Ministry of Health

NZ Government

    
 ©Copyright
 Published: 21/11/2007

• Tubes, catheters and wires should be displaced, as much as possible from the area of interest. 

Chest Radiographs

• The first chest radiograph includes a rolled lateral 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 checking on the position of chest drains. These lateral films are done as a shoot through lateral so that the infant is not lying on the tubing.
• AP and lateral films, for assessment of the position of umbilical lines, include the abdomen and chest.

Abdominal Radiographs

• Abdominal films, in cases of suspected obstruction or NEC, include both an AP view, and a left side down decubitus view that must include the right hemidiaphragm/right lower chest.
• Consideration should be given to obtaining a prone abdominal film to define lower obstruction, or lateral film to assess for peritoneal calcification, at the time of the original abdominal series. 

Long Lines

• For long lines inserted below the groin, a babygram (AP chest and abdomen) is appropriate.
• For long lines inserted from the arms or head, an AP chest with the head turned away from the site of insertion is appropriate.
• 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 Surveys

• Skeletal survey for infection includes:
  • Babygram to include chest, and abdomen, shoulders and hips
  • Both arms AP
  • Both legs AP
  • Hands and feet and other views (e.g. spine/skull) only if there is local swelling or erythema
• Skeletal survey for syndromes or dysmorphic babies includes:
  • AP and lateral skull
  • Chest AP and lateral if not already done (includes thoracic spine)
  • Lateral lumbar, sacral, and cervical spine
  • Abdomen/pelvis on the same film
  • Left leg, foot, arm and hand
    (Right side only if there is definite asymmetry)
• Skeletal survey for post mortems
  • AP whole body (skull to toes)
  • Lateral radiograph (skull to sacrum)
  • Lower limbs - hips to feet with the legs in a frog position lateral

Contact Details

• Radiographer
  • 0730 to 2400hr Monday to Friday
  • 0830-2400hr Saturday, Sunday and Public Holidays
  • Page 93-4040
    
    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: 25130 (online reporting) or 25134 (reception)
• Radiology registrar beeper, evenings until 2200hr: 93-5210
• Radiology registrar beeper, nights: 93-5954

Dr Rita Teele (Starship Radiology) and Dr Carl Kuschel
April 2006