Radiation Safety in Fluroscopy

Time, distance, and shielding are the three basic guides that could and should be taken for radiation safety. First and foremost, do not allow any unauthorized visitors during x-ray exams. Only individuals required for the radiographic procedure should be present in the radiographic room during exposures.

Timing. As we mentioned before, with timing, shorter fluoro times can be achieved when the physician uses intermittent fluoroscopy. Also, analyze original radiographs before performing a fluoroscopic examination. Viewing original radiographs, especially for orthopedic studies, can dramatically reduce the repeat rate for the time required for procedures.

Distance. Observers should stand on the image intensifier side of the C-arm if possible, to avoid radiation leakage from the x-ray tube. When not assisting, step away from the patient during fluoro, as feasible. Stepping even one foot further back can significantly reduce a person’s dose.

Shielding. In interventional fluoroscopy procedures the tissue of concern is the skin. The skin that is at the site where radiation enters the body receives the highest dose than any other body tissue. All workers in the x-ray room during studies must have a lead apron, and other appropriate shielding wear.

Lead Apron and Thyroid Shields. Verify that the apron is 0.5 mm lead equivalent, and be sure aprons and shields are in good condition (remove any damaged ones). Insist on well fitting protective gear with a weight your body can handle. Hang aprons and shields on racks. Do not bend or fold them as this can cause cracks and tears in the protective material, making exposed body parts susceptible to radiation.

Wrap-around Apron. When wearing lead aprons, it is imperative to keep the lead between you and the x-ray tube. Meaning, do not turn your unshielded back to the x-ray tube. If you do need to move about the room where exposing your back may be likely, insist on using a wrap around style apron.

Leaded Eyeglasses. Those who routinely fluoro for long or interventional procedures, lead glasses with side shields can provide additional protection to the lens of the eyes. Remember, you may need to look sideways from the C-arm x-ray tube to see the image on the monitor, which will leave the lens unprotected if glasses do not have side shields.
Leaded Gloves. Lead gloves are required if hands are potentially close to or in the primary beam.