Author/s (Year)

Country

Study Design

Study Population

Identified c-arm movement communication terminology

Key findings

Chaganti, et al. [5]

United Kingdom

Descriptive non-experimental

·           45 Orthopedic Surgeons

·           45 Radiologic Technologists

·           Orbital

·           Angulation

·           Swivel (wig-wag)

·           Horizontal movement of the image intensifier (Towards patient’s head, Towards patient’s foot)

·           Vertical movement of the image intensifier (Towards ceiling, Towards floor)

·           A common language and precision in command can avoid confusion and has the potential to improve theatre time utilization.

·           The adoption of a common language between surgeons

·           And radiographers have the potential to save valuable theatre time and, hence, improve theatre throughput (utilization).

Palley and Kreder [6]

Canada

Descriptive non-experimental

·           261 members of the Canadian Orthopedic Association

·           225 members of the Canadian Association of Medical         Radiation Technologists

·           Raise, Lower

·           In, Out

·           Distal, Proximal

·           Rotate Over, Rotate Back

·           Tilt Distal, Tilt Proximal

·           Swing Proximal, Swing Distal

·           Tremendous inconsistency in language used by orthopedic surgeons and radiation technologists.

·           Many radiation technologists were inexperienced in operating the fluoroscope.

·           Adoption of a common terminology would improve communication, potentially shorten surgical durations and reduce exposure to ionizing radiation.

Stirton, et al. [7]

Canada, USA

Descriptive non-experimental

·           212 orthopedic surgeons

·           235 radiologic technologists

·           Raise Arm Up

·           Lower Arm Down

·           Push Arm In

·           Pull Arm Out

·           Push Base In

·           Pull Base Out

·           Rotate Arm Over

·           Rotate Arm Back

·           Slide Base Distal

·           Slide Base Proximal

·           Tilt Arm Distal

·           Tilt Arm Proximal

·           Swing Arm Proximal

·           Swing Arm Distal

·           Swing Base Distal

·           There is no standard universal c-arm language. Thus, significant confusion and miscommunication exists between surgeons and technologists.

·           Unnecessary radiation exposure occurs as a direct consequence of this miscommunication

·           Majority of respondents would accept a standardized language similar to the one proposed in the study.

Stroh, et al. [8]

USA

Prospective, cross-sectional survey

·           46 orthopaedic surgeons

·           70 radiologic technologists

·           C-over/under

·           Tilt towards the patient’s (head/foot/fingers/chest)

·           Slide base to patient’s (head/foot/fingers/chest)

·           Angle base toward patient’s (head/foot/fingers/chest)

·           Wigwag toward patient’s (head/foot/fingers/chest)

·           Rotate through the never-lever towards the patient’s (head/foot/fingers/chest)

·           Flip 180 through the tilt-lever vs. the never-lever

·           Raise/lower arm

·           Push arm in/Pull your arm out

·           Slide your base in/out

·           A standardized terminology for the C-arm movement is described that will help fill a void in OR communication, combat confusion, and provide reproducible results during orthopedic cases.