/policies/,/policies/clinical/,/policies/clinical/uwmf-clinical/,/policies/clinical/uwmf-clinical/uwmf-wide/,/policies/clinical/uwmf-clinical/uwmf-wide/medical-imaging/,

/policies/clinical/uwmf-clinical/uwmf-wide/medical-imaging/112003.policy

201411314

page

100

UWMF,

Policies,Clinical,UWMF Clinical,UWMF-wide,Medical Imaging

Use of OEC Mini View Imaging and Orthoscan HD - AFCH Systems (Flueroscan) (112.003)

Use of OEC Mini View Imaging and Orthoscan HD - AFCH Systems (Flueroscan) (112.003) - Policies, Clinical, UWMF Clinical, UWMF-wide, Medical Imaging

112.003

UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
IMAGING POLICY AND PROCEDURE
Use of OEC Mini View Imaging and Orthoscan HD – AFCH Systems (Fluoroscan)

Effective Date: September 1 2013 Approval: See Authorization
Supersedes Protocol: None Contact:

Reviewed


PURPOSE: To ensure proper image quality and low exposure to the patient and minimal
scatter to the operator. It is the operator’s responsibility to observe all safety procedures
and to keep radiation exposures as low as reasonably achievable.

II. INDICATIONS

The OEC Imaging System and Orthoscan are a compact, mobile C-arm designed for x-
ray imaging of extremities. A fluoroscopic device emits a continuous beam of x-rays in
order to view an object in what is called “real time”. The x-rays pass through the object
being observed and cast a shadow of the object on a detector screen. The screen material
is fluorescent and converts the x-rays into a visible light image of the object in the beam.
An image intensifier amplifies the light several thousand times in order to produce a
likeness bright enough to be viewed by a video camera and displayed on a video monitor.

It should be noted that it may be possible to receive significant exposure if strict safety
procedures are not observed at all times.
A. Precautions - OEC Mini View and Orthoscan (Refer to Safety Section in
OEC Manual and Orthoscan Operator’s Manual)
1. If a person is within six feet of the unit during use, a lead apron or portable
lead shield is required. The average dose rate for scattered radiation given
off by the unit, when under power for 1 full minute is about 0.0007
mGy/minute. The x-ray beam is tightly collimated and heavily filtered and
operates at levels in the micro-Ampere (µA) range which results in greatly
reduced levels of radiation exposure for the patient and staff.
a. Make sure the outlet is working where machine is plugged in.
Sudden power loss may cause data to be corrupted. To prevent
this:
i. Ensure that users allow adequate time for the system to shut
down before it is unplugged or removed from power. A
warning added to new user manuals requires users to wait

at least one minute after an image has been saved to power
down the system.
ii. Back up patient data periodically to permit information
recovery if data is lost (see Operator's Manual)
b. Check all the cables on the machine and C-arm to make sure they
are intact.
c. OEC Mini View Source-to-Skin Distance (SSD)
i. Due to the unique physical configuration of the Mini View,
a U.S. federal variance has been obtained that permits
reduction of the SSD to not less than 10 cm. Regulatory
authorities outside of the U.S. generally acknowledge and
accept the variance according to its specified terms and
conditions. It is recommended that local authorities should
be consulted to confirm acceptability of the variance.
ii. The Mini View is equipped with a spacer that maintains the
SSD at 20 cm when attached. Removal of the spacer
reduces the minimum SD to 10 cm.
iii. Note: The spacer is secured on each side of the x-ray head
by two captive screws. Removal of the spacer should only
be done with physician's approval. The spacer should be
immediately replaced after the procedure.
d. For OEC Mini View call 1-800-826-3933 if questions regarding
operations of the machine. For Orthoscan call 1-480-503-8010.
e. Do not operate equipment on unlevel floors.
f. Mechanical shocks to the equipment while disk drives are
accessing information may damage the disk drive.
g. Do not operate if the Operating Room ground fault alarm is
activated.
h. Avoid fluids such as antiseptics, cleaning solutions, or bodily
fluids. They may damage internal components if allowed inside the
equipment.
B. Establishing Power

1. Plug system into the three-wire grounded wall outlet.
2. For the Mini View turn the front switch to “ON”. The front panel pilot
lamp and the monitor (TV) screen will light. For the Orthoscan switch the
white breaker on the rear of the machine to the “ON” position and turn on
the “ON” switch on side of machine.
a. Keypoint - The Mini View System back panel has a green
indicator light showing the Mini View System is being powered.
To remove all power unplug Mini View System power cord from
the AC receptacle.
b. Keypoint - Orthoscan - After the power is on, the system will
initialize, and the home screen will be displayed on the monitor
when the system is ready.
C. Operation Instructions
1. Follow these steps to generate an image. Refer to Operator's Manual or
Quick Start Guide for detailed operating instructions.
a. Enter patient information (optional for OEC Mini View).
b. Position the patient. Fluoro should be displayed on status bar. Press
the left x-ray switch to produce a fluoro image while positioning
the patient.
c. On Mini OEC select an image mode. Standard or low dose
fluoroscopic modes are available on the Mini View System. The
status bar displays fluoro and low dose mode, if selected on the
bottom left-hand side of the Mini View System status bar.
i. Adjust system controls. Default settings are applied to
system controls each time you start the Mini View System.
If one wants different setting, one can change the
following: field size, image orientation,
contrast/brightness, technique, and low dose.
ii. Make exposures. Use foot switch, hand switch, or x-ray on
bottom to make x-ray exposures. Press the left x-ray switch
to produce a fluoro exposure. Press the right foot switch
pedal to save an exposure.
iii. Apply image processing options to enhance images such as
contrast, brightness, etc.

