Archives for August 2014

What Is ALARA?

What is ALARA?

As Low As Reasonably Achievable (ALARA) is a buzzword commonly used in medical disciplines utilizing ionizing radiation for the diagnosis and treatment of disease. It is a phrase that should be considered whenever a patient, healthcare professional or a physician is in a situation where they might be exposed to radiation.  However, what does ALARA really mean in this context, where does it come from, and why is it used?  These questions will be addressed in this article from FluoroSafety and Universal Medical.

It’s all based on the LNT model

The linear-no-threshold (LNT) dose-response model describes the risk of stochastic effects following exposure to ionizing radiation, as a function of dose.  This model is based on available scientific data* from large exposed populations, such as Japanese atomic bomb survivors and is widely accepted by regulatory agencies and governments.  If the LNT model is correct, risk increases linearly with radiation dose, and there is no safe amount of radiation exposure where the increased risk is zero.  Because LNT suggests that there is no safe radiation dose, this motivates us to keep both our radiation dose, and the radiation dose that our patients receive very low.   More details on the LNT are available in the Advanced Training Program from FluoroSafety.

What is reasonable?

The use of ionizing radiation is necessary in many medical disciplines and while the LNT tells us that there is no safe level of radiation, we also understand that there are many cases where radiation must be used.  For example, before X-rays and CT scans, exploratory surgery was often utilized to diagnose unknown medical conditions.  Certainly, no patient would choose to receive exploratory surgery instead of a CT scan because they were concerned about radiation risk!  These risks must be put into perspective and the benefit weighed against the risk—for both patients and medical professionals who work around radiation.

For patients, the benefit of medical exposure to diagnose and treat disease is clear.  However, just because the patient receives a well-defined benefit, does not mean that radiation can be used indiscriminately.  The smallest amount of radiation that will allow the physician to diagnose or treat the suspected condition should be used—in other words, doses should be kept ALARA.  ALARA in diagnostic imaging may be as simple as using the lowest possible CT, X-ray or fluoroscopic technique factors.  It may also include protection devices such as lead aprons or gonadal shields to protect organs that do not need to be imaged.   Newer protection devices such as bismuth breast and eye shields can be useful for certain CT exams and can reduce dose to these sensitive tissues.

In occupationally exposed individuals, the benefit is entirely that of gainful employment.  There is no potential health benefit like there is for a patient receiving a chest X-ray to diagnose disease; therefore, risk/benefit must be adjusted accordingly.  The federal government strictly enforces dose limits for the occupationally exposed to protect this population which does not receive a well-defined benefit for their radiation exposure.  In practice, very few occupationally exposed individuals approach the federal dose limits, primarily due to their job function.  A CT technologist for instance, leaves the scanner room prior to starting the scan.  Lead shielding in the walls keeps the technologist’s dose ALARA.

However, technologists, nurses and physicians involved in fluoroscopic procedures often do not have the luxury of leaving the examination room while X-rays are being produced.  For these individuals, doses may be maintained ALARA by following the three cardinal rules of radiation protection, which are also discussed in detail in the Advanced Training Program from FluoroSafety.

Time, Distance and Shielding

In fluoroscopic procedures, occupational dose is proportional to the amount of time spent in the room when X-rays are being produced.  Staff dose can be reduced by keeping non-essential personnel out or by stepping outside when performing digital acquisition imaging or rotational CT angiography.  Power injectors are necessary in these cases and allow for both a reduction in staff dose as well is improved vascular contrast.

Another key component of keeping occupational doses ALARA is distance.   Often times the scattered radiation coming from a patient in a fluoroscopic, CT or X-ray procedure can be approximated as a point source; to this end the inverse square law applies.  Therefore, if one doubles their distance away from the source of radiation, the dose to that individual is decreased by a factor of four.  In fluoroscopy or CT procedures, it is often the case that taking one step back away from the patient will cut your dose in half.  Ancillary personnel who do not need to be near the patient can minimize their dose by maximizing their distance.

