Operational Protection in Diagnostic Radiology

Question 1

What in terms of overarching management may need to be considered for the use of mobile x-ray equipment (e.g. mini C-arm) outside of radiology management?

Answer 1

• Trust wide protocol for dealing with this situation.
• Trust approval required prior to purchase.
• A radiation safety committee should be in place.
• A mechanism should be in place to inform the trust (RPA/MPE).
• Short reports should be submitted annually to the radiation safety committee including details of personal dosimetry results, training, QA/servicing etc.

Question 2

What in terms of IR(ME)R may need to be considered for the use of mobile x-ray equipment (e.g. mini C-arm) outside of radiology management?

Answer 2

• Trust IR(ME)R procedures must be followed.
• Stand alone procedures specific to the mini C-arm use may be required to complement the main trust wide document.
• Staff carrying out the role of referrer, practitioner and operator need to be identified and given appropriate training.
• Records of training should be kept and routine update training given.
• Advice should be sought from the MPE in terms of protocols and optimisation.
• The clinical evaluation and outcome of each exposure should be recorded.
• Suspected accidental or unintended exposure should be reported for investigation to the trust MPE/RPA via the RPS.
• Commissioning tests must be carried out and arrangements made for routine local and medical physics QA and equipment servicing.
• Commissioning and QA reports to be reviewed and recommendations followed up.

Question 3

What in terms of IRR17 may need to be considered for the use of mobile x-ray equipment (e.g. mini C-arm) outside of radiology management?

Answer 3

• Radiation risk assessment and local rules to be drawn up in conjunction with the RPA. The RPA will advise on designation of work areas.
• An RPS must be identified and given appropriate training to ensure compliance with local rules.
• PPE and personal dosimetry should be arranged with advice from RPA. Routine checks of PPE and personal dosimetry records should be performed.

Question 4

What may need to be considered in terms of dose constraints with loan equipment?

Answer 4

In this case, dose constraints should be scaled for the length of the equipment loan.

Question 5

What should be considered when selecting occupancy factors and workload information for dose calculations and shielding/PPE requirements?

Answer 5

Be conservative with estimates. These factors will often change so it is best to be over cautious in the case of any future changes.

Question 6

What may be considered instead of a very thick viewing window for a PET-CT room?

Answer 6

• Consider increasing dose constraint.
• Consider re-design (e.g. cameras and viewing screens instead of viewing window).

Question 7

What are the five steps to a risk assessment?

Answer 7

• Identify hazards.
• Who might be harmed and how?
• Evaluate risks and precautions.
• Record (and implement) findings.
• Review and update.

Question 8

What might be considered in terms of risk assessment when conducting medical physics tests on a new piece of equipment for which likely radiation doses to be received during testing are unknown?

Answer 8

• Staff could wear EPD on outside of leads during testing.
• Perform initial tests behind control panel and with mobile Pb shields if possible.
• Perform scatter dose measurements simultaneously with multiple survey meters.
• Attach dosemeter to tripod or similar rather than individual takin measurements directly.
• Assess nearby staff areas early on.