FAQs

When you purchase any of our medical imaging or pain management products, it is just the start of a long-lasting relationship between you and OR Support. You can contact us 24 hours a day 7 days a week to answer questions, get training, product quotes or (in those rare cases) emergency service. There will always be someone from our support staff to help you with anything you need any time you need it.

So, whether you are planning your next office, next equipment purchase or next grand adventure, (many of our staff travel the world to, skydive, scuba dive, shark dive, wreck dive, snorkel, saltwater-freshwater fish, and mountain climb all over the world) and all of us are happy to offer suggestions and advice that might help you make a more informed decision. We even have an owner who has hundreds of photographs in all types of publications as well as his images on dozens of magazine covers worldwide. Please reach out to us by phone or text at 858-336-1377 or email us at support@orsupport.com if you have questions about medical equipment, training, financing or just want to ask any of us about any of the crazy things we do and where is the best place to do them. We will respond immediately.

Until then, we have included a list of questions we’re most commonly asked, and hopefully, some helpful answers.

Autoclaves

Desktop-Autoclave-Tuttnauer-3870EA-Sterilizer

The quick answer is no you don’t need any type of plumbing for a desktop autoclave, although other types of sterilizers do require plumbing.

C-arm Table Accessories

how to clean c-arm table pads
How to clean medical table pads

The following are the standard approved products and methods for the cleaning and disinfecting of c-arm table pads and most medical exam tables and medical stretcher pads.

Cleaning a c-arm table or other medical table pad

Option 1.

Wash the table pad with a generous application of neutral soap suds and lukewarm water. Do not immerse the pad. Rinse with water and dry.

Option 2.

Use a diluted bleach solution of 10-parts water to 1-part bleach.
Do not immerse. Bleach MUST be diluted to the 10:1 ratio or the medical table pad may disintegrate or dissolve. The life of the table pad will be greatly reduced if harsh cleaning agents are used. Wipe dry with a clean cloth. Do not let the cleaning agents dry on the pad.

All chemicals/solutions MUST be diluted to the manufacturer’s recommendations (look closely, often the proper dilutions are in “fine print” on the chemical’s container and may often request that you use more than you need to or should use)

After the recommended time has passed to ensure disinfection, the pad surface should be wiped again with a wet cloth to remove any remaining chemical or solution.

Disinfecting a medical table pad.

Option 1.

Use Lysol Brand III I.C. Disinfectant Spray by Reckitt Benckiser Inc, Montvale, NJ per manufacturer’s instructions.

Reference: National Laboratories Item # 36241-95029-3

OPTION 2.

Use a diluted bleach solution of 10-parts water to 1-part bleach.

Wipe dry with a clean cloth.

Do not immerse or soak the pad. Bleach MUST be diluted to the 10:1 ratio.

If you want your medical table pad to last a long time here are some cleaning do’s and don’ts.

Cleaning DO’s

DO clean all stains promptly.

DO use only fabric-safe cleaning agents or disinfectants.

DO use appropriate quaternary or phenolic type disinfectants if nylon fabric needs to be sanitized.

DO dilute all disinfectants and germicides in accordance with the manufacturer’s instructions.

DO wipe fabric clean with neutral soap suds and lukewarm water.

DO rinse thoroughly.

DO allow adequate drying time before returning to service.

DO use a soft sponge with liquid cleaner as specified on the manufacturer’s product label for hard-to-clean areas.

DO clean daily to control or prevent odors on long term incontinent applications.

DO use a scented cleaner or disinfectant that is designed for use on fabrics if needed to control odors on long term incontinent applications.

DO disinfect blood contamination with a 1:10 dilution of household bleach (5.25% sodium hypochlorite) as recommended by the CDC (Center for Disease Control, US Department of Health and Human Service, February 1989); a weaker dilution, e.g. 1:100 can be used, but may not be in accordance with CDC recommendations. CDC’s Guideline for Disinfection and Sterilization in Healthcare Facilities

DO be aware that staining chemicals and cleaning agents can affect fabric strength, finish, longevity and color.

