How to Properly Move a C Arm In and Out and End Up in the Same Place
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- čas přidán 15. 07. 2017
- CMworldservices got a chance to work with Radiologist Dr. Bowman. We got a chance to go into CHOMP and put together a whole instructional video series for those currently in the medical field and to those pursuing.
This is one of the videos out of that series Dr. Bowman gave us permission to post on our youtube page.
Thank you to Leslie and Dennis.
Radiation Protection in Fluoroscopy: How to Properly Move a C-Arm In and Out and End Up in the Same Place
Instructed by Dr. Dennis Bowman
Filmed at Community Hospital of Monterey Peninsula.
Filmed and Edited by Carlos Fidalgo of CMworldservices
Crew were Anthony Jamison and Gregg Galdo
Video equipment provided by Le Sage Productions and Monterey County Producers Club
To contact CMworldservices email us at cmworldservices@gmail.com
fluororadpro.com/
/ mcproducersclub
/ @jameslesage1260 - Zábava
Man i tried this today at clinical and it worked every single time. So glad I saw this vid! Now I wont look like an imbecile when I get to work on a real case!
Oh my god I just realized who this guy is. I went to the radiography conference right before COVID, as a student, and he was teaching seminars. I forget his name unfortunately but I saw this video before I even became a student. This guy is super cool and does tons of experiments with radiation protection like the best locations to stand for certain exams and a bunch of other stuff and he is such a nice guy!
Michael `s theatre II Tips
1. Take all the keys to every machine just in case yours stops working
2. Let the surgeon decide where the II comes from , where the Monitor should go, don’t assume
3. If the body part is over the steel table base, or the metal table edge, or gaps in the foam table are in the way then -solution- Move the patient.
4. Beware sandbags , can be put under hips/ chest by inexperienced theatre staff
5. Set a manual kv for extremities -so that even if you come in and are centred in the wrong place , the image will be correctly exposed. Otherwise if your going in and out, over the body part, even slight miss centering, will result in a black/ underexposed image, because it will give a fresh air exposure eg 44kv ( which would not get through a finger). Generally hand 52kv, ankle 57kv, knee/ shoulder 62k , then tweek it. I once I had a student who never centred bang in the middle once, for an ankle op . The surgeon didn`t notice. The foam table makes 2 kv difference. Some machines require the first exposure to be on the AED.
6. The ii has an obese button, which is the maximum mA output, find out where this is. If this doesn’t work and the image is black - still under exposed , the only thing you can do is try and use the Monitor brightness/contrast - this may well not work ! there`s nothing you can do !! with this machine.
7. Save all the images- make this a habit- you don’t know which operation turns out wrong, even though it seems ok at the time
8. If your doing AP and Lateral, every time you go to the other position , swap the image over on the monitors. So you always keep an AP on one side, and a Lateral on the other. This takes concentration.
9. The worst problem is obesity with osteoporosis. Obesity means the II will use a high KV eg 110kv ,so LOW contrast. The bones will be very hard to see, because they don’t have any bone in them ! If the surgeon is moaning explain this LOL I had the same problem with AP hip on a young man- biggest muscular thigh in England.
10. Expect the first image to be wrong, wrong place , wrong orientation. Move the wheels in the direction you want to go, either towards head/ foot or in/out , make it easy for yourself , move in each direction in turn, and you will get where you want to be. Small movement`s to keep control.
11. Don’t let the surgeons use the flat II surface to apply a wet Plaster of Paris, unless you cover it first with a plastic bag, or water will get into it and it will go bang !
12. For hips / DHS cover the tube ( under the table/ hip) with a plastic bag ,so blood doesn’t get into it.
13. You can get a lateral of the humerus, femur with the patient flat ( both legs down) on the table if you come in sideways, from the opposite side, and angle 70 degrees. and the body part ( shoulder/ hip/ femur) is right over the edge of the table ( so the metal table sides are not in the way)
14. If you leave the theatre for a break ( very long case) always tell someone whose sterile ( surgeon/ scrub nurse) where you will be, just in case they suddenly need you back.
15. Only ask the surgeon a question when hes not doing something dangerous e.g. with a drill.
16. At the end of the operation get a clear answer you are finished BEFORE you remove the sterile xray cover.
Omg thank you. I will try this tomorrow. Went from being a graveyard tech that rarely did OR stuff to a mid shift tech that relieves all the OR techs for lunch breaks. I hate it when the doctors look at you like you’re an idiot because you can’t get it back in the same spot. One of our ortho surgeons will actually position the c arm exactly where he wants it then gets down and tapes around all 3 wheels. He’s very particular but very consistent at least. This will come in handy doing his cases.
This is helpful! I just started clinicals and utlized the c-arm just a little bit but I will remember this going surgical rotation!
Thank you! Sharing this with my students
Awesome tip, for a real problem. Th so you so much for making it!!!! Thank you. 🙏🏽😌
I am radiographer for past 8 years and i have alot exp with arthopedic and spine surgeries that i dont even feel these truck i just fix the specific place in my mind and for better imaging i also do patient positioning and other stuff to counter issues we face from table and especially in traction table .
VERY HELPUL.
It's not working for me 😢
We have no room so I have to really swing the c-arm out of the way
I tried messing around with the equipment and I'm always off
Laser pointers help too.
Eye opener! I'm taking this to work.
Xray peps what's uppp!!!
I do that all the time already lol!
We trained your method at work and nobody needed up in the same spot
Sorry nobody ended up in the same spot
C--ARM IS ESSENTIAL FOR ORTHOPAEDICS
tried this
the tech I was with thought I was retarded
Lol are you better at it now? I'm still a student & not looking forward to using the c arm and getting screamed at.
@@pb4ugo19
Yes! I'm almost graduated, just another month now. I only use this occasionally in Ortho cases when I'm coming in at a weird angle. Other than that for neuro especially I just stay straight. The surgery rooms I'm in are reasonably spacious so I'm usually ok.
Honestly even now I still sweat just a little in surgery, but I always have a cool calm exterior. I'm just glad I like CT more so soon I can forget about C-arms.
@@pb4ugo19 you're going to annoy someone, whether it's the surgeon, nurses or even other techs. Don't get discouraged if you get yelled/snipped at. Unfortunately, people forget what it's like to be new. They don't have a ton of patience for students. Try to learn from every encounter, good and bad. During down time, see if you can practice with the machine. Bring a small notebook & take notes. You can also watch the various videos on youtube, take notes and compare. I was very lucky that I comped with a chill tech. I never really got comfortable with the c-arm because we didn't have one in lab. We just read up on it, but that doesn't help much. Best of luck!
Worst job ever