J. Galimany Masclans1, I. Blanca Yela2, J.C. Perna Canadell2

1Universitat de Barcelona (SPAIN)
2Hospital de la Santa Creu i Sant Pau (SPAIN)
Chest radiography is present everyday in intensive care units (ICU). Together with physical examination, laboratory tests and the electrocardiography, is used as a tool for assessing the patient's clinical condition.
Chest radiography uses ionizing radiation and the nurse must have knowledge and training necessary to manage an effective diagnostic procedure. This involves training on radiation protection measures to ensure its safety and the patient. The nurse also performs radiological images, as a necessary element of patient assessment. The ICU nurse does not always have sufficient knowledge in relation to radiology, radiation dose and safety and radiation protection measures.
Therefore, the nurse should be trained to be able to identify nursing interventions in relation to the chest radiography to specify the activities and incorporated into protocols to ensure clinical safety.

The study was carried out to identify the importance of nursing action to ensure patient safety in relation to the chest radiography in the ICU.
The needing conducted to a literature review to study nursing activities in relation to the chest radiography in the ICU, and how which are the risks and deficiencies identified in relation to this procedure. Subsequently, we have identified nursing interventions related with the procedure.
The results of the search and analysis of literature shows that there are knowledge gaps that can lead to situations where increasing the risk of overexposure to radiation for both the patient and the professional himself.
The management of radiological tests in general and especially in chest radiography in the critical patient setting, identifies various aspects of training related to nursing interventions to consider:
Preparing the patient for testing, this also includes providing the same information to a conscious patient or family information.
Environmental management: comfort.
Environmental management: safety and worker safety ensure the radiation protection measures for the nurse and the patient, avoiding unnecessary exposure or X-rays or repeat them.
Medication administration: intravenous contrast injection management.
Basic assessment of the image obtained: enables swift action against medical diagnostic process signs of abnormality.

-Kelly-Heidenthal P, O'Connor M. Nursing assessment of portable AP chest x-rays. Dimens Crit Care Nurs. 1994 May-Jun;13(3):127-32.
-Desai S, Chan O. Interpretation of a normal chest X-ray. Nurs Stand. 1992 Nov 4-10;7(7):38-9.
-Pandit-Bhalla M, Diethelm L, Espenan G. Portable chest radiographs in the intensive care units: Referral patterns and estimated cumulative radiation exposures. J Thorac Imaging. 2002 Jul;17(3):211-3.
-Brateman L. Radiation safety considerations for diagnostic radiology personnel. Radiographics. 1999 Jul-Aug;19(4):1037-55.
-Duetting T, Foerste B, Knoch T, Darge K, Troeger J. Radiation exposure during chest X-ray examinations in a premature intensive care unit: Phantom studies. Pediatr Radiol. 1999 Mar;29(3):158-62.
-Trotman-Dickenson B. Radiology in the intensive care unit (part I). J Intensive Care Med. 2003 Jul-Aug;18(4):198-210.
-Rubinowitz AN, Siegel MD, Tocino I. Thoracic imaging in the ICU. Crit Care Clin. 2007 Jul;23(3):539-73.