Hi Julia,

Portable flouroscopy has been a win-win solution for all stake-holders in our dept. Radiology CAN generate a formal report because once saved, these images are uploaded into their picture archiving system (PACS). This also means that the hospital can generate facility charges for  this technology. The orthopedists are delighted because they can obtain real time images to assess adequacy of fracture reduction. For us as PEM's, fracture manipulation time, procedural sedation time & ED through put are significantly reduced because we do not have to send these patients back and forth to the radiology suite. 

Similarly, we have also found portable flouroscopy to be extremely helpful when performing an orthopedic manipulation or extracting a radio-opaque FB. There is nothing better than real time localization of a deep FB prior to exploration and removal. I also use it to screen the  preschooler with a history of FB ingestion.
My suggestion is that you collaborate with your orthopedic & radiology colleagues to jointly petition the administration to purchase one for your ED. It has been really beneficial in the management of these types of patients. 

Hope that helps. 

Jay Pershad 
Le Bonheur ED

-------------- Original message ----------------------
From: Julia Whitefield <[log in to unmask]>
is anyone of you familiar with the procedure of introducing 
the use of a C-arm to your ED and here in particular what arguments you used 
radiology - as they might be afraid of losing 'business' - and the interactions 
with ortho? Did your ortho department take care of it, did you have to help 
them... are any of you familiar with the best brands - Siemens?  etc... I would 
greatly appreciate any input.
Julia S. Whitefield MD, Ph.D.

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