The final way to maintain doses ALARA is to use shielding whenever possible.  Personnel protective equipment consisting of lead or lead-free garments an integral component of proper radiation safety practice when working near fluoroscopy, CT or X-ray procedures.  Individuals in the room during fluoroscopy procedures should also wear protective thyroid collars and lead glasses to protect these sensitive organs.  For interventional fluoroscopy procedures, some operators find that sterile radiation reduction drapes can decrease their exposure to radiation.  Rolling and hanging glass shields provide superior protection compared to radiation reduction garments and should always be worn when commensurate with the goals of the procedure.

About the Author: 

Alexander S. Pasciak, PhD, DABR
Co-Founder, Fluoroscopic Safety, LLC
www.FluoroSafety.com
 
 Dr. Alexander Pasciak earned his B.S. in electrical engineering from the University of Washington and his M.Sc. in health physics and Ph.D. in nuclear engineering from Texas A&M University. Dr. Pasciak completed a two-year diagnostic medical physics residency program at MD Anderson Cancer Center in 2009.  For the past five years, Dr. Pasciak has worked as Diagnostic Medical Physicist at the University of Tennessee in Knoxville where he carries the rank of Associate Professor of Radiology.
 

Sources: 

*National Research Council. Health risks from exposure to low levels of ionizing radiation: BEIR VII—Phase 2. National Academies Press; Washington, DC: 2005.

 

Using Gel Positioners To Prevent Pressure Ulcers

Preventing Pressure Ulcers In The Operating Room

Pressure sore, decubitus ulcer, and pressure ulcer are all terms used interchangeably to describe localized injuries to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction.

What Is A Pressure Ulcer?

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure ulcer as an area of unrelieved pressure over a defined area, usually over a bony prominence, resulting in ischemia, cell death, and tissue necrosis.

According to a 2009 article, Prevention of Pressure Ulcers in the Surgical Patient, in the AORN Journal; “pressure ulcers (PUs) are a serious health care problem, and it is crucial to assess how patients acquire pressure ulcers after admission to a health care facility. In the OR, factors related to positioning, anesthesia, and the duration of the surgery, in addition to patient-related factors, all can affect PU development¹. . . All surgical patients should be considered at-risk for pressure ulcer development; therefore, preoperative departments should develop and implement strategic plans for pressure ulcer prevention.”

Quick Facts

Did you know?

Number of patients affected by pressure ulcers: 2.5 million per year

Cost

  • Pressure ulcers cost $9.1-$11.6 billion per year in the U.S.
  • Cost of individual patient care ranges from $20,900 to $151,700 per pressure ulcer.
  • Medicare estimated in 2007 that each pressure ulcer added $43,180 in costs to a hospital stay.

Pressure Ulcer Management

In 2008, The Centers for Medicare & Medicaid Services (CMS) included hospital acquired pressure ulcers (HAPU’s) as a “Never Event” which marked a turning point for most facilities. “Pressure ulcer management has become a standard part of every modern hospital’s protocol¹.”

Four Major Factors Contributing To Pressure Ulcers¹

  1. Uneven weight distribution
  2. Pressure
  3. Shear
  4. Heat and humidity build up

“Pressure ulcers are a costly, debilitating, and avoidable complication of surgery².”

The National Pressure Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel (EPUAP) created the Pressure Ulcer Prevention: Quick Reference Guide outlining risk factors for patients in the operating room.

1. The following factors increase the risk the patient developing a pressure ulcer during a surgical procedure include:

a)Length of the operation
b)Increased hypotensive episodes intraoperatively
c)Low core temperature during surgery
d)Reduced mobility on day one of postoperatively
2. Use a pressure-redistributing mattress on the O.R. table for all individuals identified as being at risk of pressure ulcer development.

Action Products manufactures O.R. overlays that are cited by AORN best practices for Pressure Ulcer Prevention. The O.R. overlays, available in standard and custom sizes, provide pressure redistribution and reduce shear effects across the entire table surface. The low profile, simple design of the 1/2 inch Akton poymer O.R. overlay maximizes effectiveness and minimizes patient movement.

3. Position the patient in such a way as to reduce the risk of pressure ulcer development during surgery.

4. Elevate the heels completely (offload them) in such a way as to distribute the weight of the leg along the calf without putting all the pressure on the Achilles tendon.

The heel support gel positioner by Action is designed to secure and protect the heel area as well as cradle the patient’s Achilles tendon area.

