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C - A R M
S A F E T Y
underneath the patient. Positioning the X-ray tube above the patient is often an issue with hand and foot surgeons, who like to use the image intensifier as an operating surface. This isn't a recommended practice, but surgeons who have good clinical reasons to use the image intensifier as a patient support must always wear proper eye protection and focus on keeping their hands out of the raw X-ray beam.
Also, place the image intensifier as close to the intended imaging site as possible. This will keep the X-ray tube far from the patient. Many surgeons wrongly move the image intensifier away from the patient in order to gain more room to operate.
Stand near the image receptor side of the C-arm. Most of the radiation that reaches staff bounces off patients and back toward the X-ray tube. On a typical C-arm, there's 5 to 10 times more radiation on the X-ray tube side than on the image intensifier side. When you stand on the X-ray tube side, the patient is your source of radiation; on the image intensifier side, the patient is part of your protection system.
Remain vigilant when positioning C-arms over patients. In one facility, according to a report in the journal Anesthesia & Analgesia, the lower half of a C-arm wedged onto the floor control of an operating table when the unit was moved into position. The table tilted uncontrollably before the surgical team noticed the issue and removed the arm from the floor control. Their quick thinking saved the patient from a potentially tragic fall.
3 Image judiciously
Surgeons must capture images that let them see enough to work confidently. The highest dose rates that the machines can produce are seldom a clinical necessity. In addition, C-arms should be activated only when there will
be immediate use of the images.
Physicians must understand the importance of limiting exposure risks, and activate the C-arm only when they're looking at the X-ray monitor. They can't forget
