Fluoroscopic C-Arms require knowledge and education 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. Good safety practices, below, can also keep radiation amounts As Low As Reasonably Achievable (ALARA).
Fluoroscopy C-Arm Safety Guidelines:
First and foremost, do not allow any unauthorized visitors during x-ray exams. Only individuals required for the radiographic procedure should be present in the radiographic room during exposures. Time, distance, and shielding are the three basic guides that could and should be taken for fluoroscopy C-Arm safety.
- Timing. As we mentioned before, with timing, shorter fluoro times can be achieved when the physician uses intermittent fluoroscopy. Also, analyze original radiographs before performing a fluoroscopic examination. Viewing original radiographs, especially for orthopedic studies, can dramatically reduce the repeat rate for the time required for procedures.
- Distance. Observers should stand on the image intensifier side of the C-arm if possible, to avoid radiation leakage from the x-ray tube. When not assisting, step away from the patient during fluoro, as feasible. Stepping even one foot further back can significantly reduce a person’s dose. These are things to consider when calculating the size of the room for the C-arm.
- Shielding. In interventional fluoroscopy procedures, the tissue of concern is the skin. The skin that is at the site where radiation enters the body receives the highest dose than any other body tissue. All workers in the x-ray room during studies must have a lead apron, and other appropriate shielding wear.
Guide to Shielding:
- Lead Apron and Thyroid Shields. Verify that the apron is 0.5 mm lead equivalent, and be sure aprons and shields are in good condition (remove any damaged ones). Insist on well-fitting protective gear with a weight your body can handle. Hang aprons and shields on racks. Do not bend or fold them as this can cause cracks and tears in the protective material, making exposed body parts susceptible to radiation.
- Wrap-around Apron. When wearing lead aprons, it is imperative to keep the lead between you and the x-ray tube. Meaning, do not turn your unshielded back to the x-ray tube. If you do need to move about the room where exposing your back may be likely, insist on using a wrap around style apron.
- Leaded Eyeglasses. Those who routinely fluoro for long or interventional procedures, lead glasses with side shields can provide additional protection to the lens of the eyes. Remember, you may need to look sideways from the C-arm x-ray tube to see the image on the monitor, which will leave the lens unprotected if glasses do not have side shields.
- Leaded Gloves. Lead gloves are required if hands are potentially close to or in the primary beam.
Additional Safety Guidelines:
- For needles, try using just one hand so you can keep your other hand away from the needle, and any potential exposure. Be sure there is ample lighting for accuracy. Properly dispose of used needles immediately after use.
- If possible, structural shielding (such as ceiling-mounted lead acrylic shield and an under-the-table shield) should be implemented.
- Always check for damages. If the C-arm or fittings are damaged, the x-ray tube and intensifier may become misaligned, resulting in image degradation or loss, as well as presenting a potential injury to the staff and patient.
- The fluoroscopy beam-on time and x-ray field size should be reduced as much as possible, and the x-ray beam kept well collimated. Failure of the x-ray beam collimation may lead to primary beam x-ray exposure outside of the selected image intensifier input area. This would result in image degradation and additional exposure for the patient.
- Pulsed fluoroscopy, single pulse fluoroscopy mode, manual mode, fluoroscopy timer warning, and last image hold (“freezing the screen”) are also good safety practices.
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.