5. Pay attention to pressure redistribution prior to and after surgery.

a) Place patient on pressure-distributing mattress prior to and after surgery.
b) Position the patient in a different posture preoperatively and postoperatively than the posture adopted during surgery.

Types of Gel Positioners

Head & Neck Gel Positioners help protect and cradle the patient’s head and neck by stabilizing the head movement and assists in the prevention of neck overextension.

  • Lateral Head Pad with Center Dish
  • Donut Head Pads
  • Prone Headrests
  • Horseshoe Head Pads
  • Contoured Head Pad
  • Ophthalmic Headrests
  • Ophthalmic Cradle Headrests

Extremity Gel Positioners protect the patient’s arms and legs during procedures.

  • Contoured Armboard Pads
  • Armboard Pads
  • Hand/Wrist Support
  • Foot Pad
  • Heel Support
  • Stirrup Pad Set

Torso & Hip Gel Positioners provide support for the torso and upper body by providing increased stability.

  • Flat-Bottomed Chest Rolls
  • Contoured Chest Rolls
  • Chest Gel Positioners
  • Trapezoid Gel Positioner
  • Dome-Shaped Gel Positioner

Proper patient positioning and cushioning of all pressure points is a priority and using the correct padding can protect the patient from pressure ulcers.

“Procedures longer than 2 1/2 hours to 3 hours significantly the risk of pressure ulcer formation. Positioning problems can result in significant injuries and successful lawsuits.” ~Patient Positioning In The Operating Room

AORN recommends “Classifying all surgical patients as “at risk” for PU development is an appropriate preoperative intervention to successfully reduce the incidence of possible PU development.” The uncontrollable length of surgeries and effects of anesthesia are two of the main contributing factors leading to the development of pressure ulcers. Although it is impossible to eliminate the risk of patients developing pressure ulcers during surgical procedures – some patients will develop pressure ulcers from skin breakdown regardless of preventative measures. It is important to be aware of the causes of pressure ulcers and what steps you can take to minimize the risk.

Additional Information:

References:

 

3 Different Types Of Prescription Lead Glasses

For those who wear corrective lenses and need to protect their eyes from radiation, we offer three different prescription lens types for our lead glasses. After reading this post you will understand the different types of prescription lens types that we offer, eyeglass prescription terminology, and what prescription information is needed to properly place your order.

Before placing your order, it is important for you to understand the differences between the various corrective lenses before making your decision. Lead glasses provide you with the necessary eye protection to help reduce your risk of developing cataracts from prolonged exposure to ionizing radiation. In the past, those who wore corrective lenses would often be required to wear bulky radiation safety goggles or fit over lead glasses. However, a number of the lead glasses that we now offer are available with various types of prescription lens.

Prescription lens types:

  • Single vision prescription lenses
  • Lined bifocal prescription lenses
  • Progressive bifocal lenses

Single Vision

Single vision prescription lenses have the same magnification throughout and correct for only one distance. These lenses are designed to correct conditions such as myopia (nearsightedness¹), hyperopia (farsightedness), and astigmatism². Our single vision prescription radiation safety lenses offer the industry standard 0.75mm lead equivalency and are manufactured using SCHOTT SF-6 HT radiation resistant glass.

How do I know if I have a single vision prescription?

To illustrate, an example of a single vision prescription is shown below. While reviewing the sample prescription, you may notice several abbreviations, listed below are common terms found on eyeglass prescriptions. If your prescription doesn’t have any values or abbreviations in the ADD column, you have a single vision prescription.

 Single Vision Prescription Lenses
RxSPHERICALCYLINDRICALAXIS
O.D.-2.00-0.5040
O.S.-1.75
Pupillary Distance65

Prescription Abbreviations & Terminology 

  • OD – Oculus Dexter, from the Latin word dexter meaning “right”, means the right eye.
  • OS – Oculus Sinister, sinister which is derived from the Latin word sinistra meaning “left hand”, means the left eye.
  • SPH – Spherical, is the main strength of the lens prescription, and is written in 0.25 increments. It is also referred to as power and is abbreviated as PWR.
  • CYL – Cylinder, this will only appear on your prescription if you have an astigmatism, and is written in 0.25 increments. It is possible that this will only apply to one eye. If you don’t have an astigmatism, your doctor may leave this field blank, or they may choose to put ‘00’, ‘DS’, SPH’, or ‘Plano’ in this field. If the field has one of those abbreviations you will know that you don’t have an astigmatism correction in one or both eyes.
  • AX – Axis can be abbreviated as AX, or simply X. If the cylinder field is left blank or has any of the following abbreviations including ‘00’, ‘DS’, SPH’, or ‘Plano’, this field will be left blank or have an ‘0’.
  • PD – Pupillary distance or interpupillary distance (IPD) is the distance (industry standard is in millimeters) between your right pupil and left pupil. The PD is usually written in the lower row labeled P.D. on your prescription.

