The Critical Chest Flashcards
What is the definition of a critical chest x-ray?
an AP CXR of an acutely ill patient
what 5 things do you have to think about when x-raying an acutely ill patient?
location - critical care intubated multi-organ failure multiple co-morbidites maybe haemodynamically unstable
What 3 things need to be looked out for in the critical care environment?
Lines
Devices
Drains
what does ETT stand for?
Endo-tracheal tube
what does an ETT do?
ventilates the patient and provides a ‘secure’ airway
What 2 types of chest drains might be found and why?
intercostal - for a pneumothorax to drain air
mediastinal - to drain blood from around the heart post surgery
what types of catheter might be identified?
central venous catheter
central arterial catheter
why are these types of catheter used?- 5 points
to administer medication, fluids, dialysis, obtain blood results, quantify fluid balance
what can happen with the use of specific drugs?
can cause phlebitis in the peripheral veins
what 5 devices might be identified?
Swan Ganz catheter temporary pacing wires Naso-gastric tubes external ECG leads Intra-Aortic Balloon Pump
what does an SG catheter do?
monitors heart function and blood flow
how does IABP work?
works with the systolic and diastolic heart cycles to increase blood flow down the coronary arteries and decrease the resistance in the ascending aorta
what is the technique for an AP CXR - 7 points (OPQRSTU)
observe the patient from the end of the bed space
position patient properly to ensure diagnostic image
quality
remove ECG leads/oxygen tubing/lines etc.
set tube head at appropriate distance and angulation
test breath hold of patient to ensure full inspiration
use timing and prep of anode to expose on inspiration
what are 6 technique issues with an AP CXR - 6 points
Poor inspiration Rotation Missed anatomy Lordosis Poor collimation Artefacts
what should be seen on an AP CXR?
6th anterior rib
D dome at the level of the 3rd/4th intercostal space
clavicles should be equidistant
