XR Chest
Normal
Normal adult
Lungs clear.
No pleural effusion.
No pneumothorax.
Normal cardiomediastinal silhouette.
No suspicious osseous lesions.
Upper abdomen is normal.
Normal child < 10 years old
Lungs clear.
No pleural effusion.
No pneumothorax.
Normal cardiothymic silhouette.
No suspicious osseous lesions.
Upper abdomen is normal.
A - Air
Hemithorax whiteout
(Left/Right) hemithorax whiteout (collapse, infiltrate, and/or pleural effusion).
Peribronchial thickening
Mild diffuse peribronchial thickening.
Pulmonary vasculature
Ordering from least to most severe, the pulmonary vasculature progresses from pulmonary vascular congestion, to interstitial pulmonary edema, to alveolar pulmonary edema. Each condition builds on the previous condition. For example, a patient with alveolar pulmonary edema will also have interstitial pulmonary edema and pulmonary vascular congestion.
If the pulmonary vasculature is normal, there is nothing to add to the report. If it is abnormal, these are your reporting options, ordered from least to most severe:
- Pulmonary vascular congestion.
- Pulmonary vascular congestion with interstitial pulmonary edema.
- Pulmonary vascular congestion with (mild, moderate, severe) alveolar pulmonary edema.
D - Diaphragm
Pleural effusion
(Mild/Moderate/Severe) (left/right) pleural effusion with adjacent atelectasis.
E - Everything Else (tubes & lines, upper abdomen)
Endotracheal tube (ETT)
- Good position: Endotracheal tube tip ends X cm above the carina.
- Too low: Endotracheal tube tip ends X cm above the carina. Recommend retracting Y cm and reimaging.
- Bronchial intubation: (Left/Right) mainstem bronchus intubation. Recommend retracting Y cm and reimaging.
Enteric tube (Feeding Tube)
- Tip in stomach: Enteric tube courses below diaphragm with tip inferior to field of view.
- Tip below field of view: Enteric tube courses below diaphragm with tip inferior to field of view
- Tip in esophagus: Enteric tube tip located in the (proximal/mid/distal) esophagus. Recommend advancing X cm and reimaging.
- Tip in esophagus and coiled: Enteric tube tip coild in the (proximal/mid/distal) esophagus. Recommend retracting, repositioning, and reimaging.
- Tip in bronchus: Enteric tube in the (right/left) bronchus. Recommend retracting, repositioning, and reimaging.
Note: This is an emergency and you should report immediately to the team if you see this, so that the enteric tube can be removed.