Radiation Badges: Have Em?

[Coastie]

If not, why not?

If so, what happens when you reach "the limit", whatever that might be?

Should the ASA come out with a practice statement on wearing radiation badges?

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[Salt Creep]

Don't have them here (not for us anyway). I'd really prefer to consistently be able to find a freakin thyroid shield at our hospital. I end up holding the apron up to my chin while I'm charting because the things are nowhere to be seen.

 

[IlDestriero]

If not, why not?

If so, what happens when you reach "the limit", whatever that might be?

Should the ASA come out with a practice statement on wearing radiation badges?

I wear mine every day, per policy, changing it out when a new one appears in my mailbox. I've never had any feedback at all. Ever.
I feel safe.

 

[IlDestriero]

Don't have them here (not for us anyway). I'd really prefer to consistently be able to find a freakin thyroid shield at our hospital. I end up holding the apron up to my chin while I'm charting because the things are nowhere to be seen.

Just buy your own lead. It's not very expensive.

 

[urge]

If not, why not?

If so, what happens when you reach "the limit", whatever that might be?

Should the ASA come out with a practice statement on wearing radiation badges?

My guess is hospitals monitor you so you cannot sue them in the future when you develop cancer.

Being unmonitored will become handy to you when you are getting chemo.

 

[urge]

Just buy your own lead. It's not very expensive.

While you are at it buy your own tape, ett, laryngoscope, ekg pads....

 

[IlDestriero]

While you are at it buy your own tape, ett, laryngoscope, ekg pads....

He can't find a thyroid shield, so there's the solution to bypass the problem forever. I'm guessing complaining to the DH, Head of radiation safety, etc has already failed. 90% of our lead has a thyroid shield attached. 100% in IR. He could also just keep complaining, but avoiding thyroid cancer is probably worth $500. Maybe he could just buy a thyroid shield. I bet they sell them alone.

 

[IN2B8R]

If not, why not?

If so, what happens when you reach "the limit", whatever that might be?

Should the ASA come out with a practice statement on wearing radiation badges?

You turn into KFC chicken.
No, actually, here's a helpful table for you:


Effect Single Dose Threshold (Gy) Onset Peak

Early Transient Erythema 2 hours -24 hours
Main Erythema 6 -10 days -2 weeks
Temporary Epilation 3 -3 weeks N/A
Permanent Epilation 7 -3 weeks N/A
Dry Desquamation 10 -4 weeks -5 weeks
Moist Desquamation 15 -4 weeks -5 weeks
Secondary Ulceration 20 >6 week -
Late Erythema 15 6-10 week -

Main point: stay away from radiation. Distance and correct attire is your best protection.

 

[rsgillmd]

You turn into KFC chicken.
No, actually, here's a helpful table for you:


Effect Single Dose Threshold (Gy) Onset Peak

Early Transient Erythema 2 hours -24 hours
Main Erythema 6 -10 days -2 weeks
Temporary Epilation 3 -3 weeks N/A
Permanent Epilation 7 -3 weeks N/A
Dry Desquamation 10 -4 weeks -5 weeks
Moist Desquamation 15 -4 weeks -5 weeks
Secondary Ulceration 20 >6 week -
Late Erythema 15 6-10 week -

Main point: stay away from radiation. Distance and correct attire is your best protection.

Interesting numbers. I did not know them. I'd also add a comment made by several of my attendings: 6 feet is like an inch of lead. So just increase your distance if you can.

 

[IN2B8R]

Interesting numbers. I did not know them. I'd also add a comment made by several of my attendings: 6 feet is like an inch of lead. So just increase your distance if you can.

Are you flouroscopy credentialled at your institution? I am, as I do some chronic pain....

 

[Salt Creep]

Maybe he could just buy a thyroid shield. I bet they sell them alone.

That's been done; it's currently en route to me via Fed Ex.

I just don't think a resident should be forced to purchase his own radiation safety equipment, and I suspect OSHA would agree. While undeniably there was a degree of whining in my post, the larger reason for saying that was to see if anybody else expressed the same problem.

Incidentally, in IR all of the aprons/vests have thyroid shields attached. I think there are about 5 total in the ORs (22 ORs with about 4 using fluoro at any given time)

 

[rsgillmd]

Are you flouroscopy credentialled at your institution? I am, as I do some chronic pain....

No. Haven't done chronic pain in about 2 years. In the procedure room we wore the standard lead and thyroid shield. Those rooms were too tiny for anyone in there to be at a safe distance.

Unfortunately my knowledge of the adverse effects of different degrees of radiation is limited to a lecture by a radiologist in residency. That's why I found your numbers interesting and helpful.

 

[rsgillmd]

That's been done; it's currently en route to me via Fed Ex.

I just don't think a resident should be forced to purchase his own radiation safety equipment, and I suspect OSHA would agree. While undeniably there was a degree of whining in my post, the larger reason for saying that was to see if anybody else expressed the same problem.

Incidentally, in IR all of the aprons/vests have thyroid shields attached. I think there are about 5 total in the ORs (22 ORs with about 4 using fluoro at any given time)

We had a similar problem at my residency program -- relative shortage of lead. During my last year the program started ordering lead for the incoming residents. I filled out the form also, but never got anything.

 

[rsgillmd]

Are you flouroscopy credentialled at your institution? I am, as I do some chronic pain....

IN2B8R, is there a difference is protection based on the color? The only reason I ask is because I was told don't wear the yellow lead. What's the point in creating lead aprons that don't provide adequate protection?

 

[urge]

IN2B8R, is there a difference is protection based on the color? The only reason I ask is because I was told don't wear the yellow lead. What's the point in creating lead aprons that don't provide adequate protection?

Some are thinner than others. I don't think it is color coded. Read the labels on aprons.

 

[IN2B8R]

IN2B8R, is there a difference is protection based on the color? The only reason I ask is because I was told don't wear the yellow lead. What's the point in creating lead aprons that don't provide adequate protection?

As mentioned, some are thinner than others. Your best protection is an appropriately fitted, thick apron with a thyroid sheild. Remember: radiation harms fast metabolizing/replicating tissues. That's where the DNA is most vulnerable and where damage can occur. Also, X-rays ionize human tissue and deposit energy. The concentration of energy deposited in tissue is called the absorbed dose and provides an important measure of the potential for biological effects. A standard lead apron, with 0.5 mm of lead, will shield the wearer from approx. 90% of the scatter x-rays. In addition to being positioned behind a barrier, you should position yourself as far from the patient and beam as possible. The dose drops inversely with the square of distance.