...THE EYES see what THE MIND knows!
P.S. X-RAY is a 2-dimensional representation of a 3-dimensional object - height and width are seen but depth is not. Just need to see the x-ray as if the patient is facing the observer - left side of the film is the actual right side (R) of the patient.
...AIR appears black (less dense - radiolucent), bone and metal appear white (more dense - radiopaque) and fat, soft tissues, water appear as gray - shade in between black and white.
...POSTEROANTERIOR (PA) view implies that the x-ray is coming from posterior side (back) of the patient and the x-ray plate is in front of the patient; and anteroposterior (AP) view implies that x-ray is going from anterior side (front) of the patient and plate is on the back side. Though, to see the lungs and the cardiac shadow, PA view is better compared to AP view (for bones). it is not possible bedside in an ICU because x-ray can only be emitted from above the bed (from below the bed - iron rods and sheets will interfere); plate is inserted between the bed and back of the patient (AP view).
...THEREFORE, postero(x-ray)anterior(plate) (PA) view and antero(x-ray)posterior(plate) (AP) view. That is, in PA or AP, the first letter denotes the x-ray emission side.
...BETTER, to follow the ABCDE approach to see: A- Airway, B - Bones, C- Cardiac shadow, D- Diaphragm and E- Everything else like lungs.
...IN ASPIRATION pneumonitis, chest x-ray shows an infiltrate (fluffy white spots) usually in the dependent lung segments i.e. the superior or posterior basal segments of a lower lobe or the posterior segment of an upper lobe. Usually the right lung is more involved because the right bronchus is more in line (25 degrees) with the trachea than the left bronchus (45 degrees).
...ASPIRATED material can be gastric acid with some regurgitated food. The patient should be intubated and bronchial toileting should be done with frequent suctioning through endotracheal tube besides oxygenation and proper ventilation.
...IN ORDER TO prevent superimposed infection, ventilator associated infection or hospital acquired infection, antibiotics like Piperacillin Tazobactum 4.5 gm IV 8 hourly, Metronidazole 500 mg in 100 ml IV 8 hourly and to prevent gastric acid excess production and possible regurgitation, a proton pump inhibitor, Pantoprazole 40 mg IV once a day need to be given. Besides other supportive measures a steroid, Methylprednisolone 50 mg IV 8 hourly can be added for anti-inflammatory effect.
How to Read a Chest X Ray:
https://m.wikihow.com/Read-a-Chest-X-Ray?amp=1
How to read - step by step:
http://www.southsudanmedicaljournal.com/archive/2008-05/how-to-read-a-chest-x-ray-a-step-by-step-approach.html
Chest X-ray Systematic Approach:
https://www.radiologymasterclass.co.uk/tutorials/chest/chest_system/chest_system_start
Chest x-ray interpretation:
https://geekymedics.com/chest-x-ray-interpretation-a-methodical-approach/
Aspiration Pneumonitis and Pneumonia:
https://www.msdmanuals.com/professional/pulmonary-disorders/pneumonia/aspiration-pneumonitis-and-pneumonia
P.S. X-RAY is a 2-dimensional representation of a 3-dimensional object - height and width are seen but depth is not. Just need to see the x-ray as if the patient is facing the observer - left side of the film is the actual right side (R) of the patient.
...AIR appears black (less dense - radiolucent), bone and metal appear white (more dense - radiopaque) and fat, soft tissues, water appear as gray - shade in between black and white.
...POSTEROANTERIOR (PA) view implies that the x-ray is coming from posterior side (back) of the patient and the x-ray plate is in front of the patient; and anteroposterior (AP) view implies that x-ray is going from anterior side (front) of the patient and plate is on the back side. Though, to see the lungs and the cardiac shadow, PA view is better compared to AP view (for bones). it is not possible bedside in an ICU because x-ray can only be emitted from above the bed (from below the bed - iron rods and sheets will interfere); plate is inserted between the bed and back of the patient (AP view).
...THEREFORE, postero(x-ray)anterior(plate) (PA) view and antero(x-ray)posterior(plate) (AP) view. That is, in PA or AP, the first letter denotes the x-ray emission side.
...BETTER, to follow the ABCDE approach to see: A- Airway, B - Bones, C- Cardiac shadow, D- Diaphragm and E- Everything else like lungs.
...IN ASPIRATION pneumonitis, chest x-ray shows an infiltrate (fluffy white spots) usually in the dependent lung segments i.e. the superior or posterior basal segments of a lower lobe or the posterior segment of an upper lobe. Usually the right lung is more involved because the right bronchus is more in line (25 degrees) with the trachea than the left bronchus (45 degrees).
...ASPIRATED material can be gastric acid with some regurgitated food. The patient should be intubated and bronchial toileting should be done with frequent suctioning through endotracheal tube besides oxygenation and proper ventilation.
...IN ORDER TO prevent superimposed infection, ventilator associated infection or hospital acquired infection, antibiotics like Piperacillin Tazobactum 4.5 gm IV 8 hourly, Metronidazole 500 mg in 100 ml IV 8 hourly and to prevent gastric acid excess production and possible regurgitation, a proton pump inhibitor, Pantoprazole 40 mg IV once a day need to be given. Besides other supportive measures a steroid, Methylprednisolone 50 mg IV 8 hourly can be added for anti-inflammatory effect.
How to Read a Chest X Ray:
https://m.wikihow.com/Read-a-Chest-X-Ray?amp=1
How to read - step by step:
http://www.southsudanmedicaljournal.com/archive/2008-05/how-to-read-a-chest-x-ray-a-step-by-step-approach.html
Chest X-ray Systematic Approach:
https://www.radiologymasterclass.co.uk/tutorials/chest/chest_system/chest_system_start
Chest x-ray interpretation:
https://geekymedics.com/chest-x-ray-interpretation-a-methodical-approach/
Aspiration Pneumonitis and Pneumonia:
https://www.msdmanuals.com/professional/pulmonary-disorders/pneumonia/aspiration-pneumonitis-and-pneumonia
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