Chapter 7

Mobile

Chest

AP

Patient position

• Position patient upright or to greatest angle tolerated.

• Position critically ill or injured patients supine.

Part position

• Center midsagittal plane to IR.

• Position IR under patient with top about 2 inches (5 cm) above relaxed shoulders.

• Internally rotate patient’s arms to prevent scapular superimposition of lung field, if not contraindicated.

• Ensure that patient’s upper torso is not rotated.

Respiration:

Inspiration.

Central ray

• Perpendicular to center of IR

Collimation:

Adjust to 14 × 17 inches (35 × 43 cm).

kVp: 90 (40˝ SID, non-grid) 105 (40˝ grid)

Reference: 13th edition ATLAS p. 3:192-193.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Chest

AP or PA (right or left lateral decubitus)

Patient position

• Position patient in lateral recumbent position.

• Place firm support under patient to elevate body 2 to 3 inches (5 to 7.5 cm).

• Raise both arms up and away from chest region.

• Ensure that patient cannot fall out of bed.

Part position

• Perform AP projection whenever possible.

• Adjust patient to ensure true lateral position.

• Place IR behind patient and below support.

• Adjust grid so that it extends 2 inches (5 cm) above shoulders.

Respiration:

Inspiration.

Central ray

• Horizontal and perpendicular to center of IR

Collimation:

Adjust to 14 × 17 inches (35 × 43 cm).

kVp: 105 (40˝ grid)

Reference: 13th edition ATLAS p. 3:180-181.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Abdomen

AP

Patient position

• Position patient supine using horizontal bed placement.

Part position

• Position grid under patient.

• Keep grid from tipping side to side by placing it in center of bed and stabilizing with blankets if necessary.

• Center midsagittal plane to grid.

• If emphasis is on upper abdomen, center grid 2 inches (5 cm) above iliac crests or high enough to include diaphragm.

Respiration:

Suspended.

Central ray

• Perpendicular to center of grid at level of iliac crests

Collimation:

Adjust to 14 × 17 inches (35 × 43 cm).

kVp: 85

Reference: 13th edition ATLAS p. 3:196-197.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Abdomen

AP or PA (left lateral decubitus)

Patient position

• Place patient in left lateral recumbent position.

• If necessary, place firm support under patient to elevate body.

• Ensure that patient cannot fall out of bed.

Part position

• Adjust patient to ensure true lateral position.

• Place grid vertically in front of patient for PA or behind patient for AP. Support grid to prevent grid cutoff.

• Position grid so that its center is 2 inches (5 cm) above iliac crests to ensure that diaphragm is included.

Respiration:

Suspended.

Central ray

• Horizontal and perpendicular to center of grid

Collimation:

Adjust to 14 × 17 inches (35 × 43 cm).

kVp: 85

Reference: 13th edition ATLAS p. 3:198-199.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Pelvis

AP

Patient position

• Position patient supine.

Part position

• Position grid under pelvis so that center is midway between ASIS and pubic symphysis (about 2 inches [5 cm] inferior to ASIS).

• Center midsagittal plane to midline of grid. Pelvis should not be rotated.

• Rotate patient’s legs medially 15 degrees when not contraindicated.

Respiration:

Suspend.

Central ray

• Perpendicular to midpoint of grid. Central ray should enter patient 2 inches (5 cm) above pubic symphysis and 2 inches (5 cm) below ASIS.

Collimation:

Adjust to 14 × 17 inches (35 × 43 cm).

kVp: 85

Reference: 13th edition ATLAS p. 3:200-201.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Femur

AP

Patient position

• Position patient supine.

Part position

• Cautiously place grid lengthwise under patient’s femur, with distal edge of grid low enough to include fracture site and knee joint.

• Elevate grid with towels under each side to ensure proper grid alignment with x-ray tube.

• Center grid to midline of femur.

Respiration:

Suspend.

Central ray

• Perpendicular to long axis of femur; center to grid

• Ensure that central ray and grid are aligned to prevent grid cutoff.

Collimation:

Adjust to 1 inch (2.5 cm) on sides of shadow of femur and 17 inches (43 cm) in length.

kVp: 85

Reference: 13th edition ATLAS p. 3:202-203.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Femur

Lateral (dorsal decubitus)

Patient position

• Position patient supine.

Part position

Respiration:

Suspend.

Central ray

• Perpendicular to long axis of femur; center to grid

Collimation:

Adjust to 1 inch (2.5 cm) on sides of shadow of femur and 17 inches (43 cm) in length.

kVp: 85

Reference: 13th edition ATLAS p. 3:204-205.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Cervical spine

Lateral (right or left dorsal decubitus)

Patient position

• Position patient supine with arms extended along sides of body.

• Do not remove cervical collar without consent of physician.

Part position

Respiration:

Full expiration.

Central ray

• Horizontal and perpendicular to center of grid

• Use SID of 60 to 72 inches (158 to 183 cm).

Collimation:

Adjust to 10 × 12 inches (24 × 30 cm).

kVp: 85

Reference: 13th edition ATLAS p. e3:206-207.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Chest and abdomen: Neonate

AP

Patient position

• Position patient supine in center of IR. If IR is directly under infant, cover IR with soft, warm blanket.

Part position

• Carefully position x-ray tube over infant.

• Ensure that chest and abdomen are not rotated.

• Move infant’s arms away from body, and bring legs down and away from abdomen.

• Leave infant’s head rotated.

Respiration:

Inspiration

Central ray

• Perpendicular to midpoint of chest and abdomen

Collimation:

Adjust to 1 inch (2.5 cm) on all sides of chest and abdomen.

kVp: 64

Reference: 13th edition ATLAS pp. 3:209-210.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________

Chest and abdomen: Neonate

Lateral (right or left dorsal decubitus)

Patient position

• Carefully place x-ray tube to side of bassinet.

• Position infant supine on radiolucent block covered with soft, warm blanket.

Part position

• Ensure that infant’s chest and abdomen are centered to IR and not rotated.

• Move infant’s arms above head.

• Place IR lengthwise and vertical beside infant, then immobilize IR.

• Leave infant’s head rotated.

Respiration:

Inspiration

Central ray

• Horizontal and perpendicular to midpoint of chest and abdomen along midcoronal plane

Collimation:

Adjust to length of chest and abdomen and 1 inch (2.5 cm) above abdomen.

kVp: 72

Reference: 13th edition ATLAS pp. 3:211-212.

Manual Factors

Part Thickness (cm)	mA	kVp	Time	mAs	SID	Image Receptor Size	CR, DR Exposure Indicator	Grid	HF, 1Ø or 3Ø

Notes: _________________________________________________________________________ Competency: ________/____/______

_______________________________________________________________________________ Instructor: _______________________