X-ray Department Research Articles

Intercomparison of passive dosimetry technology at EDF facilities in France

Since the spring of 1999, new French radiation protection legislation has allowed the use of passive dosemeters, other than the silver emulsion film badge, for the measurement of H(p)(10). Faced with the eventual obsolescence of its dosimetry system, Electricité de France (EDF, the French electricity provider) initiated a comparative study of passive dosemeters, based on different technologies, that had received accreditation by national laboratories and regulatory bodies, namely: TLD, RPL and OSL. An extended field study in nuclear power stations and medical X-ray departments has shown that all technologies provide compatible dosimetric estimates. It also showed that the selected dosemeters based on RPL and OSL technologies gave better results due to their energy responses and to a lower detection threshold compliant with the new regulation. A final suggestion to implement a new OSL based dosimetric system is made due to its overall performance and to its lower cost of implementation.

Too little compassion in health care?

I have been visiting one of England's major teaching hospitals a couple of times every week for most of this year. My father in law is a ‘frequent flier’ with heart failure and various comorbidities. Seeing the NHS through the lens of his care is sobering. The NHS's addiction to structural change as a way of sorting things out seems unlikely to shift his shoddy support. This obsession with moving the resources around seems to know no bounds and yet is useless for him. In the media we see continued coverage about sacking unaffordable staff this year and senior NHS and DoH leaders encouraging the closure of hospitals in the tail end of this decade. Others offer rationing services and big projects (like the national IT programme) as the only routes to sustainability. From my experience these are pretty irrelevant—what is really needed is a fundamental shift in how people relate to each other: staff to staff, patients to staff. And this is measured in the small things: the nurse who phones social services (again) to try to get a completed and accurate assessment—not the nurse who refused to go to the hospital shop to buy the barriernursed patient a bottle of orange squash. If everyone who works in NHS did one extra act of kindness a day (the GP on a home visit who boils that egg for a housebound patient, the consultant who buys a phone card for a bed-bound patient and helps them to use it) and took one extra step to make things join up better for a patient (the SHO who phones the GP, the ward clerk who talks to the X-ray department, the sister who phones the relatives to brief them on a change in regime), the whole system would take a massive step forward in terms of service and smoothness, and would seem simpler to patients and more satisfying for staff. Once the NHS shifts out of its chaotic turbulence it is possible to try other improvements. Structural change is a side alley en route to giving patients and carers greater and greater value from the skills of staff. Process improvements with IT are only part of the answer. Changing the way that compassion is shown, kindness demonstrated, conflict is handled and decisions managed would be totally transforming. Starting with the little things is critical. It doesn't need a government policy or mandate from the top. This is a strategy that everyone can create—and all can implement.

Surface and Radiological Anatomy. Fifth edition. Edited by W. J. Hamilton, M.D., D.Sc., F.R.C.S., F.R.C.O.G., F.R.S.E., Emeritus Professor of Anatomy in the University of London; G. Simon, M.D., F.R.C.P., D.M.R.E. (Cantab.), F.F.R. Radiologist to the Diagnostic X-ray Department, St. Bartholomew's Hospital, and to the Brompton Hospital; and S. G. Ian Hamilton, M.A., M. Chir. (Cantab.), F.R.C.S, Consultant Suergeon, Royal Cornwall