DO inspect mattresses frequently to ensure that new stains can be treated promptly and that there are no rids or tears in the table pad.

DO ask your support surface manufacturer for additional information related to the care and cleaning of the support surface.

Cleaning DON’Ts

DO NOT machine wash or machine dry. Ok, I was forced to say that, but Duh!

DO NOT use harsh cleaners or solvents ( I know I have said it before).

DO NOT use cleaning agents designed for use on hard, non-porous, or metal surfaces.

DO NOT use iodophor type disinfectants, such as Betadine, because they will stain the fabric.

DO NOT use household bleach or concentrated cleaning agents, disinfectants or germicides without diluting the product according to the manufacturer’s instructions.

DO NOT allow any cleaning agent to remain in contact with the fabric or sit on the fabric for a prolonged time.

DO NOT fail to adequately rinse the cleaning agent or disinfectant from the fabric.

DO Not apply tape to any pad. I know this always happens, but try to avoid it if you can. The solvent in the tape’s adhesive dissolves the table pads covering.

The information contained herein is offered as being typical for the indicated product. The customer is solely responsible for determining fitness for use.

This company disclaims liability for any incidental or consequential damages resulting from any breach of the express warranty contained herein. The above cleaning recommendations are offered as information regarding commonly accepted cleaning practices for nylon fabrics. No fabric can be made permanently “stain-proof.”

radiolucent-carbon-fiber-armboard-for-c-arm-tables-single-sided

After several years of use many radiolucent carbon fiber arm boards break. It can be that a screw comes out, or if you have a pain management clamp-on style armboard, a clamp may no longer hold onto or even fall off of a c-arm table. Sometimes the cheaper ones will even splinter or crack.

Whatever the case, most of these issues can be resolved by a company that specializes in either radiolucent armboards or carbon fiber arm boards. (In case you noticed the inconsistent spelling, some people spell it “armboard” and others, “arm board”) Not all c-arm compatible armboards are made out of carbon fiber (again some people spell it “carbonfiber” or “carbon-fiber”)

If your arm boards are broken or malfunctioning in any way, immediately take them out of patient service and call a repair company. You can save as much as 75% off the price of replacing your arm boards with a new pair.

If you have a broken arm board that and want to know if it can be repaired and how much it will cost, just take a picture of the whole arm board and a closer shot of the broken area and text it to 858-336-1377 or email it to service@orsupport.com and we will get back to you ASAP.

Exam Tables

How much do used medical exam tables cost? We hear this question almost every day. The short answer is as low as $300 for a table that looks good and has good upholstery. The prices really depend on the brand; Ritter and Midmark are two of the most popular brands of used and refurbished exam tables. The features: There are fixed height exam tables, motorized height exam tables (sometimes called powered exam tables) and medical speciality exam tables like OB/GYN exam tables that have built-in leg stirrups. There are different height ranges, 21″-34″ is pretty standard although there are models that go higher and lower. Different weight capacities 450 pounds is normal with some of the more expensive “$17,000 list” powered bariatric examinations tables, like the Midmark Ritter 244 exam table having patient weight limits of 850 pounds. Accessories, like lockable casters and paper roll holders, also can make a big difference in the price you would pay for a good, used exam table.

Pain Management C-arm Tables

O.R. Support gets this question a lot. We are often asked if we can add one or more motorized movements to a physician’s pain management c-arm table. This question normally happens after the pain management doctor has attended a cadaver injection workshop where one of the instructors showed them a new way to do an injection or a faster way to perform some other pain management procedure.

