PORTABLE CXR NEONATE SCBU
Baby should be at least 4hrs old before a routine chest x-ray is to be taken
when querying Surfactant deficiency (‘wet lung’) only.
When Clinically indicated it will be necessary to perform the examination
before this time window has been reached on a clinical need basis:
Ventilated baby
Intubation (ETT) check
Pneumathorax
Patient Preparation
1. Horizontal incubator
2. Baby undressed and any removable leads removed
3. Sheepskin removed from under baby
4. Baby should be positioned to avoid porthole of incubator
5. Set exposure
6. Ensure supporting nurse is wearing lead rubber apron
7. Ensure cassette has been cleaned and place in new plastic bag or paper
towel placed on top.
Radiographic technique
1.Supine with 15-degree pad placed under baby’s shoulder and head
Angle 5 to 10 degrees caudally to reduce lordosis
2.Baby held with arms straight above to immobilise head and held across
abdomen if necessary/Alternately a rolled up towel or small blanket can be
placed around the baby’s head to stabilise the head in a neutral position, with
the arms down but abducted away from the chest.
IF BABY IS IN AN INCUBATOR USE THE TRAY PLEASE.
Radiation Protection
Lead rubber covering the abdomen
Baby in incubator; lead masking on 4 sides, positioned on the top of the
incubator
Ensure only the chest is in the primary beam
Holder’s hands not to be in the primary beam
Image Quality Criteria.
1.Performed at peak of inspiration.
2.Reproduction of thorax without rotation or tilting from cervical trachea to
T12/L1.
3.Reproduction of the vascular markings in the central lungs.
4.Reproduction of the trachea, proximal bronchi, diaphragm and costophrenic
angles.
5. Reproduction of the spine, paraspinal structure and visualisation of the
retrocardiac lung and mediastinum.
6.Mandible must be included on all intubated patients.
Lateral
Preparation as above
Radiographic Technique
Baby turned onto appropriate side
Arms immobilised above and in front of head
Lead rubber secured across abdomen
Collimate just to include chest in primary beam
Lateral for pneumothorax (with radiologist agreement) or if drains in situ
Preparation as above with addition of rectangular foam pad
Radiographic Technique
Baby supine on foam pad
Arms immobilised above head
Lead rubber secured across abdomen
Cassette placed adjacent to appropriate side
Horizontal tube
Ensure chest only in primary beam
Image Quality Criteria.
1.Performed at peak of inspiration.
2.True lateral projection.
3.Demonstration of the trachea including cervical trachea and main bronchi.
4.Demonstration of both domes of the diaphragm, sternum and dorsal spine.
5.Clear visualisation of any drains.