1. Select the required view(s) based on the request.
2. Gather the necessary materials and supplies.
a. Appropriate cassettes.
b. Lead shielding.
c. Letter markers.
3. Prepare the patient.
a. Bring the patient into the X-ray room.
b. Ensure the patient removes all foreign objects.
(2) Hair clips and/or bows.
c. Explain the procedure.
d. Seat the patient facing the upright X-ray table or bucky.
4. Measure the body part through the entry-exit site of the central ray.
5. Set the control panel.
a. Consult the technique chart.
b. Set the appropriate mAs and kVp on the control panel.
6. Select the proper size cassette.
NOTE: Use an 8" x 10" cassette for all views.
7. Place the cassette in the bucky lengthwise for all views.
8. Position the overhead tube.
a. Set the tube angle perpendicular to the film.
NOTE: Set the tube angle 15 degrees caudad for the Caldwell view.
b. Set the source to image receptor (SID) to 40 inches (101 cm).
c. Center the tube to the cassette.
d. Adjust the conefield to 6 x 6 coverage.
9. Place the lead shielding around the patient's waist.
10. Position the sinuses.
NOTE: To allow free fluids and air to settle, direct the patient to sit for several minutes.
a. Caldwell view.
(1) Place the patient seated or standing, with their nose and forehead in contact with the table or wall bucky.
(2) Place the median plane perpendicular to and over the centerline of the table.
(3) Adjust the orbitomeatal line (OML) perpendicular to the cassette.
(4) Project the nasion to the center of the cassette.
b. Water's view.
(1) Place the median plane perpendicular to and over the centerline of the table.
(2) Adjust the OML to form a 37 degree angle with the cassette.
(3) Center the acanthion to the cassette.
c. Lateral view.
(1) Place the medial plane parallel to the table.
(2) Adjust the interpupillary line perpendicular to the cassette.
(3) Adjust the infraorbitomeatal line (IOML) perpendicular to the front edge of the cassette.
(4) Center the external canthus of the eye to the center of the cassette.
11. Place the appropriate identification marker on the cassette.
12. Tell the patient, "DO NOT BREATHE AND DO NOT MOVE."
13. Make the exposure.
14. Tell the patient, "BREATHE NORMALLY AND RELAX."
15. Develop the exposed cassette(s) with the patient's identification.