The chest X-ray is the most commonly used diagnostic test in medicine. A patient overall outcome is greatly impacted by radiology and therefore it is important to understand the basis of approaching the chest X-ray (Lee & Enzmann, 2012). The PIPER N ABCDE mnemonic ensures that clinicians identify key abnormalities and that no area is overlooked. PIPER N ABCDE stands for: Patient information, Inspiration, Penetration, Exposed area, Rotation, Ng tube location, Airway, Breathing, Circulation, Diaphragm, Everything else.
Patient Identification: Always begin by identifying the patient name and demographic details; review the clinical history, and any previous imaging.
Inspiration: Counting ...view middle of the document...
A narrowing airway can be present with malignancies (Sparshott, n.d.).
Breathing: When assessing breathing scan all six-lung zones and compare appearance for normal, too white, too dark, or have too many lines. Common causes of the white lung include collapse, effusion, or consolidation. COPD presents in the dark lung with hyperinflation, flat diaphragm, and a stretched heart border. Pneumothroax is present on the dark lung image with increased radiolucency and shrunken lung markings. Lungs with too many lines can be determined as fibrotic lungs or pulmonary edema. After reviewing the lung zones, look at the Hila, which contains the pulmonary vessels and lymph nodes. The Hila may become more prominent in some diseases (Dains,Baumann, & Scheibel, 2007).
Circulation: Review the heart silhouette and pay particular attention to the aortic knuckle and the left and right heart borders. Look for swellings that could be suggestive of an aortic or ventricular aneurism. Loss of the heart border is suggestive of disease in the adjacent lung lobe. Look at the heart size and measure the heart and thorax at their widest point (Sparshott, n.d.).
Diaphragm: In a normal radiograph,...