A systematic approach to chest x-ray interpretation in the perianesthesia unit

In the perianesthesia setting, the chest X-ray has become an essential diagnostic tool to help direct the optimal care of critically ill patients. The ordering of medical tests, the interpretation of the results, and the determination of an appropriate medical plan of care remain within the role of the physician. In many United States acute care hospitals, however, the perianesthesia nurse is taught to implement emergency standing orders including obtaining a chest X-ray for unexpected respiratory distress, unexplained hypoxemia, or unequal breath sounds. This article will offer the perianesthesia nurse the basic knowledge to rapidly and systematically read chest radiographs and compare the findings with the patient's previous films and current clinical presentation. The assessment tool outlined in this paper may be combined with the clinical picture the patient presents to ensure that the nurse implements needed interventions in a timely manner.