You have a request for an X-ray examination of the facial bones. You have the assistance of additional personnel if required. You will need a properly equipped X-ray exposure room with various sizes of film in cassettes, sandbags, lead apron, letter markers, and various sponges.
1. Select the required views(s) based on the request.
2. Gather the necessary materials and supplies.
a. Appropriate cassettes.
b. Lead apron.
c. Letter markers.
3. Prepare the patient.
a. Bring the patient into the x-ray room.
b. Ensure the patient is properly dressed.
(1) Ensure foreign objects are removed from the patient as necessary.
(2) Ensure the patient is dressed in a gown, if necessary.
c. Explain the procedure if applicable.
d. Assist the patient onto the table.
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.
8. Position the overhead tube.
a. Set the angle perpendicular to the film.
b. Set the source to image receptor distance (SID) to 40 inches (101 cm).
c. Center the tube to the portion of the film being used.
d. Adjust the conefield to full field coverage.
9. Position the facial bones.
NOTE: Because pf the extreme mobility of the head on the neck, all positions of the skull require a two-way head alignment (TWHA) for exact positioning of the skull.
a. Water's view (TWHA).
(1) Place the patient prone with the chin on the table.
(2) Place the median plane perpendicular to and over the centerline of the table.
(3) Adjust the orbitomeatal line (OML) to form a 37 degree angle with the cassette.
(4) Center the acanthion to the cassette.
b. Lateral view (TWHA).
(1) Place the patient semiprone with the side of the injury nearest the table.
(2) Place the median Plane parallel to the table.
(3) Adjust the interpupillary line to the cassette.
(4) Adjust the infraorbitomeatal line (IOML) parallel to the lower edge of the cassette.
(5) Center the midpoint of the IOML to the cassette.
10. Place the appropriate identification marker on the cassette.
11. Place the lead apron across the patient's lap.
12. Tell the patient, "DO NOT BREATHE OR MOVE."
13. Make the exposure.
14. Tell the patient, "BREATHE NORMALLY AND RELAX."
15. Develop the exposed cassette(s) wit patient identification for processing.
16. Return the patient to the waiting area.