Journal Article Surface and Radiological Anatomy. Fifth edition. Edited by W. J. Hamilton, M.D., D.Sc., F.R.C.S., F.R.C.O.G., F.R.S.E., Emeritus Professor of Anatomy in the University of London; G. Simon, M.D., F.R.C.P., D.M.R.E. (Cantab.), F.F.R. Radiologist to the Diagnostic X-ray Department, St. Bartholomew's Hospital, and to the Brompton Hospital; and S. G. Ian Hamilton, M.A., M. Chir. (Cantab.), F.R.C.S, Consultant Suergeon, Royal Cornwall Hospital, Truro, Cornwall. Pp. 397 + x. Illustrated. 1971. Cambridge: W. Heffer & Sons Ltd. £6 Get access Surface and Radiological Anatomy. Fifth edition. Edited by W JHamilton, M.D., D.Sc., F.R.C.S., F.R.C.O.G., F.R.S.E., Emeritus Professor of Anatomy in the University of London; GSimon, M.D., F.R.C.P., D.M.R.E. (Cantab.), F.F.R. Radiologist to the Diagnostic X-ray Department, St. Bartholomew's Hospital, and to the Brompton Hospital; and S G IanHamilton, M.A., M. Chir. (Cantab.), F.R.C.S, Consultant Suergeon, Royal Cornwall Hospital, Truro, Cornwall. Pp. 397 + x. Illustrated. 1971. Cambridge: W. Heffer & Sons Ltd. £6. British Journal of Surgery, Volume 59, Issue 2, February 1972, Page 164, https://doi.org/10.1002/bjs.1800590249 Published: 12 December 2005

Modern trends in diagnostic radiology (second series). Edited by J. W. McLaren, M.A., M.R.C.P., F.F.R., Radiologist, X-ray Department, St. Thomas's Hospital, London. 6½ × 9½ in. Pp. 413 + xi, with 359 illustrations. 1953. London: Butterworth Co. (Publishers) Ltd. 70s

Journal Article Modern trends in diagnostic radiology (second series). Edited by J. W. McLaren, M.A., M.R.C.P., F.F.R., Radiologist, X-ray Department, St. Thomas's Hospital, London. 6½ × 9½ in. Pp. 413 + xi, with 359 illustrations. 1953. London: Butterworth Co. (Publishers) Ltd. 70s Get access Modern Trends in Diagnostic Radiology (Second Series). Edited by J W McLaren, M.A., M.R.C.P., F.F.R., Radiologist, X-ray Department, St. Thomas's Hospital, London. 6½ × 9½ in. Pp. 413 + xi, with 359 illustrations. 1953. London: Butterworth Co. (Publishers) Ltd. 70s. British Journal of Surgery, Volume 41, Issue 166, September 1953, Page 224, https://doi.org/10.1002/bjs.18004116626 Published: 06 December 2005

A textbook of X-ray diagnosis. Vol. IV. Edited by S. Cochrane Shanks, C.B.E., M.D., F.R.C.P., F.F.R., Director, X-ray Diagnostic Department, University College Hospital, London; and PETER KERLEY, C.V.O., C.B.E., M.D., F.R.C.P., F.F.R., D.M.R.E., Director, X-ray Department, Westminster Hospital, London. Third edition. 9¾ × 7 in. Pp. 714 + xvi, with 735 illustrations. 1959. London: H. K. Lewis & Co. Ltd.

Journal Article A textbook of X-ray diagnosis. Vol. IV. Edited by S. Cochrane Shanks, C.B.E., M.D., F.R.C.P., F.F.R., Director, X-ray Diagnostic Department, University College Hospital, London; and PETER KERLEY, C.V.O., C.B.E., M.D., F.R.C.P., F.F.R., D.M.R.E., Director, X-ray Department, Westminster Hospital, London. Third edition. 9¾ × 7 in. Pp. 714 + xvi, with 735 illustrations. 1959. London: H. K. Lewis & Co. Ltd. IIos Get access A textbook of X-ray diagnosis. Vol. IV. Edited by S Cochrane Shanks, C.B.E., M.D., F.R.C.P., F.F.R., Director, X-ray Diagnostic Department, University College Hospital, London; and Peter Kerley, C.V.O., C.B.E., M.D., F.R.C.P., F.F.R., D.M.R.E., Director, X-ray Department, Westminster Hospital, London. Third edition. 9¾ × 7 in. Pp. 714 + xvi, with 735 illustrations. 1959. London: H. K. Lewis & Co. Ltd. IIos British Journal of Surgery, Volume 47, Issue 203, November 1959, Page 334, https://doi.org/10.1002/bjs.18004720341 Published: 06 December 2005

