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Importance of Radiation Protection



Who Should Protect Themselves?

Areas where fluoroscopic procedures are performed include:

  • Cath Lab
  • Interventional Radiology
  • Endoscopy
  • GI
  • EP Lab
  • OR
  • Radiology / Special Imaging
  • Pain Management

Cardiac Cath with Angiography and Electro-physiology can deliver the greatest dose of x-ray radiation of any of the diagnostic medical procedures. The physicians and techs in these specialties receive low levels of scatter radiation over a period of months to decades. The physicians performing these procedures should be familiar with the potential genetic and somatic effects of radiation and the products available to them to help to reduce or eliminate x-ray exposure. The use of x-rays in Cath Labs and EP Labs are only deemed acceptable due to the patient benefits derived from these procedures, which are considered to outweigh the risks to the physician. Personnel exposure results from the radiation of the primary x-ray beam being scattered by the patient's skeletal structure. The chest area, thyroid and eyes of doctors and other medical personnel in the room receive most of the exposure of scatter radiation.

ALARA Principle

As Low As Reasonably Achievable

The National Council on Radiation Protection has established maximal permissible doses for persons who receive occupational exposure. The Nuclear Regulatory Commission has suggested that occupational exposure should be as low as reasonably achievable.

Three Principles of Radiation Protection: TIME, DISTANCE, SHIELDING

  1. Reduce exposure time
  2. Increase distance from the source
  1. Wear shielding & protective products

AORN

2001 Standards, Recommended Practices, and Guidelines

During fluoroscopy, personnel should wear:

  • Lead Aprons
  • Thyroid Collars
  • Eye Protection
  • Radiation Reducing Gloves

"The areas at greatest risk of radiation exposure for personnel within a 6-ft (ie-2m) range of the radiation source are the head, neck, and hands. In practice, preoperative personnel may receive the same exposure to their unprotected thyroid as the surgeon. Moving and holding the C-arm unit during fluoroscopy exposes the surgeon's fingers to high dosages of radiation. Radiation-attenuating surgical gloves block 50% of the dosage."

How Radiation Exposure Affects the Eye

Relatively high doses of radiation can damage the conjunctiva, iris, sclera, and blood vessels of the retina. The lens, however, is the critical site, for it may sustain irreversible damage from a relatively low dose of radiation. The lens, or focusing part of the eye, is where cataracts form. Radiation-induced cataracts are distinct from naturally occurring cataracts in that they form in the posterior (back) pole of the lens.

The sensitivity of the lens to radiation is due to the failure of normal cell replacement. The cell damage from low dose radiation consists of cell death and abnormal cell reproduction, which produces mutated cells. The normal metabolism of the eye cannot remove these mutated radiation damaged cells. This results in a premature clouding of the crystalline lens causing reduced vision, which can be corrected only when the cataract matures (over time) and is removed.

Increasing Popularity of Radiation Protective Eyewear

With the availability of newly designed frames and ultra light lenses, protective leaded eyewear is used by approximately 95% of the physicians and staff in Cardiac Cath and EP labs, and increasingly for urological procedures, interventional radiology, pain management and orthopedic surgery.

Today, with the increased selection of styles and the ability to provide protective eyewear with prescriptions, there are options available to any physician or medical professional.

 

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