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Radiation Safety in Chiropractic Radiography
Published in Russell L. Wilson, Chiropractic Radiography and Quality Assurance Handbook, 2020
Accessories such as calipers, the Nolan filtration system, lead blockers, lead aprons, and radiographic sponges are some of the key tools for proper radiation safety. The proper use of these items will demonstrate a commitment to keep the exposure for the patient as low as reasonably achievable (referred to as the ALARA standard). The use of compensating filters will reduce the exposure to parts of the patient’s anatomy that are less dense. It will improve image quality as well as lower the dose for the patient. Lead blockers are used to eliminate any film fogging from scatter radiation on extremity views. This will reduce the number of retakes. Lead aprons are used by the patient for gonadal protection and by the operator if there is a need to be in the room during an exposure.
Radiation safety in the cardiac catheterisation laboratory
Published in John Edward Boland, David W. M. Muller, Interventional Cardiology and Cardiac Catheterisation, 2019
All personnel who are not positioned behind a radiation barrier must wear a protective lead apron and thyroid collar during the procedure. Aprons and collars are usually recommended to have a shielding value of not less than 0.3 mm lead equivalent at a set X-ray energy, but regulatory requirement will vary for each jurisdiction. Lead aprons must be properly stored on a hanger when not in use and handled with care to avoid damage that may compromise their shielding characteristics. Annual inspections should be conducted to detect imperfections in lead aprons. Leaded eyewear, fitted with side panels to reduce penetration of tangential scatter to the cornea, provide an extra measure of protection.
The neurosurgical operating room
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Erika Freiberg, Sara Kadlec, Sharad Rajpal
Long-term radiation exposure in the OR can lead to increased risk of cancer. The best way to reduce radiation exposure is distance. Standing at least 3 meters away from the radiation source drastically diminishes exposure. Radiation scatter is also a huge risk and occurs greatest at the beam source secondary to backscatter from the patient (McCormick, 2008). Next to distance, shielding is essential. The most effective lead apron is the wraparound two-piece garment. Minimizing time of exposure is also key to avoiding long-term consequences from radiation. Remember to use thyroid- and eye-shielding devices.
Evaluating the physical, psychosocial and ergonomic burden of lead aprons among Jordanian interventionists: a nationwide study
Published in International Journal of Occupational Safety and Ergonomics, 2022
Hanna Al-Makhamreh, Farah Al-bitar, Aseel Saadeh, Abdallah Al-Ani, Muayad Azzam, Dana Alkhulaifat, Asim Khanfar, Yousef Toubah, Lujain Aburaddad, Kamal Hassan, Hashim Al-Ani
Although lead aprons are of vital importance in radiation shielding, the present literature indicates that they are frequently associated with higher rates of injury. In fact, higher apron-related total caseloads are strongly associated with orthopedic disease [2,8,17]. Moore et al. [9] demonstrated that frequent apron users and long-term apron users report more back pain and severe limiting back pain in comparison with less frequent users. Multiple reports support the aforementioned statement, as prolonged apron usage is associated with increased forefoot load in the elderly, increased thoracic kyphosis in the young and contributes to indiscriminate body aches [5,18]. It has been demonstrated through infrared thermography that apron strain affects axial posture and results in accelerated muscle fatigue, which could affect performance and introduce vital operative errors [19]. In addition to increased frequency of apron use and duration of procedures, MSK injuries are frequently associated with the female gender, older age, poor ergonomic practices and lack of physical fitness throughout the literature [7,12,17,20,21]. On the other hand, interventionists and surgeons have been shown to report significantly less back pain on days devoid of apron usage [18]. The variable specifications of aprons in terms of age, size and shape, in addition to their improper usage, could contribute to an increased likelihood of MSK injuries.
Contact force sensors in minimally invasive catheters: current and future applications
Published in Expert Review of Medical Devices, 2021
Weyland Cheng, Manye Yao, Bo Zhai, Penggao Wang
Fluoroscopy is commonly used to observe the catheter’s location within the body or to assess arterial and cardiovascular structures. However, radiation exposure to the patient and catheter operator can be undesirable consequences when using x-ray imaging. Although operators wear partly protective lead aprons during the procedure, radiation exposure to the head can increase the risk of cataracts, hematological malignancies, and neural tumors [10]. Moreover, constantly wearing heavy lead aprons can lead to the development of chronic back pain and orthopedic injuries [10]. Therefore, minimizing operation time and fluoroscopy duration is necessary for maximizing safety for both the patient and operator. Magnetic resonance (MR) angiography is another option for visual feedback. Yet, drawbacks such as high expense, shielding requirements, and prohibition of using ferromagnetic materials can limit its usage [11].
A randomized comparison of bone-cement K-wire fixation vs. plate fixation of shaft fractures of proximal phalanges
Published in The Physician and Sportsmedicine, 2019
Xu Zhang, Yadong Yu, Xinzhong Shao, Vikas Dhawan, Wei Du
Some pitfalls and pearls of cemented K-wire fixation are as follows: (1) The leverage technique using a pin is helpful in difficult fracture patterns (Figure 8(a)). (2) In order to decrease the risk of pin track infection caused by joint motion postoperatively, all insertion points are better located at 5 mm distal or proximal to the joint lines (Figure 8(b–d)). In the case that the fracture site is located more distally or proximally, oblique wire positioning can achieve the goal. (3) Keeping the distance between skin and cement about 1 cm so that the K-wires are removed easily in the future. (4) In order to reduce exposure to radiation, a lead apron can be used to cover the patient’s body. The surgeons can stay outside the operation room while X-ray irradiation. (5) Because the wires do not block joint motion, their early removal is unnecessary unless pin track infection develops. (6) When removal the system, first remove the cement by cutting off the K-wires using diagonal cutting pliers, and then remove the K-wires one by one.