Week 2 :Radiation Protection RTEC 111 Bushong Ch 1 & 38

Do I have your attention?

Why are x-rays harmful?

Reduction of Occupational Radiation Exposure Radiography as a profession is very safe .. if you follow the ALARA rules Most technologist exposure occurs from fluoroscopy exams and mobile exams During all fluoroscopy and mobile exams technologists should wear a protective apron The primary beam should never be pointed at the tech or other staff… primary at the patient!

ALARA ALWAYS KEEP RADIATION EXPOSURES AS LOW AS REASONABLY ACHIEVABLE Can you think of ways to do this?

CARDINAL RULES OF RADIATION PROTECTION Time Distance Shielding

TIME The exposure is to be kept as short as possible because the exposure is directly proportional to time. 20 mrem = 2min 10 mrem = 1min

DISTANCE Distance from the radiation source should be kept as great as possible Physical Law: Inverse Square Law

INTENSITY IS SPREAD OUT…

Position When primary beam is on.. Your distance should be kept as great as possible The dead man foot or hand switch should be used sparingly The closer you are to the patient or primary beam the more exposure you are receiving.

Holding patients ECC policy: STUDENT RADIOGRAPHERS ARE NOT PERMITED TO HOLD PATIENTS FOR PROPER POSITIONING DURING EXPOSURES Mechanical devices should be used

Immobilization

Holding patients Otherwise, a relative or friend accompanying the patient should be asked to help Occasionally, other hospital employees such as nurses and orderlies may be asked to help Radiology staff should never hold patients

If holding a patient is required… Use shielding Apron, gloves, thyroid shield, glasses Avoid exposing assisting person to the primary beam.

SHIELDING A lead protective shield is placed between the x-ray tube and the individuals exposed, absorbing unnecessary radiation

Primary Barriers

SHIELDING TECHNOLOGIST . 25 mm LEAD LEAD APRON, GLOVES THYROID SHIELD, GLASSES PATIENT – GONAD SHEILDING . 5 mm LEAD

GONAD SHIELDING MUST BE . 5 MM OF LEAD MUST BE USED WHEN GONADS WILL LIE WITHING 5 CM OF THE COLLIMATED AREA (RHB) KUB. Lumbar Spine Pelvis male vs female shielding

TYPES OF SHIELDING Flat or contact Shaped Shadow

Flat/Contact

Shadow Shield

Your first exam! 2V CXR A wrap-around apron would be better Why?

Minimizing radiation exposure Is easy the equipment is designed to !! Filtration Intensifying screens Protective barriers Mechanical restraining devices

Filtration REDUCES PATIENT EXPOSURES REMOVES LOW ENERGY PHOTONS

Minimizing radiation exposure Is easy when technologist and student technologist are informed! Collimation Protective apparel/Gonadal shielding

Permissible Occupational Dose Annual dose: 5 rem / year 50 mSv / year Cumulative Dose 1rem x age 10mSv X age

Occupational Dose ANNUAL LIMITS WHOLE BODY = 5 rem / 5000 mRem LENS OF THE EYE = 15 rem EXTREMITIES = 50 rem

OCCUPATIONAL EXPOSURES 5 rem / YEAR BUT NOT TO EXCEED 1.25 rem/QUARTER OLD “MPD 5(Age – 18)”

PUBLIC EXPOSURE 10 % OF OCCUPATIONAL NON MEDICAL EXPOSURE (MUST BE MONITORED IF ABOVE 10%) NON MEDICAL EXPOSURE .1 rem OR 100 mrem OR 1 mSv (Freq) .5 rem OR 500 mrem OR 5 mSv (Infreq) UNDER AGE 18 & STUDENTS .1 rem OR 1 mSv

Personnel Monitoring Devices Film Badges TLD / OSL Pocket Dosimeter Ring Badge

Occupational radiation monitor does NOT protect against radiation exposure!

Occupational radiation monitor Should be a life time dose record Should NOT be worn when YOU are the patient Should be left at the hospital for safe keeping Should be stored in a radiation free area

Pregnancy & Embryo Mother – occupational worker (5 rem) Baby – (500 mrem) .5 rem/ year .05 rem/month 5 mSv .5 mSv / month

Declared Pregnant Worker Must declare pregnancy – 2 badges provided 1 worn at collar (Mother’s exposure) 1 worn inside apron at waist level Under 5 rad – negligible risk Risk increases above 15 rad Recommend abortion (spontaneous) 25 rad

Fetal Exposure (“Baby exposure” approx 1/1000 of ESE) ALWAYS ASK LMP before exposure made … any females that could be exposed to primary or scatter

Reduction of unnecessary patient dose Unnecessary exam If the order is unclear…clarify If the order is wrong.. Fix it Repeat exams

Patient Positioning When ever possible primary exposure to the gonads, breasts, lenses of the eyes and thyroid should be avoided. Especially female patients… perform exams PA as apposed to AP PA = posterior anterior AP = anterior posterior

I don’t think so…..

That’s all folks….Questions?