Using Chest Radiography in the Intensive Care Unit

Chest radiograph evaluation and interpretation

Chest imaging is an important tool in managing critically ill patients. Basic chest radiology is still used to quickly detect abnormalities in the chest. Critical care nurses are often the ones who first read the radiologist's report of chest radiograph results and provide their interpretation to a physician. Oftentimes, chest radiographs are obtained routinely on a daily basis for every critical care patient, with the goal of effective clinical management. Critical care nurses can confirm cardiopulmonary assessment findings by also evaluating their patient's chest radiographs and reviewing the radiologist's report. By learning some basic skills in interpreting and evaluating chest radiographs, nurses can recognize and localize gross pathologic changes visible on a chest radiograph. This article provides basic chest radiograph interpretation information that allows readers to review relevant anatomy and physiology, summarize normal and abnormal findings on chest radiographs, and describe radiographic findings in common pulmonary and cardiac disorders.

A Study of the Relationship of the Superior Vena Cava to the Bony Landmarks of the Sternum in the Supine Adult: Implications for Magnetic Guidance Systems

This study was a retrospective investigation of computed tomography (CT) images of an Australian adult hospital population. These images were used to evaluate the spatial relationships of the superior vena cava (SVC) to the midsagittal line, the sternal paracoronal plane, and commonly used landmarks of the sternum. Consistent relationships were found between the long axis of the SVC and both the midsagittal line and sternal paracoronal plane. When the sternal paracoronal plane was used as the plane of reference, the angle of Louis was found to approximate the SVC in 99.5% of cases, and the right 2nd intercostal space approximated the SVC in 94% of cases. Constraints on the use of landmarks are discussed with regard to magnetic guidance systems for catheter tracking.