Guidelines on Radiation Protection in Fluoroscopy
About 50% of the interventional pain procedures performed annually is done under fluoroscopy. Fluoroscopy ensures correct needle placement and accurate release of the injected medication. This is used in several areas and one should be aware about how to protect your patients, staff and surgeons from the dangers posed by invisible radiation. Distance, shielding and time is the basic guidelines for securely using radiation.
The main aim of interventional radiology methods is to treat and improve a patient’s health. The physician should discuss about the radiation risks involved in the interventional procedures with the patients, especially if they are exposed to a higher dose of radiation.
A dose of 5 rads/min is delivered by fluoroscopy in the direct beam. In addition, the exposure rate depends on the patient’s thickness. If the patient is thicker, then higher would be the exposure. Small radiation doses could also damage DNA (1 rad = one chance for every 100,000). This could cause severe health effects.
Distance and time play a key role in reducing the exposure. By using intermittent fluoroscopy (instead of continuous), the patient will get shorter fluoro. The exposure increases exponentially, when the patient is positioned closer to the x-ray. This could be avoided by positioning your patient away (12 – 15 inches) from the x-ray device and closer to image intensifier.
Lead Aprons and Shields
- Lead aprons give significant protection against radiation
- Protective eyewear and thyroid shields should be used
- Although Lead shields give protection to only a part of the body, it should still be used
- C-arm drapes will help in reducing the risk of scatter
Evaluation of C-Arm Unit
- A radiation physicist must assess the unit once a year.
- In case, the unit is used every day, then it should be evaluated twice a year
- Necessary adjustments and knowing the output of radiation are the key factors
- The radiation output can increase or decrease as the model becomes older.
Monitor Radiation Exposure
- The staff tags should be monitored by the Radiation Safety officer to ensure that there is no increase in the exposure. In case, there is an increase, then the c-arm has to be recalibrated.
- The staff members should use monitor tags on the lead aprons.
- Education plays a key role in reducing and monitoring the amount of exposure
- A qualified professional such as radiological physicist, health physicist or radiologist should train the staff.
Additional Safety Tips
- Check for any damages. In case, the fittings or c-arm is damaged, the intensifier and the x-ray tube could become misaligned. This results in image degradation and also there is a risk of potential injury to both the patient and the staff.
- Pulsed fluoroscopy, manual mode, last image hold, fluoroscopy timer warning and single pulse fluoroscopy are good safety practices.
- Structural shielding should also be implemented.
A variety of refurbished or used C arms are available from manufacturers in this business. The skilled sales staff will provide necessary guidelines to make the smartest purchase within your budget.