Radiologic Technology Program/MRI Certification
C - AR M S U R G E RY: N O N - O R T H O P E D I C
Student Name
Date
G R AD IN G SC AL E
Grading Scale: (Passing: 75%)
Score:
Procedure #
M
Mastery (4 points)
A
Acceptable, a little assistance needed (3 points)
U
Unsatisfactory, a lot of assistance needed (0 points)
NO
Not Observed
NA
Not Applicable
1
2
3
Procedure:
C-Arm Surgery Non-Orthopedic competency requires the completion of two different types of surgical procedures from the following list (other procedure
requires faculty approval):
•
Brachytherapy Insertion
•
ERCP
•
Perma Cath Placement
•
Operative Cholangiogram
•
Pacemaker Insertion
•
Runoffs
Do you feel that this student would be able to do surgery examinations in the future without any assistance based upon what you have observed
during this procedure and according to the grading criteria listed above?
Yes
Place comments below or on the back of this form.
No
COMPETENCIES
Patient/Facility Preparation
The student should be able to:
1. Position C-Arm in the appropriate area/position before the procedure.
2. Inform staff of obstacles that will hinder the smooth operation of the C-Arm procedure.
3. Properly connect power cords / cables to ensure functionality and turn on unit.
4. Enters/Annotates all pertinent patient information into the workstation.
5. Assure that equipment is available for exam. (Aprons, markers, etc.)
6. Observe and maintains the sterile field.
7. Take scout image (if applicable)
Procedural Tasks
1. Approach patient from the appropriate direction with the c-arm
2. Center appropriately or per surgeon’s direction
3. Manipulate C-arm images for the surgeon
4. Set the proper technique for fluoroscopy (kVp, mA, time)
5. Follow instructions for additional images or cine run
6. Place lead marker in the appropriate area of the image or cassette and is visible on the image
7. Use appropriate collimation
8. Provide appropriate radiation protection for self and others in and around the exposure area (lead aprons, etc.)
Page 1 of 2; C-Arm Surgery: Non-Orthopedic
TMCC is an EEO/AA institution. See http://eeo.tmcc.edu for more information.
Created: 12/1/2015; Rev: 12/2/2015
C-Arm Surgery: Non-Orthopedic
Manipulation of Equipment During a Procedure
1. Moves unit appropriately for the procedure being performed.
a. Drives unit into position for the procedure.
b. Swivel unit head for the exam using appropriate locks
2. Manipulates image on monitor for proper viewing and orientation.
a. Reverse
b. Rotated
3. Maintains sterile environment while manipulating C-Arm around sterile field
4. Selection of appropriate mode
a. ABS versus manual fluoroscopy
b. Low dose puled
c. Magnification
d. Part programs – chest, extremity, spine/hip, standard mode, etc.
5. Demonstrate working knowledge of:
a. Collimation
b. Alarm reset
c. Image manipulation (contrast/density)
d. Noise reduction / averaging
6. Imaging
a. Transfer monitor A image to monitor B
b. Adds comments and markers appropriately for imaging
c. Retrieval of images
Post Procedure
1. Completes paperwork appropriately
2. Archives images to disk and / or PACS (if applicable)
3. Returns C-arm to proper location
P AT IENT INF ORM AT IO N
Patient Name/Medical Record No:
Type of Examination
Comments
SIG NAT URES
Technologist’s Signature
Date
Student Signature
Date
Page 2 of 2; C-Arm Surgery: Non-Orthopedic
TMCC is an EEO/AA institution. See http://eeo.tmcc.edu for more information.
Rev.: 12/2/2015