Modern trends in diagnostic radiology. Edited by J. W. McLaren, M.A., M.R.C.S., L.R.C.P., D.M.R.E., Director, X-ray (Diagnostic) Department, St. Thomas's Hospital, London; Examiner in Radiology, University of London. 9⅝ × 6⅝ in. Pp. 464 + xxi, with 381 illustrations. 1948. London: Butterworth & Co. (Publishers) Ltd. 60s. net

Modern trends in diagnostic radiology. Edited by J. W. McLaren, M.A., M.R.C.S., L.R.C.P., D.M.R.E., Director, X-ray (Diagnostic) Department, St. Thomas's Hospital, London; Examiner in Radiology, University of London. 9⅝ × 6⅝ in. Pp. 464 + xxi, with 381 illustrations. 1948. London: Butterworth & Co. (Publishers) Ltd. 60s. net Get access Modern trends in diagnostic radiology. Edited by J WMcLaren, M.A., M.R.C.S., L.R.C.P., D.M.R.E., Director, X-ray (Diagnostic) Department, St. Thomas's Hospital, London; Examiner in Radiology, University of London. 9⅝ × 6⅝ in. Pp. 464 + xxi, with 381 illustrations. 1948. London: Butterworth & Co. (Publishers) Ltd. 60s. net. British Journal of Surgery, Volume 36, Issue 142, October 1948, Pages 221–222, https://doi.org/10.1002/bjs.18003614232 Published: 06 December 2005

A text-book of X-ray diagnosis. By British Authors, in three volumes. Edited by S. Cochrane Shanks, M.D., F.R.C.P., F.F.R., Director, X-ray Diagnostic Department, University College Hospital, London; and Peter Kerley, C.V.O., C.B.E., M.D., F.R.C.P., F.F.R., D.M.R.E., Director, X-ray Department, Westminster Hospital; Radiologist, Royal Chest Hospital. Third edition. 10 × 7 5/8 in. Pp. 521 + xiv, with 533 illustrations. 1957.

A text-book of X-ray diagnosis. By British Authors, in three volumes. Edited by S. Cochrane Shanks, M.D., F.R.C.P., F.F.R., Director, X-ray Diagnostic Department, University College Hospital, London; and Peter Kerley, C.V.O., C.B.E., M.D., F.R.C.P., F.F.R., D.M.R.E., Director, X-ray Department, Westminster Hospital; Radiologist, Royal Chest Hospital. Third edition. 10 × 7 5/8 in. Pp. 521 + xiv, with 533 illustrations. 1957.

X-ray Diagnosis. For Clinical Students and Practitioners. By G. Simon, M.D., B.Ch. (Cantab.), F.F.R., Assistant Radiologist at St. Bartholomew's Hospital and Assistant Director of the X-ray Department, The Brompton Hospital. 9½ × 7¼ in. Pp. 208 + x, with 180 illustrations. 1949. Cambridge: W. Heffer & Sons Ltd. 20s. net

Journal Article X-ray Diagnosis. For Clinical Students and Practitioners. By G. Simon, M.D., B.Ch. (Cantab.), F.F.R., Assistant Radiologist at St. Bartholomew's Hospital and Assistant Director of the X-ray Department, The Brompton Hospital. 9½ × 7¼ in. Pp. 208 + x, with 180 illustrations. 1949. Cambridge: W. Heffer & Sons Ltd. 20s. net Get access X-ray Diagnosis. For Clinical Students and Practitioners. By GSimon, M.D., B.Ch. (Cantab.), F.F.R., Assistant Radiologist at St. Bartholomew's Hospital and Assistant Director of the X-ray Department, The Brompton Hospital. 9½ × 7¼ in. Pp. 208 + x, with 180 illustrations. 1949. Cambridge: W. Heffer & Sons Ltd. 20s. net. British Journal of Surgery, Volume 37, Issue 147, January 1950, Page 373, https://doi.org/10.1002/bjs.18003714737 Published: 06 December 2005

