A repeatable read
Read the film the same way every time so nothing is skipped under pressure.
- Confirm patient, date, and projection. Portable films are AP, which magnifies the heart — never call cardiomegaly on a portable.
- Assess quality: adequate inspiration is 8–10 posterior ribs; rotation is judged by clavicle symmetry around the spinous processes.
- Then tubes and lines, then bones and soft tissue, then diaphragm and costophrenic angles, then mediastinum, then lung fields last.
- Compare with the prior film — a change is more informative than any single image.