The units Sievert (Sv) and Roentgen equivalent man (Rem) are used to measure the equivalent dose. The units Gray (Gy) and Rad are used to measure the absorbed dose, that is the amount of physical energy that is deposited in matter.
There are several units of measurement that need to be understood when describing radiation exposure. This pattern of deflection, or scatter, produces a field of radiation that is responsible for the incidental radiation exposure to the surrounding staff. X-rays that are not absorbed are deflected and continue on with lower energy. X-rays that pass through the patient and reach the x-ray detector, result in formation of a radiographic image. The x-rays interact with bone, soft tissue, and air within the patient resulting in different patterns of x-ray distribution. The function of each part is outlined in Table 1. Figure 1 diagrams the basic parts of a c-arm unit. X-rays are created by the interaction of electrons with matter, with conversion of some of their kinetic energy into electromagnetic radiation. The external power source creates an electrical potential difference within a vacuum and is responsible for the acceleration of electrodes as they travel from the cathode to the anode. A cathode acts as the source of electrons, while the anode is the target of the electrons. Basics of radiationĪ fluoroscopic unit consists of an electron source, an evacuated tube, a target electrode and an external power source. These studies demonstrate a clear need for additional education in radiation safety for residents. Only 18% of respondents reported reading any literature on radiation safety during their training. Ī second study of basic surgical trainees also demonstrated a lack of knowledge and adherence to techniques in order to decrease radiation exposure. Common barriers to adherence to safety protocols included unavailability of protective equipment or the thought that the protocols were unnecessary. Surprisingly, 62% of respondents did not believe any additional protection was required in pregnancy. 96% of respondents used lead aprons, but a much lower percentage used thyroid shields or dosimeters. 69% were aware of the As Low As Reasonably Achievable (ALARA) principle to reduce radiation exposure. Only 65% of trainees reported attending a radiation safety course at some point in their training. A recent survey of Irish Orthopaedic trainees demonstrated low compliance with several important techniques in reducing radiation exposure. Radiation safety and proper c-arm use instruction varies greatly from residency training site to residency training site. Current protocols for intraoperative radiation safety in orthopaedic training
A 0.5 MM THICK LEAD APRON REDUCES SCATTER RADIATION HOW TO
This review article will outline the basics of fluoroscopy and educate on how to best utilize this tool. Many training sites have no orthopaedic training in radiation safety. Furthermore, there is no standardized curriculum in orthopaedic residency training in teaching radiation safety. Currently, there are no universally accepted guidelines for minimizing radiation exposure in the operating room. Effective communication with the technician allows efficient acquisition of images with decreased risk to the patient and staff. By learning the basics of how a c-arm operates, one may better understand how to obtain useful images. Although fluoroscopy is utilized on a daily basis, there is a paucity of knowledge by the average orthopaedic trainee in terms proper usage and safety. One of the most valuable tools in an orthopaedic surgeon’s armamentarium is the fluoroscopic imaging (c-arm) unit. This review article will outline the basics of fluoroscopy and educate the reader on how to safe fluoroscopic image utilization. In Europe, studies have also exhibited a lack of standardized teaching on the basics of radiation safety in the operating room. Currently, in the United States, guidelines for teaching radiation safety in orthopaedic surgery residency training is non-existent. This knowledge ensures that the amount of radiation exposure is as low as reasonably achievable.
Personal protective equipment, proper positioning, effective communication with the radiology technician are just of few of the ways outlined in this article to decrease the amount of radiation exposure in the operating room. There is a paucity of knowledge by the average orthopaedic resident in terms proper usage and safety. The benefits of fluoroscopy are not without risk of radiation to patient, surgeon, and operating room staff. The use of fluoroscopy has become commonplace in many orthopaedic surgery procedures.
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