California Radiation Control Regulations: Responsibility of the Supervisor and Operator
Robert J. Parelli in Principles of Fluoroscopic Image Intensification and Television Systems, 2020
Fluoroscopic equipment should be in compliance with state and national regulatory provisions at all times. Satisfactory operation of all x-ray equipment should be checked periodically. More importantly, radiologic technologists should observe a number of precautions to reduce their own personal radiation exposure as follows:A lead apron must be worn by each person (except the patient) in the exam room when fluoroscopy is being performed. The personnel monitoring device should be fastened to the outside of the apron at the shoulder level. During image intensification, the radiologic technologist should remain behind the protective barrier, or if that is not possible, should stand as far from the table as practicable or behind the fluoroscopist.A technologist must remain at least 6 ft from the patient, away from the primary x-ray beam, during portable examinations. A lead apron or a portable lead shield must be provided.Additional personnel protective devices should be worn.
Radiation safety
Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead in Cardiovascular Catheterization and Intervention, 2017
Personal protective equipment is evolving. The half- value layer is a standard expression of how much radiation is absorbed by the lead apron. At a kVp of 75, a lead apron of 0.5 cm thickness will absorb 95% of all the X-rays produced. Two-piece wrap-around aprons offer more protection than single-piece lead aprons and reduce musculoskeletal aches. It is important the lead apron is stored properly to prevent any cracks from forming. More recently a “weightless” apron has been promoted that hangs from the ceiling and may help reduce back injury.[59] It may have an additional advantage of reducing side and cranial radiation exposure. Radiation glasses are effective in protecting the eyes from radiation, and they should have side shielding.[60]
Radiation safety in the cardiac catheterisation laboratory
John Edward Boland, David W. M. Muller in 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.
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.
Summary of Radiation Research Society Online 67th Annual Meeting, Symposium on “Radiation and Circulatory Effects”
Published in International Journal of Radiation Biology, 2023
Helmut Schöllnberger, Lawrence T. Dauer, Richard Wakeford, Julie Constanzo, Ashley Golden
This problematic subject can also be transposed to the risk assessment of medical radiation workers. One of the biggest issues is lead apron-wearing. Dosimeters are often worn outside of the lead apron, which can bias results for dose. In addition, it is crucial to understand the specific exposure scenario. Therefore, all medical workers should not be pooled in a single group and dosimetry should be determined in each category of medical workers. Overall, the usually only limited availability of information on well-known risk factors for circulatory disease (such as cigarette smoking, hypertension, diabetes, physical activity and other lifestyle factors) indicates that this may have biased any observed association between radiation exposure and detrimental health outcome. In the low-dose range, any observed deviations from a linear dose-response may in fact be the result of the inability to construct a better baseline model due to the lack of information on other risk factors (the baseline model is a mathematical model used to describe the background or baseline risk, i.e. the risk that is not associated with radiation exposure). This is one important reason why the use of the LNT model is preferred in radiological protection (NCRP 2018b; summarized by Shore et al. 2018 ).
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
Among our cohort, 98.5% used lead aprons during their interventional practice, spending an average of 6.6 ± 7.6 h on a weekly basis. The most commonly used type of lead apron was the ‘wrap around’ apron (46.9%), followed by ‘single sided’ aprons (43.1%). A total of 101 participants (80.1%) reported use of other forms of protective garments including, but not limited to, neck shields (81.5%) and glasses (14.6%). In terms of interventionists’ knowledge regarding the characteristic of their lead aprons, 20% were not aware of the weight of their used aprons, 66.9% were oblivious to the type of material used in aprons, while 71.5% did not know the lead equivalence associated with their aprons.
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