Radiation from OR

[talia whiter]

So I completed an Anesthesiology rotation and it was great! I loved it and learned so much! What worries me is that I sat in on many neurosurgery cases where they use X-rays.

I wore the lead shields and thyroid shields but I think i may have been exposed when I turned around to get some meds for the patient and they performed an xray.

I think I was exposed couple of times when I had my back turned and I was not covered on the back.

I am getting worried about radiation exposure. Anyone else have similar experience?

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[pgg]

If you were more than about 6 feet away and the beam wasn't aimed at you, your exposure was very likely negligible.

 

[somedumbDO]

So I completed an Anesthesiology rotation and it was great! I loved it and learned so much! What worries me is that I sat in on many neurosurgery cases where they use X-rays.

I wore the lead shields and thyroid shields but I think i may have been exposed when I turned around to get some meds for the patient and they performed an xray.

I think I was exposed couple of times when I had my back turned and I was not covered on the back.

I am getting worried about radiation exposure. Anyone else have similar experience?

Do you glow in the dark?

 

[inmyslumber]

So I completed an Anesthesiology rotation and it was great! I loved it and learned so much! What worries me is that I sat in on many neurosurgery cases where they use X-rays.

I wore the lead shields and thyroid shields but I think i may have been exposed when I turned around to get some meds for the patient and they performed an xray.

I think I was exposed couple of times when I had my back turned and I was not covered on the back.

I am getting worried about radiation exposure. Anyone else have similar experience?

Before an X-Ray is taken, the tech or surgeon should announce "shot" or "X-ray" or something similar. If you pay attention and/or listen, your back should not be turned at the time the X-Ray is taken. There are also gowns that can cover your back. They are heavier but worth it if you are worried about exposure.

Like previous poster said, distance is key to level of exposure.

 

[Biochemist21]

I think about this exact problem every time I'm in one of the vascular rooms since they're almost always using lots of fluoro. At least on vascular, they're using the xray so much that they don't pause to say anything when they're about to shoot it. It seems like every time I turn around for some drugs from the Pixis I hear them start shooting. We do have some 360deg lead vests, but they are few and far between.

I agree that you raise a good point, but from a radiation exposure standpoint, those teenage years I spent as a lifeguard concern me much more than the collective 20-30hrs I've spent in the vascular suites .

 

[C.P.]

It's a really important issue. An "invisible" one too. Radiation in the OR is a poorly monitored risk. Radiographers go through extensive training and are meant to ensure the safety of anyone in the vicinity of exposure, but as we've all seen, they're more often than not the silent operator in the room.

You should bring this up to your department, just as an interesting point for a grand rounds or an inservice.
As it has been mentioned, on a standard C-Arm, anything past 6 feet and you should have close to zero exposure, but that changes a lot if it's not a c-arm (cath lab, angio suite, etc).
When you're dealing with vascular patients, interventional neuro cases, etc, we're often running around the patient, holding things together.
This is when your exposure becomes questionable and likely dangerous.


Please, please, please, respect the radiation risk.

Everyone is fairly nonchalant about it, but it's serious.

We just had a "situation" a month ago, where one of our attendings was limping a cardiac cripple through a complicated and long cerebral aneurysm coiling, spending a lot of time near the head of the bed.

I'm not sure of the details, but apparently one of the radiologists wandered by and noticed where she was (she was wearing full lead), asked her how long she had been sitting there, and then emergently had her switched out and started her on some protocol for radiation toxicity. (She was there at the emitter for over half and hour).

We are supposed to wear radiation badges, but those only tell you how much radiation you've been exposed to. . . and that's if you wear them. They do nothing to tell you when you're being exposed.

One of the angio suites I work in has real time, digital monitors which show your radiation exposure, alarming when it "redlines"
We wear one on the inside and outside of our lead.

Red on the outside: move your ass.
Red on the inside: don't have kids.

But this is only in one room, and we have nothing like this for all the other areas we deal with x-ray emitters.


I genuinely feel we're going to look back on this like people look back on asbestos and question what the hell we were thinking.

