Radiation Safety Flashcards

1
Q

Where do we get exposures?

A
computed tomography
 nuclear medicine procedures
 interventional radiology 
cardiac catheterization 
electrophysiology procedures
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2
Q

Potential Sources for Radiation for Anesthesia Providers:

Cardiac Cath Lab:

A

Angioplasty and/or stent insertion for coronary stenosis

Diagnostic cardiac cath

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3
Q

Potential Sources for Radiation for Anesthesia Providers:

Computed Tomography:

A

Assessment of the airway (neck or thoracic tumors)
Assessment of bony trauma (especially the spine)
Imaging of brain tumors or cerebral hemorrhage

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4
Q

Potential Sources for Radiation for Anesthesia Providers:

Electrophysiology Lab

A

Cardioversion
Permanent pacemaker insertion
Radiofrequency catheter ablation

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5
Q

Potential Sources for Radiation for Anesthesia Providers:

Interventional Radiology

A

Balloon angioplasty of cerebral vasospasm
Carotid cavernous fistula and vertebral fistula treatment
Catheterization of ducts, vascular lesions, and tumors for regional delivery of chemotherapy
Embolization or embolectomy of vascular lesions
Endoscopic retrograde cholangiopancreatography
Meningioma treatment
sclerotherapy of venous angiomas
Thrombolysis of acute thromboembolic stroke
Transjugular intrahepatic portosystemic shunt
Transluminal dilation, angioplasty, and/or stent insertion for vascular or biliary stenosis.

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6
Q

Potential Sources for Radiation for Anesthesia Providers:

Nuclear Medicine

A

Positron emission tomography
Single photon emission computed tomography
Ventilation-perfusion scan

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7
Q

Potential Sources for Radiation for Anesthesia Providers:

Radiation Therapy

A

Electron beam radiation therapy (usually intraoperative)
Gamma-knife surgery (eg. for brain tumors and arteriovenous malformation)
Proton beam therapy (e.g. for brain tumors and prostate carcinoma)

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8
Q

Sources of Radiation: What are the categories that electromagnetic radiation is divided into?

A

Nonionizing Radiation: Longer wavelength; less energy

Ionizing radiation: Shorter wavelength; more energy

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9
Q

What is ionization and examples of ionization radiation:

A

Ionization: removal of an electron from an atom

Examples of ioinizing radiation: x-rays, gamma rays, alpha (A) and beta (B) particles.

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10
Q

What are the natural sources of ionizing radiation?

A

Cosmic rays from space

Terrestrial radiation (resulting from deposits of uranium, radon, and other radionuclides in the earth)

Internally deposited radionuclides (mainly the natural metabolite potassium 40 [40K])

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11
Q

What are manufactures sources of Ionizing Radiation

A

Nuclear power and industrial sources

Consumer products (eg. smoke detectors, luminescent watch dials, and television and computer screens)

Medical imaging modalities using radioactive decay processes (nuclear medicine), and x-ray generation (eg. computed tomography, interventional radiology, and electrophysiology and cardiac catheterization procedures)

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12
Q

What is ALARA?

A

ALARA: The principle that radiation exposure should be kept as low as reasonably achievable.

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13
Q

What are Alpha (α) particle?

A

Alpha (α) particle: The particulate form of ionizing radiation consisting of 2 protons and 2 neutrons (the helium nucleus); emitted from the nucleus of a radioactive atom during radioactive decay.

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14
Q

What is an Anode

A

Anode: The positively charged side of an x-ray tube, which contains the tungsten target.

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15
Q

What are Beta (β) particle?

A

Beta (β) particle: The ionizing radiation with characteristics of an electron; emitted from the nucleus of a radioactive atom during radioactive decay.

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16
Q

What is Bremsstrahlung x-ray?

A

Bremsstrahlung x-ray: An x-ray resulting from interaction of the projectile electron with the tungsten target nucleus; braking radiation.

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17
Q

What is a Cathod?

A

Cathode: The negatively charged side of an x-ray tube, which contains the filament where electrons are “boiled off.”

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18
Q

What is a Curie (Ci)?

A

Curie (Ci): A unit of radioactivity; expressed as 1 Ci = 3.7 × 10^10
Disintegrations per second = 3.7 × 10^10 Bq.

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19
Q

What is the Dose equivalent?

A

Dose equivalent: The radiation quantity that is used for radiation protection and that expresses dose on a common scale for all radiations; expressed in rem or sievert (Sv).

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20
Q

What is the Early effect?

