Understanding the locks of the Mobile Image Intensifier Carm

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Understanding the locks of the Mobile Image
Intensifier C-arm

• For Medical Radiation Technology Students
• by
• Catherine Baerg, Khysar Pasha and Lance Wall

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Learning Outcomes

• Introduction to Radiographic Equipment Concept
  mapping
• Identify Equipment Parts
• Locate Equipment Locks
• Describe the Associated Movements of the Locks
• Discuss Applications of Associated Movements
• Student Self Assessment

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Student Self Assessment

• Students may be advised to
• Review this presentation
• Hot Potatoes Quiz
• Practice moving Mobile C-arm in clinical

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Mobile Radiographic Equipment

• Types
• Various types available as shown on concept map.
• Present focus
• Mobile Fluoroscopic C-arm

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Mobile fluoroscopic C-arm

• Recall
• Fluoroscopy is a dynamic radiographic
  examination.
• Why mobile fluoroscopy?
• For surgical procedures

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Mobile fluoroscopic C-arm

• They operate in same manner as stationary units.
• The designation of "C-arm" comes from the
  physical arrangement of the unit.
• C-arm consists of the image intensifier at one
  end, and the X-ray tube at the other end.

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C-arm Equipment Parts
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Rotational Lock

• Releasing this lock allows movement from vertical
  to horizontal position and angles in between.

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Horizontal position
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Flip Lock

• During some procedures it may be necessary for
  the image intensifier to be located on the
  bottom side of the C-arm. Releasing the Flip lock
  will enable the intensifier to be positioned on
  the bottom.

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• Intensifier has been flipped to the bottom
  position.

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In/Out Lock

• Releasing this lock extends or retracts the C-arm
  6. This allows a range of motion over anatomy
  while the base of the C-arm remains in place.

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In/Out Lock

• This picture shows the horizontal arm of the
  C-arm in full extension compared to the previous
  picture of complete retraction.

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In/Out lock is circled
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Pivot or Wig-Wag Lock

• Releasing this lock enables the intensifier to
  move along the long axis of anatomy without
  moving the base of the
• C-arm.

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Pivot or Wig-Wag Lock

• This photo and the previous one show the range of
  pivot of the C-arm.

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Dual articulation of locks

• In some instances the C-arm must be placed over
  the anatomy rather than under the anatomy.

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These two button pairs raise and lower the height
of the intensifier. The C-arm must be plugged in
for these buttons to activate. These buttons are
not considered locks but they can alter the
position of the machine.
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Applications of C-arm

• In surgical procedures.
• (eg. closed reduction of fractures, placement of
  pacemaker leads, hip pinning procedures)
• The following slides will show examples of
  procedures where the C-arm is used.

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Closed Reduction
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Abdominal Fluoroscopy

• Note clear plastic sterile cover over image
  intensifier.

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Hickman catheter placement

• Patient and C-arm in position for a Hickman
  catheter placement. Introduction of the catheter
  begins in the upper thorax and is completed with
  the catheter in the heart.

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•  C-arm placed in rainbow position for cervical
  procedures.

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C-arm over anatomy

• The rainbow position is used especially for
  larger patients in which the table or size of the
  patient would not allow enough elevation of the
  C-arm to include the lumbar spine.

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C-arm under anatomy
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C-arm at 90 to anatomy(vertical position)
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Hip Pinning-- Antero-Posterior (AP) Position

• Two projections are always required. Each must be
  at 90 to the other. This position of the
  intensifier shows the Antero-posterior (AP)
  position.

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Hip Pinning Lateral Position

• The C-arm is rotated to the horizontal or
  lateral position to visualize the patients
  fractured hip in the lateral position. The
  orthopedic surgeon will know if the fracture is
  reduced by viewing these two projections.

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Summary

• Understanding the locking system is very
  important.
• Why?

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Summary contd

• Because of the situations where the C-arm is
  used.
• The operating room is a stressful environment.
• You are working within a sterile field.

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Self Assessment

• Try the quiz to test your knowledge!

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Resources

• Carlton Adler Principles of Radiographic
  Imaging, An Art and a Science, 3rd Edition
• Frank Merrill's Atlas of Radiographic
  Positioning and Radiologic Procedures, 11th
  Edition Online Course
• Radiographic Equipment Course, SIAST Medical
  Diagnostics