There are 5 standard motorized pain management table movements:

  • Height adjustment
  • Lateral tilt
  • Trendelenburg – Reverse Trendelenburg (most physicians count that as one movement)
  • Extend retract (sometimes called head to toe or X motion)
  • Side to side slide (Y motion)

Other c-arm table movements:

  • Four-way free float (manual movement – mostly used for vascular procedures)
  • Four-way motorized float (a combination of X and Y motions)
  • Fowler back (a backrest that raises up to 90 degrees)

The good news is yes you can upgrade your current used c-arm table. The price just depends on the brand and type of surgical imaging c-arm table you have. If you have one of the modular PMT 8000 c-arm tables, then it is easy. The factory just sends in a factory trained c-arm table service engineer and they will add motors, pivot points and sometimes linear rails for head to foot movement or side to side slide and you are back up and running (It seems like there should be a good pain management pun here. If you think of one send us a note and we will insert it here and give you credit) ..anyway…it normally takes 1-3 hours. Not very long at all.

Other brands of c-arm imaging tables:

Your pain management c-arm table is never obsolete. O.R. Support is can upgrade any of your PMT 8000 series surgical imaging tables in the field in just a few hours. We can even upgrade your PMT 8000 fixed height table to have motorized movements. We can repair and upgrade other models of c-arm tables as well.

  • Oakworks
  • Surgical Tables International (STI)
  • Biodex
  • Morgan Medesign
  • Medstone
  • Acoma
  • Stryker
  • Stille
  • Steris

If you have one of these other brands of c-arm tables or pain management tables just give O.R. Support a call or send a text to 858-336-1377 or contact us by email at service@orsupport.com.

We are open 24 hours a day seven days a week. We will be glad to help you with any of your equipment sales or service needs.

Pain Management RF Generator

RF Generators sometimes called radiofrequency generators or RFA machines can cost as little as $1,500 or as high as $35,000. Sometimes even more. I have even seen companies give them away for free if the pain management physician is buying a large number of spinal cord stimulators on a regular basis. That doesn’t happen very often, but at least on deal seems to be mentioned at many if not most of the workshops around the country.

The single RF output (single Lead) radiofrequency generators are the least expensive RFA machines available. They typically cost between $2,000 and $5,500. The only single output pain management radiofrequency generators on the market today will be used or recertified models.

The 3 lead spinal RF generators (yes, you are right, 2 channel RF machines were never made), anyway 3 channel radiofrequency generators normally cost between $6500 to about $9,000. And yes you guessed it, the 3 electrode RFA machines are no longer being made either.

There are several 4 lead radiofrequency pain management RF generators available, in both new and used models. Prices for these top of the line RF generators run from about $9,000 for a basic used model up to and over the $35,000 high dollar mark.

When you are looking to buy an RF generator for pain management many things can affect the price greatly:

  • How many RF electrodes you are getting with it?
  • Are the RF probes Stainless Steel or Nitinol? Nitinol probes are can be as much as twice as expensive as the Stainless Steel Electrodes.
  • Sometimes even the size of the RF probes and make a difference in price.
  • “just a note” you can almost always get RF electrodes thrown in for free or at a much lower cost when you buy the RFA machine. I have seen pain management centers save over $20,000 in one year by buying their estimated yearly need for probes with the purchase of their RF Generator.
  • Is there any training included?
    • If so for how long?
    • Is the RF generator training going to be over 1 day or multiple days?
    • Is it going to be onsite radiofrequency generator training or online or just over the phone?
  • How long is the warranty on the generator?
  • What is the warranty on the radiofrequency probes?
  • Are the probes:
    • New
    • Demo
    • Recertified
    • Used?
  • What brand of electrodes are they including?
  • If you are buying a c-arm, ultrasound machine, pain management c-arm table or autoclave at the same time. A package deal can save you thousands.

 

The most popular pain management RF generator changes every few months, but it is usually one of 3. It is either the Neurotherm NT 2000 RFA machine, the Stryker Multigen radiofrequency generator or the Cosman G4 RF generator. The current RFA (radiofrequency ablation) machines are all 4 lead systems, (some RF generator manufacturers call them 4 lead, 4 channel or 4 RF output, you get the idea). The Halyard pain management RF generator and the Neurotherm NT1100, three RF output, pain management radiofrequency generators are also very popular.

