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Radiation Alert!!!

Discussion in 'Pain Medicine' started by algosdoc, Aug 6, 2006.

  1. algosdoc

    algosdoc algosdoc
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    At the most recent ISIS conference, I measured radiation levels at different locations during real time fluoroscopy. The results will be submitted for publication soon, but I would strongly suggest buying protective eyeware and thyroid shields, if not static face shields. The amount of radiation exposure to the eyes and thyroid are well above that of the rest of the body during lumbar contralateral 45 degree oblique beam rotation (beam pointing away from the physician) and cross table lateral procedures. Also, any cervical procedure in all rotations and AP causes higher exposure to the eyes than any other part of the body.
    I suggest immediate purchase of eyeware and face shielding for all procedures.
     
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  3. lobelsteve

    lobelsteve SDN Lifetime Donor
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    I've been getting on the current fellows to not wear the gloves, but they don't like to listen. I'd sit across the table from them and watch the mA climb whenever their "protective" gloves got in the field. The scatter must be amazing. I wish I had some of those Ghostbusters style spectrum analyzers to watch the Xrays bounce of their gloves and scatter into their eyes and thyroids.

    It's too bad you can't feel low dose radiation so you could be warned of the long term consequences.

    Put down the gloves or let me leave the room.
     
  4. Ligament

    Ligament Interventional Pain Management
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    My prescription won't work for leaded glasses. I'm interested in getting a face shield. Does anybody have any recommendations, places to buy, what to look for in a comfortable face sheild? thanks!
     
  5. Happy613

    Happy613 Senior Member
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  6. drusso

    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

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    Wow, the Gonadal shields look fun!
     
  7. wonthurtabit1

    wonthurtabit1 Member
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    I have to find the vendor, but at ISIS, I saw some great lead "cut-outs" in the shape of a body. You can put the shield up to the table, and reach around it's waist to work. Conceivably, you don't have to wear a lead apron.
     
  8. octrode

    octrode Junior Member
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    It's too bad you can't feel low dose radiation so you could be warned of the long term consequences.

    How about get off the pedal and keep your hands out of the beam!
    AND get some low dose C-arms Windsor.
     
  9. algosdoc

    algosdoc algosdoc
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    All C-arms can be low dose...for those without a single button setting for such, all one needs do is switch to manual operation and dial down the mA, then readjust the brightness and contrast.
    Not all the low dose machines actually produce low dose and one company's machine may produce 1/3 the standard dosage as the next company.
    Staying off the pedal is a great idea, but I would recommend not letting the fluoro tech run the machine since inevitably they will irradiate you with your hands in the beam. Also, it is astonishing how little most x-ray techs know about c-arm fluoroscopy, scatter radiation, methods of dose and scatter reduction (such as moving the beam as far below the patient as possible) etc.
     
  10. f_w

    f_w 1K Member
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    I guess studying for the physics section of the radiology boards wasn't entirely wasted after all.

    Unfortunately, outside of california, anyone who wants to can put his foot on the fluoro pedal whether they have a basic understanding of radiation protection and the function of fluoro equipment or not.

    E.g. it is not the x-rays bouncing off your gloves that increase your dose, it is the automatic brightness control trying to compensate for this apparent increase in object density (and by ramping up the mA increasing the scatter caused from within the patient).

    Keep your paddels out of the beam, learn to guide a needle with a hemostat and finally: buy some decent equipment (and then there is of course time, distance and shielding).
     
  11. spinepain

    spinepain Junior Member
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    What are the advantages of using a hemostat to guide the needle?
     
  12. f_w

    f_w 1K Member
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    It allows you to keep your fingers out of the beam while advancing under direct sight.
     
  13. spinepain

    spinepain Junior Member
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    We always use pulsed when advancing the needle. Under what circumstances do you use continuous?
     
  14. f_w

    f_w 1K Member
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    'Pulsed' as in 'pulsed fluoroscopy' or as in moving needle, tap on pedal, move needle etc. ?
     
  15. spinepain

    spinepain Junior Member
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    Yes - move needle, tap pedal, etc.
     
  16. Mister Mxyzptlk

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    Ok, I tapped the pedal. Now what?
     
  17. f_w

    f_w 1K Member
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    'pulsed fluoroscopy' is a radiation sparing mode available on fluoro equipment with a grid-controlled tube. Instead of recording 30 frames/second, you can dial down the rate to 15 or 8. Instead of a continuous x-ray beam, the machine emits brief 10ms pulses to create sort of a cinematic recording. Depending on the type of equipment, this can reduce the dose by 30-50% (some people don't like the 'jerky' picture, but you get used to it).
     
  18. Doctodd

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    pulsed all the way.......unfortunatley it is the only critique i have of the OEC8800's....they have low dose which cuts down rads by 33% but they dont have a pulsed mode.

    T
     
  19. jonesing

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    try radmart.com also.
     

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