FOUR CATEGORIES OF SAFETY

Transcription

1 OCTOBER 2013

2 FOUR CATEGORIES OF SAFETY DOSIMETRY PERSONAL SAFETY EQUIPMENT EQUIPMENT KNOWLEDGE PHYSICAL SAFETY

3 DOSIMETRY THERMAL LUMINISCENT DEVICES AND FILM BADGES

4 CNSC PERMISSIBLE DOSES WHOLE BODY DOSE 20mSV/Yr WITH A LIMIT OF 100mSV OVER 5 YEARS 50mSV ANY GIVEN YEAR WITHIN A 5 YEAR PERIOD STILL NOT TO EXCEED 100mSV EXTREMITY DOSE 140mSV/Yr

5 GENERAL PUBLIC 1mSV/Yr BACKGROUND RADIATION CANADIAN AVERAGE 2.2 msv/yr OTTAWA 2.8mSV/Yr

6 RADIATION PROTECTION BUREAU REQURIES THAT HEALTH CARE WORKERS BE MONITORED WHEN THEY ARE WORKING WITH RADIATION CLASSIFIED AS AN X RAY WORKER LEGALLY RECEIVE TWENTY (FIFTY) TIMES THE WHOLE BODY YEARLY DOSE THAT THE GENERAL PUBLIC CAN RECEIVE HOW MUCH WILL YOU ACTUALLY RECEIVE?

7 TLD/FILM BADGES CHANGED QUARTERLY RESULTS SENT TO THE RADIATION PROTECTION OFFICE AND TO THE WORK AREA EXPECTED QUARTERLY DOSE FOLLOWING SAFE PRACTICES WHOLE BODY/TORSO ONE msv HEAD/COLLAR ONE TWO msv

8 QUARTERLY READING ELEVATED ALLOWS FOR REVIEW OF SAFETY PRACTICES AND MAKE YOUR WORK ENVIROMENT SAFER FOR YOU LIFE LONG REGISTRY FOR THE AMOUNT OF RADIATION RECEIVED (FOLLOWS ACROSS CANADA AND CAN BE SENT TO OTHER COUNTRIES)

9 PERSONAL SAFETY EQUIPMENT

10 MANY STYLES OF LEAD APRONS ONE PIECE, TWO PIECE, HALF, WRAP AROUND LITE APRONS ULTRA LITE APRONS NON LEAD RARE EARTH APRONS

11 PROVINCE REGULATES WHAT IS A SAFE APRON MOST COMMON: 0.5 mm of lead in the front and 0.25 mm of lead in the back RADIATION ATTENUATION 90% at 120 kv 93 % at 100 kv 96% at 80 kv

12 NON LEAD RARE EARTH RADIATION ATTENUATION 76% at 120 kv 85% at 80 kv THE KV RANGE DURING FLUOROSCOPY kv THE KV RANGE DURING SERIAL MULTI FRAME IMAGING kv

13 THYROID SHIELD 0.5 mm OF LEAD SAME RADIATION ATTENUATION AS THE LEAD APRON

14 LEAD GLASSES NO REGULATIONS ON THE AMOUNT OF LEAD FOR ATTENUATION RECOMMEND 0.75 mm

15 MAINTAINING PROTECTION HANG UP YOUR APRON DO NOT SIT ON OR FOLD YOUR APRON HAVE THE APRON INSPECTED YEARLY CLEAN THE APRON PROPERLY

16

17

18 SHIELDING

19 SHIELDING

20 EQUIPMENT KNOWLEDGE WHAT ARE YOU USING IMAGE INTENSIFIER OR FLAT PLATE DECTECTOR SYSTEM WHAT ARE YOUR R VALUES WHAT ARE YOUR CINE/IMAGING SETTINGS

21 FLOOR MOUNTED SINGLE PLANE

22 CEILING MOUNTED SINGLE PLANE

23 C ARM IMAGE INTENSIFIER

24 INVERSE SQUARE LAW

25

26 EXPOSED PROCEDURE ROOM ELECTROPHYSIOLOGY SUITES CATHERIZATION SUITES MOBILE X RAYS BEDSIDE PROCEDURES OPERATING ROOMS

27 SAFETY MEASURES EQUIPMENT PURCHASES EQUIPMENT MODIFICATIONS EXPOSURE REDUCTION SOFTWARE PROGRAMMED DEFAULTS PREVENTATIVE MAINTENANCE QUALITY ASSURANCE PROGRAM TLD REVIEW RADIATION SAFETY OFFICE EDUCATION

28 FLUOROSCOPY AND CINE ALARA PRINCIPLE Use a pulsed fluoroscopy 3 15 fps Choose a low dose fluoroscopy setting kv ma

29 PROJECTION AND DOSE RAO RAO CRANIAL AND CAUDAL ANGULATION LAO LAO CRANIAL AND CAUDAL ANGULATION LATERAL LEFT AND RIGHT

30 Whenever possible use the store fluoro or image grab function Last image hold Use a cine rate of 15 fps (can be set to 30 fps) kv ma Single image whenever possible instead of cine

31 Use a larger detector size such as cm to acquire the cine image and use digital magnification to enlarge the image With a flat plate detector the 20 cm size requires 6 % more radiation than the 25 cm detector resulting in more scatter With an image intensifier the 6 inch requires 50% more radiation than the 9 inch

32 COLLIMATION and FILTERS Position the detector or image intensifier as close as possible to the patient Use the collimators to frame the picture Place the filters to even out the density reduce the bright spots

33

34

35 TIPS TO REDUCE DOSE Use technology that is available to be able to reduce patient and staff dose (also yours) Dual axis rotational angiography can reduce the patients cine dose by 75 % Single plane rotational angiography can reduce the cine dose by 15% By using last image hold the shutters and filters can be positioned without using fluoroscopy Auto positioning programs position the c arm, move in the detector, also set the shutters and filters

36 SINGLE PLANE ANGIOGRAPHY

37 DUAL AXIS ROTATIONAL

38 PHYSICAL SAFETY WEAR YOUR LEAD APRON NOT LOOKING AT THE LIVE MONITOR DO NOT FLUORO PLEASE DO NOT HIT THE PATIENT AND STAFF WITH THE FLAT PLATE DETECTOR OR THE C ARM