Chest X-ray - Tubes
Principles

It is essential to be systematic when checking the position of a medical device on an X-ray.

Patient details

Start by checking you are looking at the correct image. Check the name, patient identity details and date.

It is particularly important to check the time the image was acquired, as those who have medical devices placed often have several images acquired on the same day.

Image adequacy

Chest X-rays performed to determine medical device position are often performed using different radiographic parameters from those used to acquire diagnostic X-rays. Patients are also often more unwell, and so achieving good quality images can be more technically challenging.

If an image is of suboptimal quality but adequately demonstrates the position of the medical device, then there is usually no need to repeat the image.

Systematic approach

Although images may be of reduced diagnostic quality compared to conventional chest X-ray images, they must still be checked systematically for the presence of pathology.

2D v 3D?

It is not possible to determine the exact location of a medical device in three dimensions using a single X-ray image alone. However, as it is clinically evident where a tube has entered the body, only one image is usually required to confirm its internal position.