chest 3

• AP/PA lateral decubitus projection

  IR: 14 x 17 grid or bucky LW

  patient position: in a left or right lateral decubitus position on top of a decubitus sponge. patients head is supported and the chin is extended. arms above the head and out of the lung field, knees flexed. IR is behind the patients back and 1.5-2 inches above the shoulder (AP) or IR is in front of the patient (PA).

  Central ray: horizontal and perpendicular to the IR

  AP: entering 3-4 inches inferior to the jugular notch and MSP

  PA: entering T7 and MSP

  SID: 72 inches if possible

  Technique: kVp 102 mAs 8
• AP soft tissue neck projection

  IR: 10 x 12 grid or bucky LW

  Patient position: supine or upright with back to the bucky. Extend the chin.

  Central ray: perpendicular to the IR entering MSP at C4

  SID: 40 inches
• lateral soft tissue neck projection

  IR: 10 x 12 grid or bucky LW

  Patient position: upright, seated or standing, at the upright bucky. left or right lateral position, extend the chin

  central ray: perpendicular to the IR entering C4

  SID: 72 inches
• patient prep for a chest xray

  patient needs to take everything off from the waist up including jewelry and put a gown on

  earrings are ok

  hair needs to be up and out of the light field

  insulin pump removed if applicable to policy
• radiation protection for chest xrays

  collimate to the lung field

  shielding

  kVp is greater than 100 for low contrast

  low mAs

  no grid if the kVp is between 80 and 90
• patient prep for neck xrays

  no necklaces

  no earrings

  no collars

  have the hair up and out of light field
• indications for a chest xray

  pleural effusion (fluid in the lungs)

  pneumothorax (air in the chest cavity)

  hemothorax (blood in the chest cavity)
• indications for a neck xray


  difficulty swallowing

  foreign body
• what side of the body should be down if the patient has a pneumothorax of the left lung when in a lateral decubitus position?

  the right side of the body
• what side of the body should be down if the patient has a pleural effusion of the right lung when in a lateral decubitus position?

  the right side of the body
• if the patient has fluid (effusion or hemo) the fluid should be on the down side when positioning
• if the patient has air (pneumo) then the air should be on the up side when positioning