Literature DB >> 34405852

Establishing ionising radiation safety culture during interventional cardiovascular procedures.

Belinda van der Merwe1.   

Abstract

INTRODUCTION: The safety culture of an interventional laboratory was investigated in terms of the application of the three cardinal principles of radiation protection, namely distance, time and shielding.
METHODS: The application of these principles was observed and recorded with a radiation safety-culture checklist that was compiled by consulting international recommendations. The checklist evaluated the optimal compliance, especially with reference to monitoring of staff exposure, distance from the X-ray source, fluoroscopy techniques pertaining to frame rate, protective devices and personal shielding. The effective radiation dose was measured to the eyes, thyroid, hands and feet of the cardiologist, nurse, floor nurse and radiographer by means of finger dosimeters that were readily available from the local radiation-protection dosimetry service.
RESULTS: The results, after observing 11 procedures, indicated the absence of table and ceiling-suspended shields, and the distance of the cardiologist's and scrub nurse's feet from the X-ray tube were between 16 and 68 cm, with a mean distance of 59.7 and 58.5 cm, respectively. Most staff (91%) wore the dosimeter inside the lead apron at the collar level without eye protection. The highest dosimeter values recorded were 0.73 mSv to the hand of the cardiologist, 0.45 mSv to the eye of the cardiologist, 0.65 mSv to the hand of the scrub nurse, 0.54 mSv to the eye of the scrub nurse and 0.52 mSv to the foot of the scrub nurse. The dosimeter value to the radiographer's thyroid was 0.42 mSv.
CONCLUSIONS: The dosimeter readings confirmed the highest doses were to the scrub nurse and hand of the interventionalist. The safety culture was non-compliant in terms of staff distance being too close to the X-ray tube, the absence of ceiling and table screens, the theatre door not always being completely closed, and for staff without lead eye glasses, wearing dosimeters outside the lead apron at the collar level.

Entities:  

Keywords:  cardiovascular; interventional; occupational exposure; radiation safety

Mesh:

Year:  2021        PMID: 34405852      PMCID: PMC8756052          DOI: 10.5830/CVJA-2021-030

Source DB:  PubMed          Journal:  Cardiovasc J Afr        ISSN: 1015-9657            Impact factor:   1.167


  20 in total

1.  Approaches to enhancing radiation safety in cardiovascular imaging: a scientific statement from the American Heart Association.

Authors:  Reza Fazel; Thomas C Gerber; Stephen Balter; David J Brenner; J Jeffrey Carr; Manuel D Cerqueira; Jersey Chen; Andrew J Einstein; Harlan M Krumholz; Mahadevappa Mahesh; Cynthia H McCollough; James K Min; Richard L Morin; Brahmajee K Nallamothu; Khurram Nasir; Rita F Redberg; Leslee J Shaw
Journal:  Circulation       Date:  2014-09-29       Impact factor: 29.690

2.  Occupational dose constraints in interventional cardiology procedures: the DIMOND approach.

Authors:  Virginia Tsapaki; Sophia Kottou; Eliseo Vano; Tuomo Komppa; Renato Padovani; Annita Dowling; Michael Molfetas; Vassiliki Neofotistou
Journal:  Phys Med Biol       Date:  2004-03-21       Impact factor: 3.609

3.  Radiation dose to surgeons in theatre.

Authors:  B van der Merwe
Journal:  S Afr J Surg       Date:  2012-03-29       Impact factor: 0.375

Review 4.  A summary of recommendations for occupational radiation protection in interventional cardiology.

Authors:  Ariel Durán; Sim Kui Hian; Donald L Miller; John Le Heron; Renato Padovani; Eliseo Vano
Journal:  Catheter Cardiovasc Interv       Date:  2012-11-08       Impact factor: 2.692

5.  Occupational health hazards in the interventional laboratory: time for a safer environment.

Authors:  Lloyd W Klein; Donald L Miller; Stephen Balter; Warren Laskey; David Haines; Alexander Norbash; Matthew A Mauro; James A Goldstein
Journal:  Radiology       Date:  2009-02       Impact factor: 11.105

6.  Assessing doses to interventional radiologists using a personal dosimeter worn over a protective apron.

Authors:  E Stranden; A Widmark; T Sekse
Journal:  Acta Radiol       Date:  2008-05       Impact factor: 1.990

Review 7.  ICRP PUBLICATION 120: Radiological protection in cardiology.

Authors:  C Cousins; D L Miller; G Bernardi; M M Rehani; P Schofield; E Vañó; A J Einstein; B Geiger; P Heintz; R Padovani; K-H Sim
Journal:  Ann ICRP       Date:  2013-02

Review 8.  Radiation effects in fluoroscopically guided cardiac interventions--keeping them under control.

Authors:  Madan M Rehani; Pedro Ortiz-Lopez
Journal:  Int J Cardiol       Date:  2005-07-19       Impact factor: 4.164

9.  The radiation issue in cardiology: the time for action is now.

Authors:  Eugenio Picano; Eliseo Vano
Journal:  Cardiovasc Ultrasound       Date:  2011-11-21       Impact factor: 2.062

10.  Radiation safety: time to act.

Authors:  S C Brown
Journal:  Cardiovasc J Afr       Date:  2017 May/Jun       Impact factor: 1.167

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