Text-book of X-ray diagnosis. By British Authors. Edited by S. Cochrane Shanks, M.D., Physician with Charge of Out-patients, Departments of Radiology and Electro-therapy, Charing Cross Hospital; Radiologist, the Prince of Wales's General Hospital, etc.; Peter Kerley, M.D., M.R.C.P., D.M.R.E., Physician to the X-ray Department, Westminster Hospital; Radiologist, Royal Chest Hospital, etc.; and E. W. Twining, M.R.C.S., L.R.C.P., D.M.R.E., Radiologist, Royal

Text-book of X-ray diagnosis. By British Authors. Edited by S. Cochrane Shanks, M.D., Physician with Charge of Out-patients, Departments of Radiology and Electro-therapy, Charing Cross Hospital; Radiologist, the Prince of Wales's General Hospital, etc.; Peter Kerley, M.D., M.R.C.P., D.M.R.E., Physician to the X-ray Department, Westminster Hospital; Radiologist, Royal Chest Hospital, etc.; and E. W. Twining, M.R.C.S., L.R.C.P., D.M.R.E., Radiologist, Royal

A text-book of x-ray diagnosis. By British Authors. In four Volumes. Edited by S. Cochrane Shanks, M.D., F.R.C.A., F.F.R., Director, X-ray Diagnostic Department, University College Hospital, London, and Peter Kerley, M.D., F.R.C.P., F.F.R., D.M.R.E., Director, X-ray Department, Westminster Hospital; Radiologist, Royal Chest Hospital, London. Second edition. 6⅜ × 9¼ in. Vol. I. Pp. 434 + xiv, with 439 illustrations. Vol.

A text-book of x-ray diagnosis. By British Authors. In four Volumes. Edited by S. Cochrane Shanks, M.D., F.R.C.A., F.F.R., Director, X-ray Diagnostic Department, University College Hospital, London, and Peter Kerley, M.D., F.R.C.P., F.F.R., D.M.R.E., Director, X-ray Department, Westminster Hospital; Radiologist, Royal Chest Hospital, London. Second edition. 6⅜ × 9¼ in. Vol. I. Pp. 434 + xiv, with 439 illustrations. Vol.

An X-ray Atlas of the Normal and Abnormal Structures of the Body. By Archibald, McKendrick, F.R.C.S. Ed., D.P.H., F.R.S.E., Hon. Consultant (late Surgeon in charge), X-ray Department of the Royal Infirmary, Edinburgh, Examiner in the Royal College of Surgeons, Edinburgh; and CHARLES R. WHITTAKER, F.R.C.S.Ed., F.R.S.E., Assistant Lecturer in Anatomy, Surgeon's Hall, Edinburgh, Examiner. Royal College of Surgeons, Edinburgh, Second

Journal Article An X-ray Atlas of the Normal and Abnormal Structures of the Body. By Archibald, McKendrick, F.R.C.S. Ed., D.P.H., F.R.S.E., Hon. Consultant (late Surgeon in charge), X-ray Department of the Royal Infirmary, Edinburgh, Examiner in the Royal College of Surgeons, Edinburgh; and CHARLES R. WHITTAKER, F.R.C.S.Ed., F.R.S.E., Assistant Lecturer in Anatomy, Surgeon's Hall, Edinburgh, Examiner. Royal College of Surgeons, Edinburgh, Second edition, revised and enlarged. Demy 4th. Pp 256 + xvi. 1927. Edinburgh: E. & S. Livingstone. 30s. net Get access An X-ray Atlas of the Normal and Abnormal Structures of the Body. By Archibald McKendrick, F.R.C.S. Ed., D.P.H., F.R.S.E., Hon. Consultant (late Surgeon in charge), X-ray Department of the Royal Infirmary, Edinburgh, Examiner in the Royal College of Surgeons, Edinburgh; and Charles RWhittaker, F.R.C.S.Ed., F.R.S.E., Assistant Lecturer in Anatomy, Surgeon's Hall, Edinburgh, Examiner. Royal College of Surgeons, Edinburgh, Second edition, revised and enlarged. Demy 4th. Pp 256 + xvi. 1927. Edinburgh: E. & S. Livingstone. 30s. net British Journal of Surgery, Volume 15, Issue 59, January 1928, Page 526, https://doi.org/10.1002/bjs.1800155922 Published: 05 December 2005

