Ministry of Health
all tubes, catheters and wires, on and under the
chest and abdomen, should be displaced to the side
of the infant. In particular, ECG leads should be as
lateral in position as possible.
Chest / Abdominal Radiographs
- In the absence of tubes and catheters, initial
chest radiographs are an AP and rolled lateral view
unless there are mitigating circumstances (such as a
baby who is too unstable to be handled excessively).
Lateral chest radiographs are usually not required
subsequently unless requested for position of chest
drains or other explicit indications. To avoid
having the infant lie on the tubing, this lateral
image can be done as a shoot through lateral (infant
supine, arms beside head).
- AP and lateral chest radiographs, for assessment
of the position of umbilical lines, include the
abdomen on the AP view and thoracic inlet to
umbilicus on the lateral view.
- Abdominal radiographs for suspected obstruction
or necrotising enterocolitis
include both an AP view, and a left side down
decubitus view that must
include the right hemidiaphragm/right lower chest.
- When low bowel obstruction is suspected,
consider prone view of the abdomen (rectum fills
with air in the normal situation). When meconium
peritonitis is suspected, lateral view of the
abdomen may be confirmatory.
long lines inserted below the groin, a babygram (AP chest and abdomen) is appropriate.
inserted from the arms or head, an AP chest with the head turned away from
the site of insertion is appropriate, making sure that ECG lead is not near
the medial clavicle. It is easiest to interpret line position if the arm is
Contrast is used in all longline films (the registrar or NS-ANP will inject
0.5-1.0ml of non-ionic contrast medium using sterile technique).
- Skeletal survey for clinical concern of
- Babygram to include chest and abdomen,
shoulders and hips
- AP radiographs of both arms
- AP radiographs of both legs
- Views of hands, feet and other sites (e.g.
spine/skull) are done only if there is local
swelling or erythema
- Skeletal survey for dysmorphic/syndromic infant
- AP and lateral skull radiographs
- AP and lateral chest if not already done
(includes thoracic spine)
- Lateral lumbar, sacral, and cervical spine
- AP abdomen to include all of pelvis
- Left leg, foot, arm and hand (Right side
only if there is definite asymmetry)
- Skeletal survey, post mortem includes:
- AP whole body radiograph (skull to toes)
- Lateral radiograph (skull to sacrum)
- Lower limbs, hips to feet, with the legs in
Images without the umbilical clamp are preferred.
Consider thin slice CT when skeletal dysplasia suspected
- 0730 to 2400hr Monday to Friday
- 0830 to 2400hr Saturday, Sunday and Public
Holidays Ph 021893997
- At other times call the operator and ensure
you ask for the NICU on-call radiographer/MRT.
When calling in the on-call radiographer, please
consider whether the radiograph can be delayed until the
radiographers on during the day are available
(i.e.0730hr on weekdays, 0830hr on weekends)
- Starship Hospital radiologist:
- Ext 25130 (online reporting) or 25134
- Radiology registrar:
- Pager, evenings until 2200hr: 93-5210
- Pager, after 2200 hr:
Dr Rita L. Teele (Starship
Radiology) July 2012