At least 50% of an estimated 4-10 million interventional pain procedures are performed yearly in the U.S. under fluoroscopy using fluoroscopic imaging equipment, such as a Fluoroscopic C-Arm. Most clinicians favor fluoroscopy because it allows for a more exact needle placement, which ensures the accurate delivery of the injected drug. However, fluoroscopic guidance as an interventional technique does pose a radiation risk to patients, physicians, and anyone in close proximity. Rest assured, federal regulations place limitations on the maximum output for these C-arms. There are also a variety of techniques and methods for reducing the risk in the private practice setting.
Fluoroscopic C-arm Safety Radiation Exposure – Understanding the Risk:
Fluoroscopic C-Arm usage has the potential for patient radiation and is a valid and real concern that should be discussed and mitigated. Furthermore, we must always remember that the goal of all interventional radiology procedures is to treat (not harm) patients and improve their overall well-being. As a physician, any radiation risks that come with interventional procedures should be discussed with patients, especially when the possible amount of radiation could be high.
In normal conditions, fluoroscopy delivers roughly 5 rads per minute in the direct beam. The patient’s particular anthropometrics — which is the study of the variances in human sizes and measurements — can greatly determine the exposure rate. Specifically, the thickness of the patient is a variable that is known to greatly affect the exposure rate: the thicker the patient, the higher the exposure. Even small doses of radiation (1 rad = approximately one chance in 100,000) can cause damage to the DNA. The damage to the DNA caused by radiation has been associated with various health problems.
Shielding the patient is not always possible. This means that time and distance become critical in helping reduce the exposure.
- Time: shorter fluoro times can be achieved when the physician uses intermittent fluoroscopy (as opposed to continuous), and utilizes the image hold capacity.
- Distance: the patient’s exposure increases exponentially the closer he/she is positioned to the x-ray tube. Positioning the patient as far as possible from the x-ray tube (maybe 12 to 15 inches away from body), and as close as possible to the image intensifier, can lower exposure. (Decreasing x-ray field size can also reduce patient exposure).
With Fluoroscopic C-arms, knowledge and education are a must to properly monitor and reduce exposure levels to your patients and staff. You should receive training from a qualified expert (radiologist or radiological health physicist) on safety procedures and proper imaging techniques to minimize risk and future liability.
Contact us at Pacific Healthcare Imaging, and talk to one of our experienced technicians, We sell and support pre-owned, used and refurbished c-arms and other diagnostic imaging systems for medical facilities. We only sell the highest quality used and refurbished medical imaging equipment, specializing in C-Arms, Mini C-Arms, Portable Ultrasounds and more. We have rentals available as well.