How to Drape a C-Arm

Abstract

When intraoperative imaging is needed, a mobile x-ray machine must be used by a radiologic technologist (RT) to take the image. A C-arm portable imaging machine, so called because its shape resembles the letter “C”, is widely used in contemporary surgical and interventional procedures for this purpose, and its proper draping is essential for maintaining sterile field integrity. This educational video demonstrates how to receive a C-arm drape onto the sterile field, how to prepare it for use, and how to place and secure it around the C-arm using sterile technique to protect patient safety. This video was filmed in an academic setting and is intended for perioperative trainees and staff.

Article Overview

Fluoroscopic imaging via the C-arm is routinely employed across orthopaedic, vascular, and general surgical settings. The C-arm's versatility and portable, easy-to-handle design make it suitable for intraoperative use and facilitate less invasive procedures that minimize the risks associated with open procedures.^1–3 Because the imaging technology emits ionizing x-ray radiation, everyone in the operating room other than the patient must be protected, either by standing behind a shield or by wearing lead-lined protective coverings underneath their sterile gowns. Proper C-arm draping is recognized by the Association of Surgical Technologists (AST) as a fundamental skill. Although a C-arm and other portable radiographic equipment is operated only by appropriately trained radiologic staff, the AST has emphasized that equipment management, including imaging devices, must be addressed within core competency frameworks for surgical technology education.⁴ Despite its clinical ubiquity, C-arm draping may be underrepresented in textbooks and other training materials. This tutorial provides a clear, structured demonstration of C-arm draping technique in order to expand access to this information. Surgical teams can reduce the risk of contamination and ultimately improve patient outcomes by prioritizing this important skill in training.

Prior to draping, the surgical team performs a standardized surgical hand scrub, followed by donning a sterile gown and sterile gloves in accordance with aseptic technique. Once the sterile field is established, the drape is received from the circulator without compromise to its integrity.

The C-arm drape is oriented so the hand indicator markings are identified—one in the center and one at each end. The hands are inserted at the central marking and extended outward toward the end markings, allowing the drape to be fully and safely unfolded without contamination.

The unfolded drape is then positioned over the C-arm. The circulator assists by securing the inner portion of the drape. Adhesive tabs located along the drape are peeled and secured by the sterile surgical technologist to eliminate excess slack, as any material hanging over a sterile field is recognized as a potential source of contamination. A final tuck is applied to the drape to ensure a snug, secure fit.

There are various drape types for the C-arm made by different manufacturers. Take care to familiarize yourself with the materials available at your institution. Instruction in C-arm draping, through demonstration and guided practice, reinforces the principles of aseptic technique and supports the development of competencies that contribute to patient safety and infection prevention in the perioperative setting.

Disclosures

We report no conflicts of interest, financial relationships, funding, sponsorship, equipment support, or other relationships that could be perceived to influence the content of this article.