Single-Vision Pupillary Distance

  • Binocular P.D. – 65
  • Monocular P.D. – 30/30.5  (OS/OD)

Bifocal/Progressive Pupillary Distance Binocular

  • Near/Reading P.D. – 62
  • Distance P.D. – 65

The American Optometric Association states that Astigmatism is a vision condition that causes blurred vision due either to the irregular shape of the cornea, the clear front cover of the eye, or in other cases the curvature of the lens inside the eye. Astigmatism is a particularly common vision condition.

Lined Bifocal

Bifocal prescriptions are for patients who have difficulty seeing both far and near. They are commonly prescribed to individuals with presbyopia who also require a correction for myopia, hyperopia, and/or astigmatism. As their name suggests, lined bifocals offer distance correction on the upper portion of the lens, and near vision correction on the bottom portion of the lens. Lined bifocal lenses, provide two distinct optical powers with different focal lengths – one for distant vision and one for near vision. The near vision lens has a semicircle (bottom) that measures 28mm wide and has a flat-top (top). Traditional lined bifocal lenses are separated by a visible line.

Progressive Bifocal

Progressive bifocals, or simply progressive lenses, allow you to experience bifocal vision without the traditional bifocal lines. Progressive lenses provide you with a more natural way of seeing. Presbyopia³ is a common vision condition for those over the age of 40 where the eye has difficulty focusing on near-field objects. Individuals who have worn traditional bifocals in the past may have experienced “image jump”, this occurs when there is an abrupt break from distance to near-field vision. Progressive bifocal lenses provide  you with optimum vision and a seamless progression of lens strength.

How do I know if I have a bifocal prescription?

If you notice that there are numbers in the ADD column of your prescription, you have a bifocal prescription.

 Lined Bifocal/Progressive Bifocal Prescription Lenses
RxSPHERICALCYLINDRICALAXISADD
O.D.-2.00-0.5040+1.75
O.S.-1.75+2.00 PAL
Pupillary Distance65

ADD – ADD is the value commonly used for bifocal or progressive lenses. ADD indicates how much power is added to the distance prescription to create the reading-only prescription. ADD corrections will usually have the same value for both eyes. The abbreviation PAL may appear next to one of the numbers in the ADD field, or it may be written elsewhere on your prescription, this indicates that your doctor determined that you will need a different ADD correction for progressive lenses.

PAL– Progressive additive lens (ADD value specifically for progressive bifocal lenses).

Ordering Information

We hope that this post has provided you with helpful information that you will assist you during your research. To review, we covered the different types of prescription lead glasses that we offer, common terminology and abbreviations found on your prescription, and what prescription information we need to properly place your prescription lead glasses order. When ordering, please fax or email your prescription (Rx) including your pupillary distance (PD). For your convenience, prescription information can also be noted in the “Order Comments/Special Instructions” section under “Payment Information” while checking out.

Please note: Lens enhancements options are not available in combination with prescription lenses. 

Questions? Comments?

If you have any questions regarding the different types of prescription lead glasses that we offer, please feel free to contact us via live chat or simply leave a comment below.

Sources:

American Optometric Association – Eye & Vision Problems

 

How Do I Order Prescription Lead Glasses?

Question: How Do I Order Prescription Lead Glasses?

This is a frequently asked question that we receive from our new and existing customers. This post will walk you through the necessary steps to ensure that your order is processed in a timely manner. It is our goal to make your experience as painless as possible.

We currently offer over 75 different styles of lead glasses available with different types of enhancements. There are three prescription lens types available, including single vision, lined bifocal, and progressive bifocal (progressive lenses). Please note that the availability of Rx lenses will vary by frame type.

