Nasium View:

Timestamp: 34:21 – 48:30

1. Set up patient in Opal-Rad and have ready to acquire. Pre, Post1, Post2, etc.
2. Set Factors, MA, KVP, and Time for image type. Reference the X-ray Factor Sheet.
3. Get S-line off Lateral and set CR string to it (Facial Feature & Atlas). Make sure to be looking at BB markers.
   1. Note: If S2 or above, retract the chin slightly downward and back. Greater S-Line = Greater Chin retraction.
4. Turn chair facing away from the buckey.
5. Patient Instructions: “Sit up nice and tall.” Gently press at sternum and mid back and wait for patient to straighten up. Place patient on Vertical Axis (as in Lateral view.) Remember to keep the patient’s ear over their shoulder and their shoulder over their hip.
6. Setup Equipment:
   1. (SOFT RULE) Tilt buckey (No more than 10 degrees) to the plane of the posterior skull and the posterior shoulder blade (unless severe anterior head carriage)
7. Place the Marker on the right side of the bucky behind the patients right shoulder.
8. Using string, move xray tube in place so that the string goes through the appropriate S-Line facial feature and atlas.
9. Turn on collimator light and tilt xray tube and test if the cross hairs go through the S-Line facial feature and Atlas.
10. Then move buckey so that the crosshairs from the light go through the Nasium center mark on the buckey.
11. Bring Headphones down over Atlas (line up with light) Crosshiars should hit at the bottom of the head phones before tightening.
12. Get in front of patient (straight on). Check for rotation (take it out) look at the midline of the patients facial features: Parietal Area, Glabella, and Checkbones.
13. Center skull to headphones and tighten them firm to stabilize the skull.
14. Collimate 1” Top & 1” to the side structures
15. Put the appropriate Nasium filters in. Nasium B is our primary Filter, any other filter will be used due to size of patient or quality of film. This decision is made by the doc.

• Nasium O: One base of lead; Darkest filter in Parietal region.
• Nasium A: One extra piece of lead in Parietal region; lightens the Parietal region slightly.
• Nasium B: Two extra piece of lead in Parietal region; lightens the Parietal region more heavily than “Nasium A” filter.
• Nasium 1: One sheet of lead; provides the least amount of exposure to Atlas/Axis.
• Nasium 2: Two sheets of lead; provides the “mid-range” amount of exposure to the Atlas/Axis.
• Nasium 3: Three sheets of lead; provides the most amount of exposure to the Atlas/Axis.

1. Take the picture.
2. Review film before taking patient out of the head phones or position. Use the PR Check Protocol (See page # for further detail).
3. Double check rotation. It can’t be more than 2mm off. If greater than 2mm then retake the film. Check it at the parietal region, eyes, nasal septum, and skull. Pre & Post films need to be NO MORE than 2mm different left to right.
4. Check to make sure that the atlas is not “smiling”.