Tips from the OR ➤ When to Save C-arm X-ray Images || Ask The Rad Tech

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Күн бұрын

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@AskTheRadTech 2 жыл бұрын

TIMESTAMPS: Intro 00:00 Where I've been 00:35 1st Reason to save image - Initial set up & first reference 01:14 C-arm positioning tip 01:40 Why you need pre draped images 02:19 2nd Reason to save image - Doctor requests 03:20 Why you don't want to save all images 03:53 3rd Reason to save image - Placement 04:20 4th Reason to save image - Location 05:54 5th Reason to save image - Position 06:28 6th Reason to save image - Something interesting 07:27 7th Reason to save image - Updated reference 07:32

@babyfacemichael1 3 ай бұрын

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.

@AskTheRadTech 2 ай бұрын

Hi Michael. Terrific and super helpful points. This video topic needs a long-overdue update. Will be featuring your comment :) thank you.

@babyfacemichael1 2 ай бұрын

@@AskTheRadTech The first year after qualifying was horrific, each of these points was a personal disaster i had to learn from ! Most students arnt taught what they practically need to understand .

@babyfacemichael1 2 ай бұрын

@@AskTheRadTech Hi thought i would mention, very rarely i have had to penetrate through a metal intramedullary nail to show the surgeon inside it i.e a 100kv on a tibia . In both instances the operation was to remove the metal work. In one i needed to show the direction of the hook they were trying to get into the distal locking screw hole ( having removed the screws) so they could pull the nail out. In the other case the locking bolt , in the top of the nail was stuck at an angle and would not come out.

@AskTheRadTech 2 ай бұрын

Yup, it's always more than just textbook positioning. You tend to learn how to adapt over time.

@AskTheRadTech 2 ай бұрын

Very interesting @ exposure for metalwork