d. Orthoscan - At home screen press patient info key and enter patient
information. Upon pressing the new patient button info screen
system is ready to image. Acquire images with foot switch and
save images by pressing save or print key on keyboard. Digital x-
ray can be obtained by depressing and releasing the foot switch. A
real-time image may be acquired by depressing and holding the
foot switch.
e. Under Wisconsin law only a licensed practitioner such as a
physician, physician’s assistant, or nurse practitioner may operate
this fluoroscopic equipment if images are interpreted directly from
the fluoroscopic imaging. A radiologic technologist can operate
this equipment only under the supervision of a licensed practitioner
and only if the live fluoroscopic images are being interpreted by
the licensed practitioner or if the interpretation is performed using
images captured during operation of this equipment. Any operator
of this equipment must meet either requirement (i) or (ii) below:
i. Is certified by the American Board of Radiology or board
eligible.
ii. Has completed training to include the following:
 Principles and operation of the fluoroscopic x-ray
system
 Biological effects of x-ray
 Principles of radiation protection
 Fluoroscopic outputs
 High level control options
 Dose reduction techniques for fluoroscopic x-ray
systems
 Applicable state and federal regulations
D. OEC Mini View Suggested Fluoroscopic Technique
The values in the following tables represent typical technique factors for various
extremity examinations. The optimum technique factors may vary depending on
anatomical density and image field size.

NORMAL ABS TABLE:

ANATOMY kV µ A
EXPOSURE
RATE
(mR/min)
ANATOMY
DIMENSIONS
in / cm
Hand 50 35.2 44 1.34 / 3.40
Wrist 50 36.5 46 1.75 / 4.45
Forearm 51 37.6 51 2.12 / 5.38
Foot (Lateral) 53 45.4 74 2.72 / 6.91
Foot (AP) 54 47.4 77 3.13 / 7.95
Ankle 55 88 88 2.87 / 7.29
Knee (Lateral) 59 65 165 4.03 / 10.24
Knee (AP) 58 65 175 4.07 / 10.33
Shoulder 64 78.4 301 5.20 / 13.20
E.

LOW DOSE ABS TABLE:
ANATOMY kV µ A
EXPOSURE
RATE
(mR/min)
ANATOMY
DIMENSIONS
in / cm
Hand 48 29.9 35 1.34 / 3.40
Wrist 49 30.5 42 1.75 / 4.45
Forearm 50 32.1 42 2.12 / 5.38
Foot (Lateral) 55 37.6 66 2.72 / 6.91
Foot (AP) 54 36.8 63 3.13 / 7.95
Ankle 55 38.4 66 2.87 / 7.29
Knee (Lateral) 61 47.8 120 4.03 / 10.24
Knee (AP) 60 47.8 131 4.07 / 10.33
Shoulder 64 58.8 240 5.20 / 13.20
F.
G. Printer
1. Ensure that the power button is ON. Press the “print” button on the printer
to generate a hard copy.
a. Keypoint - The ability to produce hard copy gives the user a
permanent record of an image which may readily be referred to at
any time.

H. Patient and System Positioning
1. For each procedure, you must consider the benefits of bringing the patient
to the machine or the machine to the patient.
a. Keypoint - Loosen the three articulation lock levers one at a time
and move, swing or rotate the C-arm through its various positions.
b. Keypoint - Move the Flex-arm up and down while the counter
balanced Flex-arm lock is slightly tightened.
c. Keypoint - Apply sterile drape to Mini View while maintaining
sterility of the operative field.
I. Shut Down (OEC Mini View and Orthoscan)
1. Press the green power switch to OFF and unplug the power cord.
J. Borrowing Rules:
1. Mini View units may not be taken out of the OR without the permission of
the OR Control Station Charge Nurse of the day. The OSC Mini View is
not to leave the unit. Check with AFCH charge nurse for permission for
borrowing the Orthoscan.
2. A person from the borrowing department needs to log it out using the
“Internal Borrowing Log” located at the Control Station.
3. Prompt return is expected. When returned, the unit needs to be logged
back in.
4. If something is broken and the unit is not working they must tell the OR
Front Desk Charge Nurse of the day and note it in the log book.
5. Care must be taken to transport the unit with the imaging arm well
supported on the provided mouse pad and all locking levers secured.
6. Two people should maintain control of equipment when moving up or
down an incline.


WRITTEN BY:
Kari Pulfer, R.T. (R)(CT) BS, Medical Imaging Manager

REVIEWED BY:

Lynn Broderick, MD Modality Chief Radiologist – Radiology, University of Wisconsin
Peter Chase, MD Modality Chief Radiologist – Radiology, University of Wisconsin
Samuel Charles, MD Medical Director Radiologist – Radiology, University of Wisconsin
Department of Radiology Community Section
John Vetter PhD ASSOC PROFESSOR (CHS) (UWSMPH) Medical Physicist, University of
Wisconsin

AUTHORIZATION: Richard Welnick, MD, Medical Director, UWMF

REFERENCES:
A. Orthoscan Operator’s Manual
B. OEC Mini View Operator’s Manual


Medical Director Date