Vertex Film:

Timestamp: 20:51 – 34:21

1. Set up patient in Opal-Rad and have ready to acquire.
2. Set Factors, MA, KVP, and Time for image type. Reference the X-ray Factor Sheet.
3. Turn chair facing the buckey.
4. Patient Instructions: Patient Instructions: “Sit up nice and tall.” Gently press at sternum and mid back and wait for patient to straighten up.
5. Setup Equipment:
   1. 25 degree tilt on buckey (or 25 degrees off 90 on some others) 15-20 degrees for older patients
   2. Set camera angle to 45 degrees
   3. Chin Rest w/ tissue
6. Bring Patient about 2” away from the buckey.
7. Raise buckey (w/ patient’s chin level) to the base of the patient’s chin.
8. Stand behind the patient and take out the lateral flexion & rotation & center the skull to the buckey. Line up the V.P (EOP) and the Glabella in the mirror on the buckey. Also, should line up T1 to Occiput (EOP)
9. Gently guide their chin up with index finders until the Spinal Lever breaks. (This should take out all the lateral flexion)
10. Tell the Patient: “Lean forward only at the waist.” Place the chin in the cup.
11. Double Check for Rotation & Lateral Flexion. Also, must check for the center of: skull, eop, &T1 so that they line up vertically.
12. Place head clamps at base of occiput and 1 ½” behind ears firmly (Skull should be locked)
13. Hold CR string to buckey at the Vertex mark and line crown of skull & Atlas
14. Pivot Camera until the string passes through crown of the skull. Use collimator light to check angle. Crosshairs need to go through the crown of the skull and vertex mark on the buckey. Double check that the string you are holding and the string in the mirror line up with one another at the points they need to pass through.
15. Collimate 1” borders top & bottom
16. Put in Vertex Filter
17. Go and Take the Picture.
18. Review film before taking patient out of the head phones or position using the VSP line (see page # for more details).
19. Dens and Nasal septum must be 2mm or less off the center line. FILM CHECKS MUST BE DONE BEFORE ACCEPTING FILM. If greater than 2mm between sides, correct the positioning and retake film.
20. Pre & Post films need to be within 2mm NET pre-post.