Patient and staff doses in radiology and cardiology in Estonia

This paper presents a short description of the Estonian radiological facilities and the doses to staff in radiology and cardiology. For each major work practice, the annual (2002) average effective doses are listed: X-ray diagnostics (radiologists: 1.11 mSv; radiographers: 1.03 mSv), interventional radiology (doctors in cardioangiography: 6.04 mSv; radiologist in angiography: 2.71 mSv), nuclear medicine (radiologists: 0.91 mSv; technicians: 2.41 mSv) and radiotherapy (radiologists: 1.00 mSv; technicians: 1.04 mSv). This paper also presents the first results of adult patient dose measurements in diagnostic X-ray departments in Estonia. The average entrance skin dose for chest PA examinations was 0.3 mGy, for chest LAT 0.9 mGy, for lumbar spine AP 6.4 mGy, for lumbar spine LAT 10.7 mGy and for pelvis AP 3.9 mGy.

An investigation into why patients do not attend for out-patient radiology appointments

Introduction Patients who do not attend (DNA) for out-patient hospital appointments cause delays in the diagnosis and subsequent treatment of their own, and other patient's, illnesses, with potentially hazardous consequences. This also impacts upon waiting lists. Failure to attend is viewed as a specific type of non-compliance and social cognition theories have been applied to previous studies in an attempt to uncover the reasons why patients choose not to keep their appointments. Methods A case-control study was conducted throughout the X-ray departments of a District General type of NHS Trust, using telephone interview questionnaires based on the Health Belief Model, in an attempt to identify any significant differences between attenders and non-attenders, so that likely non-attenders could be targeted. Results Principal reasons for non-attendance were that the patient forgot or that they did not receive their appointment. The results differed from previous research, in that specific health beliefs were not the primary reasons for non-attendance. Departments that gave patients the opportunity to arrange their appointments for a mutually convenient time had exceptionally low DNA rates, as did those which had rigorous confirmation systems in place.

Impact of digital imaging on radiation doses to the patient during X-ray examination of the urinary tract

To compare radiation doses given to patients undergoing IVU (intravenous urography) before and after digitalization of our X-ray department. IVU examinations were monitored with dose area product meters before and after the X-ray department changed to digital techniques. The first step was a change from film-screen to storage phosphor plates, while the second step involved changing to a flat panel detector. Forty-two patients were included for the film-screen situation, 69 when using the storage phosphor plates, and 70 using the flat panel detector. A dose reduction from 41.8 Gycm2 to 31.5 Gycm2 was achieved with the first step when the film-screen system was replaced with storage phosphor plates. A further reduction to 12.1 Gycm2 was achieved using the flat panel detector. The introduction of the flat panel detectors made a considerable dose reduction possible.

453 Calculating Additional Shielding Requirements in Diagnostics X-Ray Departments by Computer

453 Calculating Additional Shielding Requirements in Diagnostics X-Ray Departments by Computer

The costs and effects of introducing selectively trained radiographers to an A&E reporting service: a retrospective controlled before and after study

