Radiation & Laser Safety Flashcards
Type of radiation that only travels through substances, not air
mechanical radiation
which type of radiation contains electrons only? What is an example?
Cosmic radiation (travels almost at the speed of light)
ex: suns UV rays
radiation produced by the motion of atoms
electromagnetic
radiation that is harmful only due to heat energy it produces, can’t knock electrons off atoms, & doesn’t break molecular bonds?
non-ionzing radiation (radio waves, microwaves)
radiation that breaks & mutates DNA & sperm or egg cells, risks can be additive, knocks electrons off atoms:
IONIZING radiation
Similar to visible light rays: both are magnetic and carried by particles called photons
X-RAYS
Difference in energy level is correlated with the:
WAVELENGTH
Wavelength is measured in:
nanometers
As the wavelength becomes smaller (shorter), the energy level _______
INCREASES
As the wavelength becomes larger (longer), the energy level _______
DECREASES
How is light emitted?
movement of electrons from high energy level + releases energy + then falls back down to original orbit = photon (light)
_____ atoms are less likely to absorb xray photons, making xray appear more gray (less bright white).
SMALL atoms (ex: soft tissue)
_____ atoms are more likely to absorb photons = brighter light
LARGE atoms (ex: bones)
filament in center of xray machine that gets heated by the current allowing electrons to fly off of filament and jump to a higher orbital level and release energy
CATHODE
made of tungsten within the xray tube that is positively charged and attracts electrons and releases photons
ANODE
what creates the film/picture we see on the xray cassette
chemical reaction
What are some examples of diagnostic xrays?
radiography
mammography
CT (computed tomography)
fluoroscopy (live images)
uses radiation therapy for cancer at much higher dosages and causes damage to cancer cell DNA
therapeutic medical Xray (radiation therapy)
What are the top 5 most common side effects of radiation therapy?
Fatigue
Hair loss
Skin changes
Diarrhea
N/V
What is the most common side effect from radiation therapy to the brain, pelvis, or abdomen?
N/V
What 3 regions receiving radiation therapy would cause urinary changes?
pelvis
rectum
abdomen
Which body region receiving radiation therapy would cause SOB side effects?
CHEST
Annual allowable xray dose for whole body?
Whole body = 5,000 mrem
Annual allowable xray dose for extremities?
extremities = 50,000 mrem
Annual allowable xray dose for lens of eye?
eyes = 15,000 mrem
Annual allowable xray dose for pregnancy?
preggo = 500 mrem (after organogenesis has taken place ~ > 1st trimester)
1 mrem (millirem) =
1/1000 of a REM
REM & RAD used interchangeably and is the:
radiation dose x a weighting factor
CXRAY mrem?
5-10 mrem
coronary angiogram mrem?
1,500 mrem
angioplasty mrem?
5,700 mrem
CT mrem?
5,000 mrem
What are the 3 factors that affect scatter?
collimation
object thickness
air gap
The thicker the object/patient = wider collimation = _____ scatter.
MORE
the thinner the object/patient = narrower collimation = _____ scatter.
LESS
Fetal doses less than ________ mrem unlikely to cause effects (after 20 wks)
10,000 mrem
What does ALARA stand for? This takes into consideration 3 ways to protect yourself and patient from radiation?
As low as reasonably achievable
TIME
DISTANCE
SHIELDING
If you DOUBLE the distance from the xray beam, you cut the exposure rate by _____.
1/4th
(2 ft to 4ft might change exposure from 20 mrem to 5 mrem)
You’ll essentially have 0 exposure if you are more than ____ ft away from patient/xray.
6 ft
Magnetic field used to orient nuclei of hydrogen molecules to north-south poles and as radio waves pulse on/off it will change the polarity/orientation which radiates energy & creates an image.
