How to Operate a C-Arm Machine: From Start-Up to Image Transfer

Before the case: checks and start-up

Position the machine near the table, unlock the wheels and plug in the mains cable. Check the cable and footswitch for damage, confirm that the emergency stop is released and power on the C-arm and the monitor cart. Many units boot in a minute or two; some have one-click startup, as on the PLX C1320/1321.

Wait for the self-test to finish. Log in with your credentials (some units use card or NFC login, as on the Arcovis family) and enter or select the patient from the worklist. Make sure the correct patient data is shown, because the images belong to that record.

Patient setup and positioning

Choose the patient type or anatomical programme on the control panel; this sets starting kV, mA and image processing. Position the patient on a radiolucent table, keep metal and cables out of the field, and place the arm so that tube and detector are on either side of the area of interest. Use the laser localiser to centre the beam without exposure.

The detector should be as close to the patient as possible and the tube below the table where the layout allows. Lock the brakes before the first exposure. Position memory, available on some models, lets you return to a saved projection.

Exposure modes and the footswitch

Fluoroscopy shows a live image while you hold the pedal. Choose the lowest mode that shows what you need: pulsed with a lower pulse rate for slow structures, higher rate for fast motion, and digital radiography (a single high-quality shot) where a documented image is required. Collimate to the area of interest before exposing.

Use the pedal in short bursts and let go while you think. Last-image hold keeps the last frame on screen so the team can study it without further radiation. The Arcovis DRF-C has six fluoroscopy modes selectable from the foot pedal, and the PLX C1520/1521 offers remote exposure so the radiographer can stand away from the beam.

• Collimate before every series
• Pulse rate as low as the task allows
• Short bursts rather than a held pedal
• Use last-image hold for review
• Never place hands in the primary beam

Image handling: save, annotate and send

During or after the case, store the key images, annotate or measure if the software allows and select what should be sent. Most systems export to PACS via DICOM, to a USB drive or to a printer. Confirm that the images are linked to the right patient and that the study has been closed.

Check local policy for retention and privacy, and whether exposure and dose data should be recorded. The dose-area-product display, if present, helps document the dose per case.

Safety habits during operation

Everyone near the beam should wear protective garments and dosimeters. Announce before exposure so staff can step back or behind a shield. Keep the arm clear of the sterile field when it is not in use, and watch cables and wheels when moving the unit. See C-arm radiation safety for the full set of habits and C-arm positioning guide for standard projections.

Operator training and authorisation should follow your facility's rules; see who can operate a C-arm.

Common operator mistakes

The most common mistake is starting to image before the patient and arm are secured: a moving arm with an unlocked brake can strike the table or a person. Another is forgetting to collimate and ending up with a large, low-quality, high-dose field. A third is selecting the wrong patient or anatomy programme, which gives poor image processing and extra exposures.

Teams also forget to save key images before the patient leaves, or send them to the wrong record. Build a short checklist: right patient, right programme, brakes on, collimated, images saved, study closed. Five seconds on the checklist prevent repeat exposures.

Shutdown and cleaning

After the case, park the arm in a transport position, power down in the order recommended by the manufacturer, disconnect the cable without pulling on the cord and wipe the machine with an approved disinfectant. Report faults immediately and record them.

For training on your specific model, installation or a service plan, request support from Beckfinity's specialists via the contact page.