Apparatus for facilitating cross-table lateral films.

Abstract

During my tour of duty in South Vietnam, July 1966 to June 1967, I designed and built the following apparatus to facilitate examinations of acute field casualties. These patients arrived on standard Army litters, and many of them could not be removed from the litters owing to the nature of their injuries. Because the bulk of these injuries were missile wounds, it was extremely important to obtain adequate anteroposterior and lateral films to determine the precise location of the missile fragments. Obtaining adequate lateral films under these conditions was difficult. The purpose of the apparatus described herein was to elevate the patient above the poles of the stretcher so that unobstructed cross-table lateral films could be obtained with no unnecessary movement of a severely wounded casualty. The apparatus consisted of a wooden box-type frame with a solid wooden back and three boxes that fit in between the crossbars of the stretcher. The frame was long enough to allow support for the patient's head or feet, if either projected beyond the length of the canvas, and was necessarily narrow enough to fit between the poles of the stretcher. The apparatus was made from scrap lumber found around the construction site at our hospital. The apparatus was usually used in the following manner: The patient was brought into the hospital on a stretcher and placed on the x-ray table, and the necessary films were taken in the anteroposterior projection. If lateral films were required because of the presence of foreign bodies or the possibility of spinal fracture, stretcher with the patient was lifted up from the x-ray table and the described apparatus was placed underneath so that the crossbars fit between the three boxes. The stretcher was then lowered onto the boxes. Often, force was necessary to depress the stretcher poles so that the canvas would arch over the boxes. This maneuver brought the level of the patient above that of the stretcher poles, making it easy to place films alongside the patient, to support these films with sandbags, and to shoot cross-table lateral views, unobstructed by the stretcher poles (Fig. 1). Since the Bucky unit could not be used, a grid cassette was generally needed for obtaining these films. Conclusion and Summary A box-like apparatus built from scrap lumber was used at the 24th Evacuation Hospital in the Republic of South Vietnam as an aid in obtaining unobstructed cross-table lateral views while the wounded patient remained on a stretcher. The platform-like apparatus fits under the standard army field stretcher and elevates the patient above the stretcher poles. It is particularly useful for hospitals operating under combat conditions where the standard type of army stretcher is used but may also be adapted for use in civilian hospitals by modifications fit local and equipment design.