Step 1 – Find your pair of lead glasses

Step 2 – Determine prescription type

  • Single vision
  • Lined bifocal
  • Progressive bifocal (no-lines)

Step 3 – Choose Your Lens Style

Please note that options will vary by frame style and manufacturer. Due to the custom nature of prescription lead glasses they cannot be returned.

  • Standard
  • Anti-reflective (not available with prescription lens)
  • Fog free (not available with prescription lens)
  • Single vision Rx
  • Lined Bifocal Rx
  • Progressive bifocal Rx

Pricing adjusts in real-time as you add enhancements to the frames. The single vision, lined bifocal, and progressive bifocal prescription radiation safety lenses all offer the industry standard 0.75mm lead equivalency and are manufactured using SCHOTT SF-6 HT radiation resistant glass.

Step 4 – Choose frame color

Please note that color options will vary by frame style and manufacturer

Step 5 (Optional) – Add frame imprint text

  • Frames will be laser engraved
  • Imprint limit is 35 characters (may vary by model)
  • Engraved glasses are non-returnable

 Step 6 – Select desired quantity and click “add to cart”

Step 7 – Review your order

  • Review your order for accuracy

 

Step 8Proceed to checkout

  • Returning customers can sign in for faster checkout
  • New customers can create a personal account (Benefits of registering: quick checkout on future orders, easy order tracking, and special offers)

Step 9 – Enter billing and shipping information

  • Enter your billing information
  • Enter your shipping information
  • Choose your shipping method (Selecting Next Day or 2nd Day Air will only change the shipping transit time, as prescription lenses are made to order)
  • Enter payment information

Step 10 – Add Prescription Information

Please note that the manufacturer will contact us if they have any additional questions regarding the prescription after their initial review to ensure accuracy.

  • Add prescription information in the “Order Comments/Special Instructions” box
  • Include OD/OS values from prescription
  • Include Pupillary Distance (PD)
  • Prescriptions can be faxed to 1-800-535-6229
  • Prescriptions can be emailed to order@universalmedicalinc.com

Ordering Information

Prescription lead glasses normally take at least two weeks to produce (may vary depending on item availability). If you need prescription lenses before a certain date contact, please customer service for specific information regarding frame availability and production time. As mentioned above, selecting priority shipping will only expedite the transit time of the package. Since the prescription lenses are made for your unique eye prescription, production times will vary. In an upcoming post, we will discuss the different prescription lens types that we offer in more detail. If you’re curious as to how prescription lead glasses are made, you’ll want to make sure and check out our video.

Questions? Comments? 

Not sure what type of frame is right for you? Many of our lead glasses have product demonstration videos to help you find the right style. If you have any additional questions, please feel free to contact us or leave a comment in the box below.

7 Reasons To Pick These Carbon Fiber Armboards

Why Carbon Fiber? 

Carbon fiber is a popular material used in many industries including the medical device field, aerospace, and automotive engineering. The fiber-reinforced polymer which contains carbon fibers is extremely strong and lightweight. Although carbon fiber may be more expensive when compared to other materials, the impressive strength-to-weight ratio and rigidity of carbon fiber makes it an excellent candidate for various immobilization and medical support devices. This fiber-reinforced polymer also helps keep radiation doses to a minimum.

Medical Applications of Carbon Fiber

Carbon fiber provides one distinct advantage over other materials in the medical device field, that advantage is that carbon fiber is radiolucent, meaning that it is virtually transparent to x-rays and appears black on x-ray images. The radiolucent quality of carbon fiber makes it an excellent material to support limbs being x-rayed or treated with radiation. This is why you may have noticed more surgical table accessories like carbon fiber armboards appearing in hospitals and clinics.