The costs and effects of introducing selectively trained radiographers reporting accident and emergency (A&E) radiographs of the appendicular skeleton in a district general hospital were assessed using a retrospective controlled before and after design. Reference standard reports were compared with a random stratified sample of 200 A&E and 200 general practitioner (GP) reports before and after the intervention. GP reports were used as a non-intervention, non-equivalent control group. An A&E specialist registrar judged whether incorrect A&E reports might have a clinically important effect on patient management. The effect of incorrect A&E reports on outcome was assessed by patient re-attendance to the hospital because of missed abnormalities. The annual, average and incremental costs of radiographers and radiologists reporting A&E radiographs were calculated and a sensitivity analysis was undertaken. The introduction of the radiographers resulted in a 1% (95% CI -7.9 to 5.9) fall in A&E radiograph reporting accuracy and 11% (95% CI -33.7 to 11.3) reduction of cases in which incorrect A&E reports might have a clinically important effect on patient management. Only two A&E reports (one before and one after the intervention) affected patient outcome in that a fracture missed at the first visit resulted in patient re-attendance to the X-ray Department. There was a saving of 361 pounds per annum to the X-ray Department. In conclusion this study provides further evidence that selectively trained radiographers can accurately report A&E plain radiographs and at no additional cost.

Interlaboratory comparison and accreditation in quality control testing of diagnostic X-ray equipment

The University of Tartu provides a quality control service to the majority of diagnostic X-ray departments in Estonia. Its methodology has been adopted from the IEC and other relevant standards. Recently the Testing Centre of the University of Tartu was accredited on this methodology by ISO/IEC 17025. Besides the implementation of the quality management system, participation in interlaboratory comparison (ILC) was one of the prerequisites for the accreditation. Tests for estimating reproducibility of tube voltage and dose rate, accuracy of the voltage and accuracy of exposure time were carried out on a diagnostic X-ray unit in the Radiation and Nuclear Safety Authority in Helsinki. The measurement performance was judged by calculating deviation E(n) normalised with respect to the stated uncertainties. E(n) values for all tests were less than unity and by the common ILC criteria the testing performance could be considered as acceptable.

Preoperative skin traction or pillow nursing in hip fractures: A prospective, randomized study in 123 patients

Purpose: To study the influence on pain and handling of different preoperative immobilization procedures for hip fractures.Method: 123 consecutive patients with displaced cervical and trochanteric hip fractures were randomized to skin traction, placement in a special foam pillow (Lasse pillow), and comfortable placement with an ordinary pillow under the hip from admission to operation. The effect on pain alleviation was evaluated with a Visual Analogue Scale and by the number of doses of analgesics administered. The processing time through the emergency department, X-ray department and to the ward as well as time to operation was registered.Results: No clinically significant difference in the VAS pain evaluation was found. There was no difference in the total consumption of analgesics in the emergency department or on the ward and no effect of immobilization type on the processing time or time to operation. Fracture type did not affect the outcome. Approximately one third of the patients found placement on a regular pillow or the application of skin traction uncomfortable as opposed to only one of 19 of the patients lying in the special Lasse pillow. There was no other difference in processing time with regard to different forms of pillow nursing and skin traction.Conclusion: The most convenient immobilization should be chosen as there is no significant difference concerning pain and handling time. Increased attention to analgesic medication and rapid handling to be operated are of importance to promote the rehabilitation process.

A comparison of the semiflexed (MTP) view with the standing extended view (SEV) in the radiographic assessment of knee osteoarthritis in a busy routine X-ray department

