The Revision Guide for Student Nurses (Part I)

Positioning & Collimation - Practical Task

In addition to setting up equipment for radiography, you will almost certainly be asked to position a patient for one or more radiographic examination. The table shows parts of the anatomy that you should be familiar with, the position of the patient and the area to which collimation is made.

In all cases, the following points are essential:

  1. Read the question carefully before attempting the task.
  2. If the patient is conscious, ask an assistant to restrain and reassure before gathering together the necessary equipment (even if it is a soft toy).
  3. Collect together the equipment as demonstrated in Practical Tasks: Equipment For Radiography. Make use of positioning aids available including troughs, foam wedges, ties and sandbags.
  4. An animal with dyspnoea or any condition where pleural effusion is suspected must never be placed in dorsal recumbency (VD position).
  5. Barium should never be given per os (by mouth) to a patient with dysphagia since aspiration pneumonia is likely to be a risk.
  6. It is advisable to take at least 2 views of any radiograph to enable improved radiographic interpretation. A hairy dog with a small metal object such as a pin or paper clip entangled in its coat may well look like the object has been ingested; a lateral and ventral view would rule out this condition. It is unlikely that your practical task will involve multiple projections, but this is an important point to remember.
  7. Limbs must be positioned 90 degrees to the primary beam and parallel with the cassette to avoid anatomical distortion.
  8. Collimate the beam to as small an area as possible to create good contrast avoiding scattered radiation.
  9. The thorax is best radiographed on inspiration to enable a better view of the lung fields; whilst the abdomen is best radiographed on expiration in order to enable better visualisation of the viscera.
  10. When performing radiography of the joints and spine, accurate centring is essential to avoid geometric distortion.
  11. Use a grid when radiography of a part of the patient's anatomy exceeds a thickness of 10cm.
  12. Finally, and most importantly; ensure that you are familiar with the anatomical directions used in radiographic positioning. You will need to demonstrate your knowledge of these in the practical examination. It is also advisable to revise your Part I anatomy and physiology notes to ensure that you are competent naming and identifying parts of the patient's anatomy; particularly those of the skeletal system.