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In general, follow this principle: Obtain plain films before
obtaining films that require contrast. Each hospital has its own
guidelines for patient preps. Consult the radiology department before ordering
any x-ray that requires a prep. Examinations that require no specific
bowel preparation are routine CXR, flat and upright abdominal films,
cystograms, C-spines, skull series, extremity films, CT scans of
the head and chest, and many others.
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Studies that usually require preps such as enemas, laxatives,
or oral contrast agents or those that require that the patient be
NPO before the examination include upper GI series, small-bowel
follow-through (SBFT), barium enema, IVP, and others. IV contrast
studies are discussed below.
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Chest X-Ray (Routine):
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Includes posteroanterior (PA) and lateral chest films. (PA means
the film is placed in front of the patient with the beam coming
from the back.) Evaluation of pulmonary, cardiac, and mediastinal diseases
and traumatic injury. See How to Read a Chest X-Ray, and Figures 15–1 and 15–2.
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Visualization of small pneumothorax
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Lateral Decubitus Chest:
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Allows small amounts of pleural effusion or subpulmonic effusion
to layer out; as little as 175 mL of pleural fluid can be detected
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Evaluation of apices and lesions of the ...