 

[norwood]

We are supposed to wear radiation badges, but those only tell you how much radiation you've been exposed to. . . and that's if you wear them. They do nothing to tell you when you're being exposed.

One of the angio suites I work in has real time, digital monitors which show your radiation exposure, alarming when it "redlines"

Good luck getting a radiation badge, much less a real-time digital one, at most ORs in the States. I had requested one at a previous job and was pretty much laughed off, on the grounds that I wouldn't be exposed enough. IMHO you are absolutely right.

To the OP, a few X-rays (vs. prolonged fluoro time) are no big deal. In future, listen for the announcement.

Pregnant residents and CRNAs can request (and get) rooms w/o radiation in use. Pregnant MDs, not always but we try to work around it.

 

[rsgillmd]

We did a ton of vascular cases in residency. Always wore lead, and in my 2nd year got radiation badges. People were pretty good about wearing them. They were exchanged each month. To my knowledge nobody's badges were ever read as having had excess exposure. As others have said, be cautious, but I wouldn't lose sleep over it.

 

[pastafan]

Good luck getting a radiation badge, much less a real-time digital one, at most ORs in the States. I had requested one at a previous job and was pretty much laughed off, on the grounds that I wouldn't be exposed enough. IMHO you are absolutely right.

To the OP, a few X-rays (vs. prolonged fluoro time) are no big deal. In future, listen for the announcement.

Pregnant residents and CRNAs can request (and get) rooms w/o radiation in use. Pregnant MDs, not always but we try to work around it.

State laws regulate radiation exposure. Radiation badges are not optional. Google your state regs. You can spring for www.instadose.com for $100 per year and monitor yourself with a usb readable badge. Report the hospital to the state for violations.

Get educated. There are resources to learn about radiation safety and how to minimize OR exposure. Most physicians that use fluoro don't have a clue about the machine and techniques that are used. The more you know the scarier common practice becomes. Not only are folks putting themselves at risk but they make their jobs tougher due to suboptimal imaging.

 

[Sharps]

I use fluoro all day long, have researched this extensively. Trust me you're fine. Reminds me of all the ailments we had when studying path that went away with completing the course

 

[Guy Caballero]

We just had a "situation" a month ago, where one of our attendings was limping a cardiac cripple through a complicated and long cerebral aneurysm coiling, spending a lot of time near the head of the bed.

I'm not sure of the details, but apparently one of the radiologists wandered by and noticed where she was (she was wearing full lead), asked her how long she had been sitting there, and then emergently had her switched out and started her on some protocol for radiation toxicity. (She was there at the emitter for over half and hour).

Something about this story seems a bit odd. I realize that you are in a different country and things may be done differently there. I am not sure if "half and hour" is a half hour or an hour and a half, but even still, people frequently have much longer exposures with no problems and no high readings on their badges. You seem to be treating it as if it was like a scene from Chernobyl, where a glowing anesthesiologist was escorted from a room and started on emergency treatment for radiation poisoning. From what you described, this response is quite a bit of overkill. I suspect the radiation dose a person gets from a single CT is quite a bit higher than this anesthesiologist, wearing full lead, received.

 

[GaseousClay]

I have been more conscious about my X-ray exposure in the OR but I realize now that we never get any protection for our eyes. Do you guys worry about radiation exposure to your eyes? Nobody really provides lead glasses in the OR.

 

[pgg]

I have been more conscious about my X-ray exposure in the OR but I realize now that we never get any protection for our eyes. Do you guys worry about radiation exposure to your eyes? Nobody really provides lead glasses in the OR.

Our pain guys always worried about cataracts and wore leaded glasses. But they're standing over the patient, 2' from the emitter, and fluoro'ing all the time. (I'm not really sure how much exposure the glasses actually cut down, since they look at the monitor and not the emitter when the thing is beeping, and the sides of the glasses are open.)

At the usual anesthesiologist distance and with the usual orientation of the C-arm, I don't worry about eye exposure. I wear lead (including thyroid shield) and that's it.