A

Early effect: A radiation response that occurs within minutes or days after radiation exposure.

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21
Q

What is Electromagnetic radiation?

A

Electromagnetic radiation: Oscillating electric and magnetic fields that travel in a vacuum with the velocity of light; includes x-rays, gamma rays, and some nonionizing radiation (such as ultraviolet, visible, infrared, and radio waves).

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22
Q

In terms of radiation, what is Frequency (f)?

A

Frequency (f): the number of cycles that occur per second measured in hertz (hz)

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23
Q

In terms of radiation, what is Gray (Gy)?

A

Gray (Gy): The name for the Systeme International unit of radiation absorbed dose (rad); 1 Gy = 100 rad.

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24
Q

What is the Inverse square law?

A

Inverse square law: The law stating that the intensity of the radiation at a location is inversely proportional to the square of its distance from the source of radiation.

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25
Q

What is Ionization?

A

Ionization: The removal of an orbital electron from an atom.

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26
Q

What is a Kilovolt (peak), or kV(p)?

A

Kilovolt (peak), or kV(p): A measure of the maximum electrical potential across an x-ray tube; expressed in kilovolts; a factor that determines the penetrability of the x-ray beam.

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27
Q

What is the Law of Bergonié and Tribondeau?

A

Law of Bergonié and Tribondeau: The principle stating that the radiosensitivity of cells is directly proportional to their reproductive activity and inversely proportional to their degree of differentiation.

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28
Q

What is Linear energy transfer?

A

Linear energy transfer: A measure of the rate at which energy is transferred from ionizing radiation to soft tissue; expressed in kiloelectron volts per micrometer of soft tissue.

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29
Q

What is Milliampere-second (mAs)?

A

Milliampere-second (mAs): The product of exposure time and x-ray tube current; a measure of the total number of electrons coming from the cathode.

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30
Q

What is Nonionizing radiation?

A

Nonionizing radiation: Radiation for which the mechanism of action in tissue does not involve ionization.

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31
Q

What is a Photon?

A

Photon: Electromagnetic radiation that has neither mass or electric charge but interacts with matter as though it is a particle; xrays and gamma rays

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32
Q

What is Planck constant (h)?

A

Planck constant (h): A fundamental physical constant that relates the energy of radiation to its frequency.

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33
Q

What is a Rad?

A

Rad (radiation absorbed dose): The unit for absorbed dose; 1 rad = 0.01 Gy

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34
Q

What is Radioactive decay?

A

Radioactive decay: A naturally occurring process whereby an unstable atomic nucleus relieves its instability through the emission of one or more energetic par- ticles.

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35
Q

What is Radiosensitivity?

A

Radiosensitivity: The relative susceptibility of cells, tissues, and organs to the harmful action of ionizing radiation.

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36
Q

What is Rem?

A

Rem (radiation equivalent man): The unit for dose equivalent and effective dose; has been replaced with the sievert (Sv) in the Systeme International system; 1 rem = 0.01 Sv.

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37
Q

What is Scatter radiation?

A

Scatter radiation: The x-rays scattered back in the direction of the incident x-ray beam; constitutes the primary source of occupational exposure to ionizing radiation.

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38
Q

What is Sievert (Sv)?

A

Sievert (Sv): The Systeme International unit of dose equivalence; 1 Sv = 100 rem.

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39
Q

What is the Stochastic effects?

A

Stochastic effects: The probability or frequency of the biologic response to radiation as a function of radiation dose; disease incidence increases proportionally with dose, and there is no dose threshold.

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40
Q

What is the Threshold dose?

A

Threshold dose: The dose below which a person has a negligible chance of sustaining specific biologic damage.

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41
Q

What is Tungsten?

A

Tungsten: A metal element that is the principal component of the cathode and the anode.

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42
Q

What is the Weighting factor (WR)?

A

Weighting factor (WR): The specific value that accounts for the ability of different types of ionizing radiation to cause varying degrees of biological damage.

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43
Q

What are the 5 physical characteristics of Radiation?

A

Mass, Energy, Velocity, Charge and Origin

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44
Q

What are 2 types of particulate ionizing radiation?

A

Alpha and Beta Particles

45
Q

Where is Ionizing Radiation primarily used?

A

In Nuclear Medicine Imaging and certain therapeutic procedures

46
Q

Ionizing Radiation is associated with ______?

A

radioactive decay processes that occur when an atom becomes abnormally excited

47
Q

How does Ionizing Radiation regain stability?

