Plain Films - Neck and Nasopharynx
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- Sit the patient beside the chest holder as for lat chest.
- Position Cassette to include nasopharynx and trachea.
- Two assistants are necessary - one to hold child's arms and pull down on shoulders and one to hold the child's head still in lateral position with neck slightly extended.
- Expose in inspiration.
- Alternatively you can lie patient on side
- NB: If there is any concern re child's airway being at risk ensure nurse or ED Dr accompanies patient to Radiology
(if request mentions 'snoring')
- Patient positioned as above but exposure centred on and coned to nasopharynx and more penetrated than lat neck
- Cassette should be positioned at side of head but do not turn the neck to achieve this, elevate chin instead.
- Expose on normal inspiration, if possible breathing through nose, with mouth closed NOT VALSALVA
- NB a lateral chest exposure at 180cm FFD is appropriate for lat neck
Nasopharynx etc for ingested foreign body
- Lie patient supine with head turned to side.
- Include nose to anus on one film if possible. If not - make sure there is overlap.
- If suspected FB is of low density (e.g. Aluminium can tab), proper lat neck and lat CXR may be needed to visualise FB if not seen on initial film.
- If FB has been poked up nose: Lat nasopharynx 1st -if can't see FB, proceed to CXR/AXR
Rarely seen these days - should not need imaging, clinical management more appropriate. If CED insist :
- Do not lie patient supine.
- If patient does have epiglottitis the epiglottis can fall back and block the airway completely.
- Should not need imaging
- As above -if possible have patient perform valsalva technique
Did you find this information helpful?
- Date last published: 23 August 2017
- Document type: Imaging Protocol
- Services responsible: Paediatric Radiology
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