MRI = magnetic resonance imaging
Different tissues have various densities of ________
hydrogen nuclei + different chemical/physical properties
What kind of MRI view is this:
- magnetic vector relaxes
- better view of normal anatomy
- fat appears bright
- water appears dark
T1 contrast/view
What kind of MRI view is this:
- axial spin relaxes (changes orientation of hydrogen molecules)
- better view of pathology (identifies tissue edema easily)
- fat is darker
- water is brighter
T2 contrast/view
Contrast medium that alters the magnetic properties of nearby water molecules which enhances the quality of MRI and can see pathology better
Gadolinium
With normal GFR, how fast will gadolinium clear
24 hrs – may increase IVF if needed to flush out contrast
What are some mild side effects of gadolinium?
itching, rash, abnormal skin sensations (give benadryl)
what is the MRI acoustic level?
125 dB (as loud as a chainsaw) = pt and provider need hearing protection
Radiofrequency energy causes:
tissue/device heating
Electromagnetic interference can cause:
ECG artifact
Which vaporizer is MRI safe?
SEVO
What issues may arise with patient positioning in the MRI?
brachial plexus injuries (if arms over head too long with abdominal scans)
airway may be inaccessible (head/neck scans)
If you walk around the MRI machine too fast, what can happen?
dizziness, HA, light flashes, nausea
Devices that are safe for MRI?
heart valves
endovascular and biliary stents (imbedded after 8 wks)
coronary stents (immediately)
vascular ports, IVC filters
orthopedic implants/screws/rods (titanium safe)
These 3 things are usually not safe (newer ones becoming MRI safe):
PPM
AICDs
Implanted insulin pumps
What dose LASER stand for?
Light Amplification by Stimulated Emission of Radiation
What kind of wavelength does a LASER have?
a very specific narrow wavelength with high-intensity precision
Uses of LASER:
cosmetic surgeries
dental procedures
eye surgery (LASIX)
general surgery (condyloma, TURP)
ENT procedures (sinuses, tracheal tumor, vocal cord polyp)
Radiation production in LASER is the same as:
Xrays (photons produced and emitted as electrons jump from different orbitals creating electromagnetic radiation)
What are the 3 properties of laser radiation?
Monochromatic = all the photons in the laser beam are the same wavelength (one color)
coherence = no scatter, synchronized photon travel
collimation = laser beam photons nearly parallel/focused/precise beam
Advantages of LASER:
precision, good hemostasis, rapid healing, less scarring, less postop edema/pain, lower infection rates
Lasing medium with modest tissue penetration (0.05-2 mm) that is used alot in dermatology on skin/subQ tissue:
ARGON LASER
Lasing medium with minimal scatter, is absorbed by water & disperses little heat so surround tissue damage is neglible, great for vocal cords/oropharynx procedures:
CARBON DIOXIDE LASER
most powerful laser that has deeper tissue penetration (2-6 mm) used alot for tumor debulking (prostate/bladder tumors…)
Nd:YAG LASER
The 2 main hazards of lasers:
Atmospheric contamination (condyloma vaporizes into air and now you got yuck mouth lol)
Airway fire
Fine particulates produced d/t vaporization of tissue from laser atmospheric contamination
LASER PLUME
Symptom noted when laser plume/atmospheric contamination occurs from laser?
HA & nausea after inhalation
could cause – interstitial pneumonia, bronchitis, emphysema
could be carcinogenic if its a malignant tumor being laser
What are the 3 components of the fire triad?
IGNITION (laser)
FUEL (drapes, NC, gauze, etc…)
OXIDIZER (oxygen)
Airway fire safety prevention:
laser-resistant ETTs
low FiO2 (21%/RA) if possible
wet pledgets around ETT to keep area cool
methylene blue in the ETT cuff for a visual if laser cuts through cuff
use scissors to cut into trachea instead of bovie
Remove ETT during lasering and reinsert ETT prn sats
LASER Anesthesia plan:
airway eval preop (may need fiberoptic intubation)
mutual planning with surgeon
TIVA (propofol, remifentanil, xylocaine spray)
methylene blue in cuff
saline gauze to protect airway/face
short repeated pulses of laser
O2 < 30%
AVOID NITROUS