A

the nucleus spontaneously emits particles and energy

48
Q

Alpha Particles are made up of ____ and ____. What is its charge?

A

2 Protons; 2 Neutrons; Charge +2

49
Q

Alpha Particles have a nucleus similar to which atomic element?

A

Helium

50
Q

The mass of alpha particles is _____.

A

Heavy

51
Q

Alpha Particles travel with high ______.

A

Velocity

52
Q

Alpha Particles penetrate far into materials and are not easily stopped (T/F)

A

False

Do not penetrate far into material and can be easily stopped

53
Q

Alpha Particles pose _____ hazard from ____ exposure.

A

Little; External

54
Q

Alpha Particles can produce ____________.

A

massive internal tissue injury if inhaled or digested. (ex. radon gas)

55
Q

What is the atomic mass of beta particles?

A

light, atomic mass approximately zero

56
Q

What is the charge of Beta particles?

A

may carry a +1 charge: positron or -1 charge: Electron

57
Q

How rapidly do beta particles travel?

A

Because of their low mass, move quickly, have a longer range and may traverse up to 2cm of tissue

58
Q

Beta particles can be stopped by:

A

thin plastic, aluminum, and short span of air (10-100cm)

59
Q

What are the 2 main types of electromagnetic ionization radiation?

A

Gamma Rays and X-rays

60
Q

At what speed does Electromagnetic radiation travel

A

All electromagnetic radiation travels at the speed of light (3 x 10^8 m/s)

61
Q

Electromagnetic Ionizing Radiation is unable to ______ and behaves as a ____ and as a _____.

A

Bend around corners; wave; particle

62
Q

The frequency of electromagnetic ionizing radiation determines ______ and _______.

A

the energy of the radiation; the potential for cellular damage

63
Q

Electromagnetic Ionizing Radiation: What is the relationship between Frequency and Wavelength?

A

Frequency and wavelength are inversely related

Higher frequencies and shorter wavelengths -> higher energy radiation (particle-like)

Lower frequencies and longer wavelengths -> lower energy radiation (wavelike)

64
Q

Why are Gamma Rays “Highly Penetrating?”

A

Because of their high energy and absence of mass, are highly penetrating and may be stopped only by dense materials:
(Lead and concrete)

65
Q

What is the greatest threat of Gamma Rays?

A

From external exposure

66
Q

How can gamma rays effect internal tissue?

A

Can also produce massive internal tissue injury

67
Q

What are some examples of external sources of Gamma Rays.

A

Computed tomography scans
Cardiac Scans
Pulmonary ventilation perfusion scans

68
Q

How do X-rays work?

A

Electrons are “boiled off” from an heated filament within the cathode and focused into a small area on a target

69
Q

How are X-rays like “light?”

A

Like light, x-rays diverge from a point of origin- the x-ray cathode

70
Q

What law do X-rays obey?

A

Obey the inverse square law

71
Q

What is the relationship of wavelength and energy between X-rays and Gamma Rays?

A

Xrays are longer wavelength and (usually) lower energy than gamma radiation

72
Q

What is the Inverse Square Law?

A

The intensity of a beam is inversely proportional to the square of its distance from the source

73
Q

How is Radiation Quantity Measures?

A

Roentgen (R)
RAD (Radiation Absorbed Dose)
REM (Radiation Equivalent Man)
Curie (Ci)

74
Q

What is Roentgen (R)?

A

Roentgen (R): the intensity of gamma or x-rays from the source

75
Q

What is RAD and when is it used?

A

RAD (Radiation absorbed dose): quantity of radiation received by a person
Used for any type of ionizing radiation (alpha and beta particles, and gamma rays and x-rays)

76
Q

What is REM?

A

REM (Radiation equivalent Man): is the unit of occupational radiation exposure

77
Q

What is Curie (Ci)?

A

Curie (Ci): is a unit of radioactive material and not the radiation emitted by the material

78
Q

REM expresses _______.

A

The biological effectiveness of radiation as the “effective dose.”

79
Q

What is the Weighting Factor (Wr) of REM?

A

the value that accounts for the ability of different types of ionizing radiation to cause varying degrees of biological damage

80
Q

What is the Equivalent Dose (REM)

A

Equivalent dose (REM) = Absorbed dose (RAD) x Wr

81
Q

What are the measurements of Ionizing Radiation?

A
1 gray = 100 Rad
1 Sievert (Sv) = 100 REM
1 Curie = 3.7 x 1010 Becquerel (Bq)
82
Q

What is the annual occupational effective dose limit for Radiation?

