Radiographic Positioning: Radiographic Positioning of a Trauma C-spine

CERVICAL SPINE (E.R. OR TRAUMA)

Trauma with collar do lateral, AP, and odontoid, either supine or if on backboard move patient to table on board and shoot through, then get cleared. Once cleared ER is to remove c-collar then do the following films:
Neutral Lateral
both Obliques or both Pillars
AP
Odontoid

If E.R./OP trauma (no collar) do:
Neutral Lateral
both Obliques or both pillars
AP
Odontoid
*NO FLEXION AND EXTENSION ARE TO BE DONE UNLESS SPECIFICALLY ORDERED.

X-FIRE LEFT LATERAL
1. 10 x 12 film L.W.
2. Patient supine with collar ON.
3. 72" SID
4. Central Ray: center to neck with film 2" above EAM.
5. Shoulders depressed
6. Must see C-7

AP
1. 8 x 10
2. Patient supine with collar ON.
3. 40" SID
4. Central Ray: thyroid cartilage
5. Tube angled 20 degree cephalad

ODONTOID (OPEN MOUTH)
1. 8 x 10
2. Patient supine with collar ON, open mouth as wide as possible.
3. 40" SID
4. Central Ray: perpendicular to film, through opened mouth.

After E.R. has cleared films and collar is removed do the following:
Left Lateral
1. 10 x 12 film
2. Patient sitting or standing at upright film holder.
3. 72" SID
4. Central Ray: center to neck with film 2" above EAM.
5. Shoulders depressed (hold weights)
6. Must see C-7

Obliques (RPO, LPO)
1. Patient sitting or standing with back against upright film holder.
2. Rotate patient so that they are 45 degrees away form film for each side.
3. Angle tube 15 degree cephalad.
4. 40" SID
USE MARKERS ACCORDING TO SIDE DOWN.

AP
1. 8 x 10 film
2. Patient supine or erect with chin extended.
3. Bucky
4. 40" SID
5. Tube angled 20 degree cephalad.
6. Center Point: thyroid cartilage

Odontoid (open-mouth)
1. 8 x 10 film
2. Patient supine or erect, adjust head so that upper occlusal plane is perpendicular to table, have patient open mouth.
3. Bucky
4. 40" SID
5. Central Ray: perpendicular to film, through opened mouth.

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DOCTORS HOSPITAL OF NELSONVILLE Cervical Spine
(E.R. or Trauma)
Page 3

OPTIONAL VIEW:

Swimmers
1. 10 x 12 film
2. Patient supine or on left lateral with one arm extended above head and one at side.
3. X-fire or Bucky
4. 40" SID
5. Central Ray: enters C-4