Plain Film (X-Ray)

24 hours / 7 days a week

Clinical Pathway

Chest X-Ray

Chest x-ray indications

A digital mobile chest x-ray will be carried out for the following indications

• Investigation of signs and symptoms thought to be due to diseases of the chest

• Investigation of an infectious disease

• Neck, chest or abdominal trauma (including iatrogenic or device related)

• Investigation of lines, tubes, other medical devices or foreign objects

• Investigation and surveillance of respiratory, cardiac or multiple organ failure

• Suspected thromboembolic disease

Abdomen X-Ray

Abdominal x-ray indications

• Investigation of signs and symptoms thought to be due to diseases of the abdomen

  • Investigation of an infectious disease

• Abdominal trauma (including iatrogenic or device related)

• Investigation of lines, tubes, other medical devices or foreign objects

• Suspected intestinal obstruction

• Constipation refractory to simple treatments, difficult to investigate (i.e. patient unconscious or incapacitated) or potentially requiring interventional management

• Suspected toxic megacolon

Other X-Ray

Requesting other x-rays

A limited range of extremity imaging will be available.

We will be able to perform the following examinations on site:

Upper limb: hand to elbow (inclusive of both areas)

Lower limb: foot to knee (inclusive of both areas)

These will only be available for acute injury within the last 7 days. We will not image these areas to investigate chronic issues.

We acknowledge that patients may require hip imaging following falls, and this will be provided by CT imaging rather than plain film, due to the doses involved with plain film.

Requesting an x-ray

Requests must be made electronically using ICE (our clinical orders system). It is also then important to communicate with the radiographer looking after your pod so that a discussion around clinical urgency and ideal timing / prioritisation can take place.

Requesting checklist

• Referral must be made by a registered nurse or doctor

• Adequate demographic details must be provided to meet a point of care 3-factor identity check

• The following data must be provided in the referrers data set

  • Name of the referrer (and supervising consultant)

  • Ward and pod

  • Telephone number for point of contact (usually team leader)

When the radiographer is outside of the clinical area

If you have requested any type of imaging please call either the plain film Radiographer for your hall or CT Radiographers to inform them there is an examination to undertake and to discuss the most appropriate time for this to happen.

Viewing X-Rays

You will be able to view x-rays in a number of convenient ways

• Immediate clinical review on the machine at the bedside for safer positioning of tubes and lines

• Any computer using PACS Xero Viewer

• Large diagnostic monitor at the Radiology Base Station in each hall

Repeat Examinations

As we are using digital radiography, images will be viewable immediately on the machine after exposure. It will therefore be possible to discuss the findings with the radiographer and make a judgement whether the images are satisfactory or need repeating.

Acceptable reasons for repeating examinations

• Clearly inadequate image quality, missing key anatomical details, under or overexposing or failing to answer clinical question due to technical factors.

• Repositioning of lines / tubes

Exposures should only be repeated when the radiographer believes there is a reasonable chance of achieving better quality and there is a clear benefit from doing so when the increased radiation dose is considered.

Reporting of x-rays

Consultant Radiologists will read and report chest x-rays during the hours 09:00 - 17:00 7-days per week. Studies acquired outside of these working hours shall be reported the following morning by routine. However if a specialist opinion is required, the on-call radiologist will provide this by remote consultation.

From 20:00 this reporting service shall be provided by teleradiology by Medica by a remote consultant radiologist.