to include bladder
    -- to include diaphragm

    Notes on including diaphragm:
    • 14x17 cassette lengthwise to patient = crosswise
    • lead blocker on bottom
    • right anatomical marker, to mark the elevated side
    • SID 40"
    • collimate 17x14
    • patient lays on left shoulder, both arms up
    • top of light lined up with top of cassette
    • CR centered to spine and 2 inches above the top of the iliac crest (3 fingers)
    • breathing: 1st expiration
  15. Lordotic CXR
    • 14x17 cassette lengthwise, lead blocker at the top
    • marker at the top (left marker in big lab room)
    • collimate 14x17
    • AP projection
    • lean patient's shoulders against bucky, walk their feet out about a foot from the bucky
    • have patient arch back
    • CR centered to mid-sternum:
    • halfway between xiphoid process and manubrial notch
    • line bucky up to tube; move patient first
    • chin up, backs of hands on hips, elbows forward, shoulders down
    • breathing: 2nd deep inspiration
    • extra: there will probably be 4-5 inches of light above the shoulder
  16. PA Obliques CXR
    -- RAO
    -- LAO
    • 14x17 lengthwise, lead blocker up
    • marker on top next to blocker
    • SID 72"
    • collimate 14x17
    • turn patient 45° (right and left)
    • CR centered to T7 using Vert. Prominens
    • centered to half-way between the mad-sagittal plane (spine) and the lateral abdominal margin (armpit)
    • arms:
    • arm closest to IR does standard CXR position
    • arm farther from IR rests on top of chest rack
    • chin lifted, shoulders relaxed
    • breathing: 2nd deep inspiration
  17. PA Obliques CXR
    Emphasis on heart
    -- RAO
    -- LAO
    • 14x17 lengthwise, lead blocker up
    • marker on top next to blocker
    • SID 72"
    • collimate 14x17
    • turn patient 45° for RAO
    • turn patient 60° for LAO
    • CR centered to T7 using Vert. Prominens
    • centered to half-way between the mad-sagittal plane (spine) and the lateral abdominal margin (armpit)
    • arms:
    • arm closest to IR does standard CXR position
    • arm farther from IR rests on top of chest rack
    • chin lifted, shoulders relaxed
    • breathing: 2nd deep inspiration
  18. AP Obliques CXR
    -- RPO
    -- LPO
    • 14x17 lengthwise, lead blocker up
    • marker on top next to blocker
    • SID 72"
    • collimate 14x17
    • turn patient 45° (right and left)
    • CR centered to T7 using manubrial notch
    • centered to half-way between the mad-sagittal plane (xiphoid process) and the lateral abdominal margin (armpit)
    • arms in normal CXR positions, but angled according to which pblique being done
    • chin lifted, shoulders relaxedbreathing: 2nd deep inspiration

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