Most pain management physicians who are just starting out often choose to save 50-75% and start with a single lead RF generator or a 3 lead RFA machine.

Here is a list of single lead RF Generators:

Single lead (or single channel) RF Generators are great for pain management physicians that are not looking to treat multiple sites concurrently. They also can be great choices for startup pain practices, second offices, or surgery centers that only do radiofrequency pain procedures a few times a week.

There are quite a few choices if you’re looking for an inexpensive Pain Management RF generator. Normally those choices would start with one of the single channel radiofrequency generators. Basically, that means that you will only be able to treat one site at a time, or another way to put it is that the RF generator will only power one RF electrode at a time. Click on the following link to see a list of single lead RF generators.
You may also be interested in looking at the least expensive 3 lead RF generators, or inexpensive 4 lead RF generators.

Here is a list of RF generators with 4 channels.

  • Neurotherm NT2000 RFA Generator
  • Stryker Multigen RF Generator
  • Halyard Pain Management RF Generator
  • Baylis Radiofrequency Generator
  • Kimberly Clark Lesion Generator
  • Cosman G4 RF Generator

There are two 3 electrode output RF generators for pain management on the market:

There are also single lead RF machines and 4 lead radiofrequency generators available.

RF Electrodes

Halyard RF Electrodes for sale
RF electrodes in a sterilization tray


How to Sterilize reusable Neurotherm RF probes (RF electrodes).

When Neurotherm reusable electrodes, Test Leads, and Stimulation Test Blocks are used they must be sterilized by autoclaving to the instructions provided by the autoclave manufacturer’s recommended sterilization procedure.

If in doubt, the sterilizer or autoclave manufacturer should be consulted for a recommendation of loading instructions and drying times.

Steam (Moist Heat). Quality of steam should be in accordance with the requirements of HTM2031 “Steam for Sterilization”. Wrapped (Porous Load) fractionated and pulse cycles.

Autoclave temperatures should be:- Pre-vacuum 1340 to 1370C (2740 – 2790F) for a minimum of 3 minutes. Do not use a gravity system processing for wrapped instruments.

When sterilizing unwrapped RF electrodes. The temperature range in each case should be:- 1340 – 1370C for a minimum of 3.5 minutes. Gravity displacement should also be 1340 – 1370C for a minimum of 3.5 minutes.

Ensure any RFA probe cables do not contact the metal housing of the autoclave or other metal instruments during the sterilization cycle, as this may reduce the effective life of the radiofrequency electrode.

RF needles (RF cannula) and disposable RF probes are supplied sterilized, double wrapped and for single patient use only. It goes without saying, the disposable one-time radiofrequency probes and RFA cannula can not be autoclaved or reused.

It is recommended that disposable Neurotherm radiofrequency electrodes (radiofrequency probes) should be used when possible, for added safety of the patient and members of the hospital staff.

Note: It is advised that autoclaves and other sterilization equipment should have validation certification and performance qualification tests undertaken of their process cycles for efficient processing.

Ultrasound Machines

Handheld wireless ultrasound probe made by Healcerion Model Sonon-300L
Handheld wireless linear ultrasound-transducer made by Healcerion Model Sonon-300L. will connect wirelessly to your iPhone or Android phone or tablet.

Ultrasound-guided pain management procedures are becoming more accurate and more popular as reimbursement for c-arm guided pain procedures drops. Reimbursement for ultrasound-guided pain procedures is not as high as most pain management physicians would like, but the ultrasound machines ease-of-use, comparatively low upfront investment, and elimination of exposure to dangerous ionizing radiation is making ultrasound guided pain management injections a more popular image-guided pain management procedure every day. (Percutaneous Ultrasound-Guided Injections in the Musculoskeletal System)

Normally, the biggest determining factor in the choice of an ultrasound machine for pain management physicians is how much will ultrasound system cost, and a close second factor being the quality of the ultrasound image. There are other factors to be considered as well like reliability, ease of use, training on the ultrasound machine, length, and comprehensiveness of the warranty, availability of a loaner ultrasound machine during any repair, et cetera.