Patient Positioning Challenges 

Medical imaging equipment (X-ray systems and CT scanners) will often present unique patient positioning challenges to medical personnel. Listed below are some of the attributes patient positioning systems will generally require for overall patient safety and image quality:

  • Lightweight
  • Durability and strength
  • Rigidity
  • Minimal impact to image quality (e.g. artifacts)

7 Reasons Why You Will Want To Choose Carbon Fiber Armboards

  1. Fully radiolucent
  2. High strength-to-weight ratio
  3. No mounting hardware is required for setup or breakdown
  4. 180° of lateral rotation
  5. Easy setup and removal
  6. Fold together for safe and compact storage
  7. Two armboard styles (rail mount carbon fiber armboard with quick release swivel and shoulder mount carbon fiber armboard with hexagonal base)

Rail Mount Carbon Fiber Armboard with Quick Release Swivel

Strength And Durability

The rail mount carbon fiber armboard has been engineered to achieve a high degree of strength, durability, and radiolucency. Utilizing a quick release mounting mechanism, the carbon fiber armboard attaches quickly and easily to any surgical table that has a standard side rail.

Radiolucent 

This single, radiolucent armboard allows complete imaging of the arm and can be used in conjunction with other carbon fiber tabletops and extensions where ionizing radiation (x-ray) is used for imaging. Ideal for imaging in a variety of medical settings, including hospitals, clinics, and private practices. This armboard has been designed for use as an imaging platform and is not to be used as a surgical platform.

Rail Mount Carbon Fiber Armboard Specifications

Dimensions 

  • 26″ Length
  • 5.5″ Width

Maximum Capacity Tested Per ISO 6061

  • 25 pounds

Aluminum Equivalency 

  • AAE @ 100 kVp = 1.15mm

Accessories  

An optional armboard pad is available and has been specifically designed for the rail mount carbon fiber armboard with quick release swivel. Constructed of high-density comfort foam, the 2″ thick pad is covered with a conductive vinyl cover for easy cleaning and patient comfort.

Shoulder Mount Carbon Fiber Armboard With Hexagonal Base

High Strength-To-Weight Ratio

The shoulder mount carbon fiber armboard has been engineered to provide the highest strength, durability, and radiolucency of any armboard on the market today.

Easy Setup and Breakdown 

Simply place the hexagonal base under the surgical table pad. By using the weight of the patient to hold the armboard in place, removal is quick and easy. A rubber brake disc is used to keep the board in position under the weight of the patient’s arm. The unique pivoting attachment allows for a full 180 degree of lateral adjustment, making patient positioning more efficient.

Radiolucent 

This shoulder mount radiolucent armboard allows for the complete imaging of the arm and can be used in conjunction with other carbon fiber tabletops and extensions where ionizing radiation (x-ray) is used for imaging. This armboard has been designed for use as an imaging platform and is not to be used as a surgical platform.

Shoulder Mount Carbon Fiber Armboard Specifications

Dimensions 

Swivel Base

  • 14″ Length
  • 18″ Width

Armboard

  • 27″ Length
  • 5.5″ Width

Maximum Capacity Tested Per ISO 6061

  • 25 pounds

Aluminum Equivalency 

  • AAE @ 100 kVp = 1.15mm

Accessories  

An optional armboard pad is available and has been specifically designed for the shoulder mount carbon fiber armboard with quick release swivel. Constructed of high density comfort foam, the 2″ thick pad is covered with a conductive vinyl cover for easy cleaning and patient comfort.

Material Of Choice

These two unique carbon fiber armboards are ideal for improving positioning accuracy for optimum imaging results. The physical properties and characteristics of carbon fiber make it an excellent material for use in the medical device field. The impressive strength-to-weight ratio, rigidity and radiolucency of the carbon fiber are attributes that make it the material of choice for supporting limbs being x-rayed or treated with radiation.

Share Your Experience

Have you used carbon fiber in your imaging department? Would you like to share your experience with us? We’d like to hear from you and learn more about your experiences. In an upcoming post, we will discuss how to properly clean and disinfect carbon fiber armboards and pads. Sign up for our blog and we will notify you when this post is available.

Whiteboard Wednesday: Surgeon Cooling Systems

How Do Surgeons Stay Cool In The Operating Room?

Today on Whiteboard Wednesday we talk about how surgeons stay cool in the operating room. A major concern for medical staff working in the OR is fatigue caused by overheating.  Overheating is caused by the multiple layers surgeons and staff must wear for protection. During certain procedures the surgeon’s body heat is intensified, the CoolVest can help keep the surgeon more comfortable and alert.

What Is A Surgeon Cooling System?

