LOADING AWESOME
CHEST XRAY
1, WHO, WHAT, WHERE, WHEN, WHY?
Patient details, AP/PA/Lateral etc, Emergency Dept/ICU, To exclude X.
2. QUALITY
- rotation: medial ends of the clavicles equidistant from the spinous processes
- inspiration: 10 to 11 posterior ribs on left side
- exposure (too bright/too dark... can you see everything?)
3. LINES/TUBES/ARTIFACTS
ETT above carina (~T4)
NG in stomachCVC's in SVC
Consider: ECG stickers, jewellery, wires, bra-fasteners, implanted cardiac stents/pacemakers/wires/valves
4. ABCDE of CXR's
- A: airway - (trachea and its branches)- B: breathing (lungs and pleural spaces)
- C: circulation (cardiomediastinum)
- D: disability (bones... think fracture)
- E: exposure (everything else)
RUL
RML
RLL
LUL
LLL
TRACHEA
AORTIC KNUCKLE
CARINA
APEX of HEART
STOMACH
(GASTRIC BUBBLE)
RIGHT DIAPHRAGM
The point the trachea splits in two to travel as the right and left main bronchus
contour of the arch of the aorta
Diaphragm - difference in R&L height should be <3cm
Heart (cardiothoracic ratio): < 55%
Trachea: < 25 mm (males) , < 21 mm (females)
SIZE MATTERS
Consolidation
Collapse
Pneumothorax
Tension Pneumothorax
Pleural Effusion
Pulmonary Oedema
IS THERE ANY....?
CLAVICLE
propofology.com
@Gas_Craic
Dr. David LynessImage: www.radiopaedia.org // Prof. Frank Gaillard
