Shielding Secrets: Mobile C-Arm Safety in Outpatient Surgery

Mobile C-arms are invaluable assets in many outpatient operating and procedure rooms. They provide real-time fluoroscopic imaging during procedures, significantly enhancing surgical precision. However, their use necessitates a careful approach to radiation safety in the design of the spaces where they are used. This post addresses important design considerations for mobile C-arm safety and shielding compliance in outpatient settings.

The Shielding Equation

Determining if radiation shielding is required involves an assessment of several variables:

• State Regulations: Each state has its own regulatory framework governing C-arm use and shielding. Consulting the relevant authorities is paramount.
• Case Mix: The types of procedures routinely performed will significantly impact radiation exposure levels. Procedures demanding higher radiation doses may necessitate incorporating shielding.
• Frequency and Duration of Use: The frequency and duration of mobile C-arm use directly influence the overall radiation burden.
• Proximity to Public Areas: If the operating room is situated near public areas, shielding may be required to minimize inadvertent radiation exposure to bystanders.
• Dedicated C-Arm: A mobile C-arm regularly stationed within a single OR, even though it can be moved, may create the demand for shielding.

Seeking Expert Guidance

To properly assess shielding requirements, it is essential to seek guidance from a certified radiation physicist. Through a detailed analysis of your facility's projected C-arm usage, they will specify the necessary safety measures. In a new facility, your architect will incorporate these requirements into the construction documents so the contractor knows what to build.

Shielding in outpatient rooms is usually required to a height of 7 feet. Where drywall itself is not sufficient to resist the radiation, lead sheets or lead lined drywall will do the trick. Doors, windows, and other penetrations in the walls may also need to be protected. Windows often must have leaded glass, which contains lead oxide to absorb and scatter radiation.

Following construction, the rooms should be tested by the radiation consultant to assure they meet the performance requirements of the design. In some states, the shielding may need to be tested on a periodic basis.

Comprehensive Staff Safety Measures

Regardless of whether shielding is implemented, additional safety measures are essential to protect staff:

• Personal Protective Equipment (PPE): Lead aprons, thyroid shields, leaded glasses, and gloves are components of a robust radiation safety program.
• Dosimeters: These devices play a critical role in monitoring individual staff members' radiation exposure levels.

The Rise of Fixed C-Arms - To Infinity and Beyond!

As medical technology continues to advance, a growing number of outpatient facilities are incorporating fixed C-arms and biplanes into their surgical suites. In these instances, lead shielding becomes an absolute necessity and consultation with a radiation safety expert is imperative in the design of the rooms.

It is certain that mobile imaging will continue to expand in the ambulatory surgical setting. Awareness of the necessary precautions in design of these facilities is essential to patient, staff, and public safety as well as regulatory compliance. Successful implementation includes informed user engagement during design, careful follow through by the design and construction teams, diligent testing by the facility, and proper use of the equipment. Contact us at HSA, www.hsarchitecture.com, if we can help you in the design of your next outpatient facility.