The Supine Chest X-ray

(Stretcher)

The Supine Chest X-ray

(Stretcher)

By: Tafawn Smith, Courtney White & Donna Lewis

By: Tafawn Smith, Courtney White & Donna Lewis

What You’ll Need:What You’ll Need:CalipersLead Shield14x17 CassetteGridGlovesCassette Covers

CalipersLead Shield14x17 CassetteGridGlovesCassette Covers

What’s Going On?What’s Going On? As you approach your patient, notice their condition and position in the stretcher, as well as any tubing that may be attached to them.

Often the reason for the supine chest, done AP, is because the patient is too ill or unable to stand.

After properly identifying the patient, introduce yourself and inform them of what will be taking place. This is a proper time to measure.

As you approach your patient, notice their condition and position in the stretcher, as well as any tubing that may be attached to them.

Often the reason for the supine chest, done AP, is because the patient is too ill or unable to stand.

After properly identifying the patient, introduce yourself and inform them of what will be taking place. This is a proper time to measure.

Adjust the PatientAdjust the Patient

More often than not, while doing a supine chest, you will need to adjust the position of the patient in the stretcher.

If your patient is conscious, ask them if they are able to help you with this task. This option is best for all involved.

More often than not, while doing a supine chest, you will need to adjust the position of the patient in the stretcher.

If your patient is conscious, ask them if they are able to help you with this task. This option is best for all involved.

Adjust the Patient (cont.)Adjust the Patient (cont.)

To begin, go the head of the patient. If they are not able to help, ask them to lay still. With gloved hands, get a firm grip on the sheet on both sides of the patient’s shoulders.

Make sure your feet are evenly spaced and in a stable position. Bend at the knees. In one swift movement, pull the patient toward you.

To begin, go the head of the patient. If they are not able to help, ask them to lay still. With gloved hands, get a firm grip on the sheet on both sides of the patient’s shoulders.

Make sure your feet are evenly spaced and in a stable position. Bend at the knees. In one swift movement, pull the patient toward you.

Move the TubeMove the Tube

It is a good idea at this point to position the x-ray tube in a location near what will be required to perform the exam.

This is important so the patient does not undergo any unnecessary discomfort as the cassette and grid combination soon to be placed behind their back is sure to be cold.

It is a good idea at this point to position the x-ray tube in a location near what will be required to perform the exam.

This is important so the patient does not undergo any unnecessary discomfort as the cassette and grid combination soon to be placed behind their back is sure to be cold.

Placement of the Cassette and Grid

Placement of the Cassette and Grid

Before beginning this maneuver, reiterate to your patient that there will be a cold, hard object or “plate” placed behind their back.

Before beginning this maneuver, reiterate to your patient that there will be a cold, hard object or “plate” placed behind their back.

Placement of the Cassette and Grid (cont.)

Placement of the Cassette and Grid (cont.) Ask the patient to

lean forward so the cassette-grid combination can be placed behind their back.

1 to 2 inches should be visible above the shoulders.

Place the appropriate marker on the grid.

Ask the patient to lean forward so the cassette-grid combination can be placed behind their back.

1 to 2 inches should be visible above the shoulders.

Place the appropriate marker on the grid.

Tube PlacementTube Placement

Place the tube approximately 72” away from the patient.

The angle of the tube should be perpendicular with the mediastinum of the chest, as should the central ray.

Place the tube approximately 72” away from the patient.

The angle of the tube should be perpendicular with the mediastinum of the chest, as should the central ray.

Before ExposureBefore Exposure Prior to returning

to the control panel, place the lead shield in the lap of the patient.

Once at the control panel, set a proper technique.

115 kVp @ 12.5 mAs is an average range for the body type of a sthenic person.

Prior to returning to the control panel, place the lead shield in the lap of the patient.

Once at the control panel, set a proper technique.

115 kVp @ 12.5 mAs is an average range for the body type of a sthenic person.

Important Note: Any handling of control panel should be done with gloves removed.

Instructions for ExposureInstructions for Exposure While keeping

watch over the patient, give the necessary breathing instructions.

If the patient is unable to comply, watch their chest for respiration in deciding when to expose.

While keeping watch over the patient, give the necessary breathing instructions.

If the patient is unable to comply, watch their chest for respiration in deciding when to expose.

Completing the ExamCompleting the Exam

After exposure, remove the cassette-grid combination from behind the patient and return them to a position as comfortable as possible, while maintaining their safety in the stretcher.

After exposure, remove the cassette-grid combination from behind the patient and return them to a position as comfortable as possible, while maintaining their safety in the stretcher.

Finishing UpFinishing Up Once the patient

is secure, cleaning the equipment properly will complete the exam.

This is an important step that should not be overlooked.

Once the patient is secure, cleaning the equipment properly will complete the exam.

This is an important step that should not be overlooked.