To compare the reproducibility of the standing extended view (SEV) (also known as the standing anteroposterior view) with the semiflexed, postero-anterior view [the 'metatarsophalangeal' (MTP)] view for assessing joint space width (JSW) and osteophytes in osteoarthritis of the knee when used in a busy routine X-ray department. Forty-seven patients (24 men) had both SEV and MTP views taken on the same day in a busy National Health Service radiography department. Repeat views were taken as entirely separate procedures some time over the following 2 weeks, in the same department and with no special arrangements for the selection of radiographers, time of day, or X-ray machine. The first 24 patients had second views in the SEV position whilst the remaining 23 had second MTP views. Radiographs were read independently by two experienced observers who measured JSW with a transparent ruler to the nearest 0.5 mm at the narrowest point in both medial and lateral compartments of the tibiofemoral joint in both knees. Osteophytes were graded 0-2 according to a standard atlas. Ten SEV and 10 MTP radiographs selected randomly were re-read by one observer. Mean (95% confidence interval) JSW in the medial compartment measured on SEV radiographs was 3.54 mm (3.08, 3.99) and on MTP radiographs it was 2.80 mm (2.37, 3.23); in the lateral compartment it was 6.04 mm (5.71, 6.37) when measured on SEV radiographs and 5.47 mm (5.09, 5.85) on MTP radiographs. The estimated variances for the medial compartment were 2.0 mm2 for SEV and 0.2 mm2 for MTP (P < 0.001) and for the lateral compartment 1.4 mm2 for SEV and 0.5 mm2 for MTP (P < 0.001). The proportion of radiographs for which there was disagreement between observers regarding osteophyte grade was not statistically different between SEV and MTP views (SEV, medial 40%, lateral 44%; MTP, medial 39%, lateral 39%). Even when radiographs are taken in a busy National Health Service radiography department, measurement of JSW from the MTP view is more reproducible than from the SEV view, the MTP view gives a slightly lower measurement of JSW, and there is no advantage in using either view in recording osteophyte grade. We recommend the wider adoption of the MTP method.

Bedside insertion of vena cava filters in the intensive care unit using intravascular ultrasound to locate renal veins.

Historically, contrast venography has been used to determine renal vein location and assist with vena cava filter placement. This technique, however, exposes the patient to nephrotoxic contrast and radiation. For trauma patients in the intensive care unit (ICU), inferior vena cava filters should ideally be placed without contrast at the bedside to avoid nephrotoxic agents, radiation, and transport of a critically injured patient to the operating room or x-ray department. Previously, the authors have shown that intravascular ultrasound is a safe and accurate method for locating renal veins and assisting with vena cava filter placement. The purpose of this study was to evaluate bedside vena cava filter placement prospectively using only intravascular ultrasound for imaging. Between August 2000 and July 2003, 29 patients met trauma service criteria for prophylactic or therapeutic placement of a vena cava filter. The 7 females and 22 males had a mean age of 51.3 years (range, 20-92 years), a mean height of 177 cm (range, 160-218.4 cm), a mean weight of 101.9 kg (range, 59.1-186.4 kg), and a body mass index of 33 (range, 14.7-56.1). Fifteen patients (55.5%) had a body mass index exceeding 30. The mean Injury Severity Score was 25.4 (range, 12-45). Intravascular ultrasound was the sole imaging method, and no contrast or fluoroscopy was used. All procedures were performed in the ICU by trauma surgeons. Data collection was prospective and included demographics, injuries, vena caval anatomy, length of procedure, complications, and follow-up radiographic confirmation of appropriate deployment. The location of the renal veins and vena cava diameter was imaged in all the patients. Three patients were noted to have accessory renal veins, and no patient had thrombus in the vena cava. The inferior vena cava diameter was less than 28 mm in all the patients, thus allowing standard filters to be deployed. Filter deployment was successful for all the patients. Of the 29 patients, 27 had abdominal computed tomography (CT) during their hospital stay. When the location of the renal veins identified by CT was compared with the level of the filter on abdominal x-ray, the filter tip was found to be at or below the level of the most caudal renal vein in 26 of the 27 patients (96.3%). In one patient, the filter tip was purposely placed 2 to 3 cm above an accessory caudal renal vein, but below the main right and left renal veins. The mean procedure time was 37.7 minutes (range, 12-86 minutes). No complications were associated with filter placement. Intravascular ultrasound is a safe and effective imaging method that may be used for the bedside placement of vena cava filters in the ICU. This technique avoids the use of nephrotoxic intravenous contrast and eliminates the risk of transporting a critically injured patient to the operating room or x-ray department.