X-rays: Patient position for determining ETT placement

The recommended position for a neonatal patient undergoing an AP chest X-ray to determine ETT placement is supine, with care taken to keep chest from rotating.  Infantís head may be left in its usual position and does not need to be turned to midline.  ETT should be neither pulled out from, nor pushed into infantís mouth.  Part of the infantís jaw should be captured on film so the position of ETT may be appropriately determined.  (Do not X-ray the whole head, only chin area needs to be included)  Below are examples of how head position alters ETT location:

Reference:  Donn, SM and Kuhns LR.  Mechanism of Endotracheal Tube Movement with Change of Head Position in the Neonate.  Pediatric Radiology 9, 37-40, 1980.

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