The CoolVest System is a unique and innovative personal cooling system that is designed to keep surgeons cool and focused while performing surgery. The Single-Surgeon CoolVest System allows you to regulate your personal comfort so that you won’t perspire, suffer fatigue or lose concentration. The surgeon cooling system includes a lightweight vest that is constructed of hospital-grade ventilated nylon for maximum cooling, a variable flow control with quick-dry disconnect, wheeled cart with handle for convenient portability, and a UL listed cooler with variable flow 110V pump.

How Does The Surgeon Cooling System Work?  

The CoolVest is worn over scrubs and under surgical gowns. The tubing connection is located at the lower back of the garment to help keep the water supply tubing from interfering with the sterile field. Cooling tubes are located in the front and back of the garment for maximum cooling. The patented, thin-walled, non-kink tubing has been specifically designed for use under lead aprons.

Setup

  1. To begin, the cooling unit is filled with a mixture of approximately one gallon of water and ice (preferably block ice) or cube ice to the top of the unit.
  2. After the unit has been properly filled, you will want to attach the 8 foot insulated supply hose (quick disconnect) to the CoolVest.
  3. Apply the protective hose cover and then attach the other end of the insulated supply hose to the cooling unit.
  4. Listen for an audible click from both quick disconnect hose connections to ensure that they are properly connected.

Operation

  1. Once the supply hose has been properly protected and connected, you will want to plug the cooling unit’s electrical adapter into a grounded 110V outlet.
  2. Turn the unit on using the green On/Off power switch.
  3. Allow the unit to cycle until L.E.D indicator on Speed Control is activated (30 second pump start delay).
  4. Press “Ice Cube” on the Speed Control display on the lid of the system to start unit at desired level. L.E.D. on display will light from left to right for increased water flow. (e.g. 20-40-60-80-100% levels)
  5. To increase flow rate, press the “Ice Cube” button again, as needed, to adjust to the desired flow rate.
  6. To reset Speed Control setting: press “Ice Cube” until the surgeon cooling system stops; restart by pressing “Ice Cube” again until correct setting is indicated.

Relief From Heat While Performing Surgery

Surgeons have been impacted by excessive heat surrounding their bodies due to stress and other environmental factors. For example, neurosurgeons are required to wear appropriate radiation protective shielding (lead aprons, thyroid collars, lead glasses) while using imaging technology to protect them from the harmful effects of ionizing radiation. The use of these protective garments in addition to scrubs and surgical gowns can significantly increase the surgeon’s body temperature during surgical procedures. The increase in temperature can result in the surgeon becoming fatigued and perspiring during long surgeries which can reduce their focus and attention, resulting in a decrease in their ability to perform their tasks at the desired level.

Share Your Experiences

Have you experienced an increase in your body temperature while performing complicated surgeries? Interested in learning more? Make sure to check out our post on the Active Cooling Vest System For Surgeons In The OR!

3 Different Styles Of Phenolic Armboards

What is phenolic?

An organic compound, phenolic is a term given to several different substances made from phenol. Phenol is an important industrial commodity that participates in the chemical reaction that produces many materials and useful compounds. One of the major uses of phenol involves its conversion to plastic or similar materials.

What are phenolic resins?

Phenolic resin is a heat-cured plastic formed from a reaction of a carbon-based alcohol and chemical called aldehyde. The resin is hard, heat resistant, and can be mixed with a wide range of materials for medical and industrial uses. Phenolics offer low density, good thermal insulation, and outstanding durability. Phenolic materials are lightweight, provide a good value, and are radiolucent. (e.g. ⅜ inch black phenolic material has a radiolucency equivalent of 0.5mm Pb).

“Phenolic laminates are made by impregnating one or more layers of the base material such as paper, fiberglass or cotton with phenolic resin and laminating the resin-saturated base material under heat and pressure.” The black phenolic armboards are constructed of many layers of a paper-like substance, where the surface and core sheets are fused at high temperatures and pressure. The finished product results in an impact, water and corrosion resistant material that does not support bacterial growth.