New ultrasound systems can cost as much as $80,000 or more. I have not been able to calculate an ROI for any pain practice where this even begins to make sense. There are a large number of units in the $20,000-to-$45,000 range that produce fantastic images, but again, any calculation resulting in a desirable ROI (return-on-investment) is virtually impossible. So that leaves ultrasound systems that cost $22,000 and below. Here are a few more popular pain management ultrasound systems in that price range:

Up until the last year-and-a-half, the most popular price range for ultrasound systems being used for pain management injections was $12,000-to-$15,000, with a significant percentage of those being in the $8,000-to-$12,000 price range. The systems in this price range produce a good-to-better-than-average image for most pain management doctors with the biggest variable being the level of expectation of image quality by the doctor.

Physicians just leaving positions where a $45,000 GE ultrasound system or Mindray system might expect a little more in terms of ultrasound image quality than what these lower-cost ultrasound systems can produce, but overall most pain management physicians would be more than satisfied with the image quality.

Over the last decade, ultrasound systems for pain management practices have gone from large console-based machines about the size of an apartment refrigerator down to desktop-based machines and then down to laptop-sized ultrasound machines. Today where there are several ultrasound machines that are hand-held and wireless small enough that you can carry them in your pocket.

The cost of the wireless handheld ultrasound can be as low as $3,000-to-$6,500. Many of these wireless transducers can connect to your iPhone, iPad or Android phone or tablet. The more expensive of these wireless ultrasound transducers have better images, longer warranties, longer battery life, better balance, better ergonomics and lower weight which can affect the price significantly.

Handheld wireless ultrasound system

One of the major disadvantages of the handheld wireless ultrasound machines is the fact they are normally either a linear transducer or a curved transducer. There is one that has different transducer types on each end. This means you need to either buy two versions of the ultrasound machines or restrict yourself to using them only with shallow injections or deep injections instead of both. Hmmm, probably not something most doctors would accept. I have several pain management physicians who just use one of the better wireless linear probes for most pain procedures and do their hip injections with a c-arm.

Over the last few months, several significant technological innovations have been demonstrated at the larger medical imaging conferences across the world. The largest medical imaging conference is the RSNA in Chicago at the end of November. I fully expect these changes to result in better and better wireless ultrasound systems being sold by ultrasound manufacturers in the very near future. There are some manufacturers that will give you a limited guarantee, that if you buy now they will upgrade you to the newer, more advanced ultrasound machines when they come out. If you decide to go this way, make sure you read the contract carefully. Some of the promises are not what they make them out to be.

So, back to the question what is the most popular ultrasound machine for pain management procedures. It is a pretty even split between the SONOSITE laptop-based systems like the SONOSITE m-TURBO, one of the GE Logiq e ultrasound systems or one of the GE Venue ultrasound machines.

Ultrasound Tables

Biodex-Ultra-Pro-Ultrasound-Table

We are asked almost every day how much does a used ultrasound table cost?

Unlike other used imaging tables, for example, pain management c-arm tables, vascular c-arm tables or mobile urology surgical imaging tables, very few used ultrasound tables come on the secondary market. When a good echo table or other ultrasound table does appear, it usually sells the same day.

Usually, it pays to get on a dealer’s waitlist or mailing list so that you will be notified before everyone else when a table does become available.

To answer the question “How much does a used ultrasound table cost?” it depends on a lot of things: brand, age of the table, the condition that it is in, length of warranty, what the warranty coversand how rare it is, but normally you will pay approximately 50-70% of what the table cost new.

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