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Plain Films - Skull

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The main challenge when imaging babies' heads is immobilisation.

  • Explain to caregivers why this will be necessary and how it will be done.
  • Ensure tube centred and positioned, cassette in place and exposure set before you start.
  • Remove from child any clothing that might impinge on x ray (T shirts with shoulder buttons, clothes with collars, hoods, etc)
  • Wrap baby firmly in draw sheet and tuck ends under baby. Have parent hold baby's head with head holders while leaning arm on baby's body to keep him/her still - or one parent to each job. Have them talk soothingly to baby.
  • It can be useful to place Pb apron over baby's body to aid immobilisation - also good for radiation protection.
  • Images can be taken in the bucky or, for smaller babies, non-bucky with head directly on the cassette.

    Routine views are: 

    AP SXR




    LAT SXR brow up with horizontal ray

    SMV views are rarely done - you can prop baby's shoulders up on a pad and let head fall back (carefully). Angle the tube so that the central ray is perpendicular to the base of skull

Older Children

Toddlers and some older children may still have to be restrained as above, but if the child is co-operative, views can be taken erect against the upright bucky. Use AEC.

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Document Control

  • Date last published: 28 October 2017
  • Document type: Imaging Protocol
  • Services responsible: Paediatric Radiology

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