Fluoroscopic Verbage and How to Flag Your Tech

[Aether2000]

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There are many terms used for movements of the fluoroscopic beam and the directions that are given vary in terminology. Many of us have encountered seasoned techs without a clue regarding commonly used terminologies regarding fluoroscopic beam manipulation/rotation/movement.

What are the terms used if your patient is prone and the fluoroscope is on the right side of the patient for a down the barrel view for a right sided approach L5S1 discogram...what commands do you use?
How about wig-wag or swivel- what term do you use? Thanks!

 

[mehul_25]

I try to keep it simple. I have been suprised at how terrible our fluoro techs are. To make matters worse, I think the others in my group confuse everyone.

Right now, I am trying to use as few terms as possible; AP, lateral, oblique and tilt. Even that seems to be confusing for some...

 

[Disciple]

Oblique towards you/towards me
Tilt towards the head/feet
Slide towards head/feet
Wig Wag

Arm motions if they don't understand

 

[lobelsteve]

Piston: Left to right across the patient

North-South: The whole machine moves towards the head or feet

Rotate the C / Oblique: duh

Tilt / Craniocaudal tilt: used to square endplates

Waggle: same as North-South but the machine doesn't roll, the entire C moves North-South

 

[Tenesma]

north south

up down

cranial caudal

oblique to me / away from me

wig-wag

collimate


but the truth is that once you can train your fluoro tech for what the procedure is and what the anatomy is then they really don't need much reminders - my previous fluoro tech would line up everything they way i like it based on the procedures i was doine - i don't think i ever had to tell him anything whatsoever except for some discrete hand signals .... boy do i miss him...

 

[drusso]

I do my own fluoro with a motor drive joystick, but when I go to the hospital and use a tech:


"Tilt Image Intensifer Toward the Head"

"Tilt Image Intensifer Toward the Feet"

"Oblique Toward Me"

"Olbique Toward You"

"Go Lateral"

"Go AP"

"Slide Cranial"

"Slide Caudad"

"Roll over"

"Play dead"

 

[drrinoo]

Wii-it!...seems simple enough

 

[Aether2000]

lol...Wii I don't yet have...
It is surprising when different techs at hospitals are rotating through the OR how they can sometimes be clueless.... The medical assistants in my office know more about the fluoro machine than the techs in the OR. For instance: go to low dose; place a right leaf collimator on the screen, vascular mode, set the mA to 1.4 on manual, edge enhancement, wig-wag/swivel, left to right transfer/swap were all foreign terms to a recent fluoro tech that had been in radiology for 10 years....go figure.

 

[SSdoc33]

ive had a similar to mehul. if i used these terms "place a right leaf collimator on the screen, vascular mode, set the mA to 1.4 on manual, edge enhancement, wig-wag/swivel, left to right transfer/swap" my tech's heads would explode.

 

[PMR 4 MSK]

me - "Tilt caudal. No, the other caudal. No. I mean toward his feet. No, not move the whole machine, just tilt. No, not rotate, just tilt please. Ok, oblique lateral. No, the other lateral..."

 

[Doctodd]

i move my arm in the direction i want it...lol....seriously, i say it in spanish so u guys wouldnt benefit from my instructions

 

[Ligament]

I do my own fluoro with a motor drive joystick, but when I go to the hospital and use a tech:


"Tilt Image Intensifer Toward the Head"

"Tilt Image Intensifer Toward the Feet"

"Oblique Toward Me"

"Olbique Toward You"

"Go Lateral"

"Go AP"

"Slide Cranial"

"Slide Caudad"

"Roll over"

"Play dead"

Dave you lucky bastard tell us more about that joystick C-arm control. Pros/Cons/Cost..is it worth the cost? I suppose if you don't need to hire a tech it might be...thanks!

 

[drrinoo]

I wonder what the techs would like to say:

doc

1. flare your nostrils
2. crane your neck to the right and to the left
3. clench your fist
4. tap your foot 3-7 times
5. squint
6. duck...you might hit the intensifier with your forehead.
7. its ok...protect the needle hub with your hand...I won't touch it with the c-arm
8. sure, you can break scrub and turn the c-arm
9. push the fluoroscope with the forefoot and not the heel.
10. sweep the floor with your foot, so you can find the remote...but don't trip
11. wow...great reaction time...you got your hands out of the field in the nick of time...you want a sticker?

 

[Mister Mxyzptlk]

I just say "Give me that view I always like for this." Then I zap them in the neck with the Bovie every time they don't get it right. It takes more time this way, but you aren't allowed to throw syringes at them any more (some kind of petty OSHA thing). Anyway, once they learn it they don't forget it.

 

[Mister Mxyzptlk]

me - "Tilt caudal. No, the other caudal. No. I mean toward his feet. No, not move the whole machine, just tilt. No, not rotate, just tilt please. Ok, oblique lateral. No, the other lateral..."

This would be funny if it wasn't so accurate.

Instead of a lateral try asking for a "sideways AP".