Phenolic Armboard Styles

1. Height Adjustable Radiolucent Armboard (Radiolucent Armboard with Built-In Rail Mount)

Designed to reduce setup time by quickly and easily matching the height of the surgical table pad, the unique armboard design eliminates the need for having multiple armboard pad sizes. The intuitive, sleek design with built-in mounting mechanism provides effortless up and down movement. The armboard will adjust to the desired level of the operating room table with a simple spin of the height adjusting knob. A positive locking mechanism allows for safe and easy mounting to any operating room table accessory rail. When mounted to either side of the O.R. table, the armboard can rotate a full 180 degrees providing maximum patient positioning versatility.

The armboard has been designed to eliminate interference during C-Arm imaging and X-Ray procedures. Constructed of ⅜ inch thick black phenolic material, this lightweight armboard weighs 4.5 pounds making setup and breakdown quick and painless. The armboard measures 6 inches wide by 26 inches long and is compatible with an optional 2-inch table pad. The Armboard pad provides protection for the bony prominences of the immobilized extremity, as well as muscle tissue areas.

Key Benefits

  • Simple sleek design
  • Securely locks to operating room table accessory rail with simple spin of the knob
  • Height adjustable to accommodate all thicknesses of pads
  • Easy 180 degree rotation
  • No interference during C-arm imaging and X-ray procedures
  • Armboard is made of ⅜ inch thick black phenolic and weighs a slim 4.5 pounds
  • Optional armboard pad

2. Standard Drop-Latch Style Armboard

The tried and true design of the drop-latch style armboard is easy to use and is made with high-quality hardware. Eliminate broken gear teeth with the extra strong gear castings. The finger latch trigger, located on the outer end of the board allows for 180 degrees of lateral adjustment and 21 different positions (gear casting has 21 gear teeth). The armboard quickly attaches and releases off of the operating room table accessory rail by simply holding the trigger lock up and lifting the outer end of the board.

The 6 inch wide armboard is constructed of durable, ⅜ inch thick black phenolic material and is available in 24 inch and 26 inch lengths. Designed to fit all standard American made operating room tables, this lightweight armboard only weighs 4.5 pounds. There are two optional 2 inch thick armboard pads available that have been specifically designed for the 24 inch and the 26 inch armboards. The vinyl covered armboard pads are designed to protect the patients bony prominences while immobilized, as well as muscle tissue areas.

Two Lengths Available 

Key Benefits

  • Tried and proven armboard design
  • Armboard drops onto rail and locks by means of a weighted trigger lock
  • Armboard releases off rail by simply holding the trigger lock up and lifting the outer end of the board
  • Finger latch trigger on outer end of board allowing for 180 degree lateral adjustment
  • Designed with extra strong gear casting to eliminate broken teeth on castings
  • Armboard is made of ⅜ inch thick black phenolic and weighs a slim 4.5 pounds
  • Choice of 6 inch wide x 24 inch long or 26 inch long to meet your needs
  • Fits all standard American made operating room tables
  • Optional armboard pad

3. Underpad Mount Armboard (Coming soon to UniversalMedicalinc.com)

Designed for operating room tables without accessory rails, the underpad mount armboard table offers effortless setup and breakdown. The ⅜ inch thick black phenolic armboard only weighs 7 pounds. Setup is simple, slide the large end of the armboard under the operating room table pad and adjust to the desired location.

This armboard is ideal for supporting the patient during the placement of PICC (Peripherally inserted central catheter) lines or the injection of contrast materials for MRI and CT scans. The underpad mount armboard is compatible with the optional 6 inch wide by 24 inch long by 2 inch thick black vinyl armboard pad for patient protection.

Key Benefits

  • Armboard is made of ⅜ inch thick black phenolic and weighs a mere 7 pounds
  • Slides under table pad
  • Accepts optional 6 inch wide x 24 inch long pad

Armboard Mounting Options

The various styles of the radiolucent phenolic armboards provide the same functionality, while the different mounting configurations are designed for specific mounting methods. For example, both the height adjustable radiolucent armboard and the standard drop-latch armboard mount to the surgical table accessory rail, while the underpad mount is designed to slide under the surgical table pad. Three different style armboards, each with unique benefits to accommodate your current surgical table configuration and your facilities unique needs.

Make sure to watch our product demonstration videos to see how easy these armboards are to setup and breakdown. Have you used armboards during imaging procedures? Would you like to share your experiences with us? As always, if you have any remaining questions, please feel free to contact us or leave a comment below.

Additional Resources