A

5,000 mrem/year (50 mSv/year)

83
Q

What is the cumulative effective dose limit for Radiation?

A

1,000 mrem x age (10 mSv x age)

84
Q

What is the cumulative lifetime dose of Radiation for a 35 year old?

A

35,000 mrem or 350 mSv

85
Q

What is the cumulative lifetime dose for and embryo or fetus?

A

35,000 mrem or 350 mSv

86
Q

How does Radiation exposure effect the risk for cancer?

A

The risk of fatal cancer increases 0.04% x lifetime rem exposure

If a person reaches their annual effective dose of 5,000 mrem/year for the next 10 years they would have a total dose of 50 rem

The person’s added risk of fatal cancer is 50 x 0.04% = 2%

87
Q

How is Xray quantity proportional to mAs?

A

Xray quantity is directly proportional to mAs: when mA is doubled, the number of electrons striking the tungsten target is doubled, the number of electrons striking the target is doubled, and the number of xrays emitted is also doubled

88
Q

Why are alterations in kilovolt peak and mAs made?

A

Alterations in kilovolt peak (kV(p)) and mAs are made by rad techs to compensate for patient body weight and habitus, and the thickness of the body part to be imaged

Some alteration in kV(p) and mAs is also necessary depending on how the xray beam is projected or oriented relative to the patient.

89
Q

What is the relationship between scattered radiation and kV(p) with patients?

A

With increased kV(p) comes increased scatter radiation from the patient

Factors requiring increased mAs or kV(p) result in increasing the dose to the patient (and anyone else in the path of the beam):
Large patient
Thick body part
Extreme angulation of the xray beam (

90
Q

What is the predominant source of radiation exposure to anesthesia personnel?

A

Scatter radiation is the predominant source of radiation exposure to anesthesia personnel

91
Q

Ionization may result in:

A

Ionization may result in

The production of reactive oxygen species including ions and free radicals

The breakage of chemical bonds (Hydrogen bonds that hold the backbone)

Damage to molecules that regulate vital cellular processes (dna, rna, and proteins)

92
Q

How does Ionizing Radiation disrupt DNA?

A
Breaks H2-Bonds
Breaks Double-Strand
Pyrimidine Dimer
Base Loss
Base Change
DNA Cross-Linkage
Cross-Linkage
Single-Strand Break
93
Q

What happens to DNA once irradiated?

A

The damage to the dna results in:

  • Cell death
  • Enzymes may repair the damaged dna with no adverse effects
  • Enzymes may inaccurately repair the damaged dna resulting in genetic mutations
94
Q

Tissue radiosensitivity:

Law of Bergonie and Tribondeau

A
  • Stem cells are the most radiosensitive
  • The more mature a cell is, the more resistant to radiation it is
  • As cellular metabolic activity increases, radiosensitivity also increases
  • As the cellular proliferation rate increases, radiosensitivity also increases
95
Q

What are the effects of radiation during pregnancy?

A
  • The fetus is most sensitive to the lethal effects of ionizing radiation during the first trimester, especially the 1st 14 days after conception
  • During the period of organogenesis (2-8 wks after fertilization) the embryo may be injured from radiation exposure
  • Congential abnormalities: Microcephaly metal retardation, gross eye abnormalities
  • After 20-25 wks gestation the fetus is relatively resistant
96
Q

Radiation risks are most significant during _______ and in the ______ and least in the ______

A

Organogenesis; early fetal period somewhat less in the 2nd trimester; 3rd trimester.

97
Q

What are the 3 ways for safe radiation practice?

A

-Time: keep time spent near the radiation source to a minimum
-Radiation exposure is cumulative and permanent
-Distance: remember the inverse square law
Shielding:. Shielding material should be positioned between the radiation source and the provider
—–Concrete wall
—–Mobile lead shield
—–Lead apron and thyroid shield

98
Q

How should one shield themselves from radiation exposure?

A
  • Lead aprons usually contain 0.5 mm of lead
  • Wrap around lead (1.0 mm lead) is superior to a one piece apron
  • Thyroid shield (0.25 mm lead)
  • Lead eyeglasses (0.5 mm lead)
99
Q

How to protect yourself form radiation exposure: education?

A
  • Training programs for staff

- Protocols should be established per facility to ensure safe practice

100
Q

How to appropriately use a Monitoring Dosimeter

A
  • Person specific and should not be shared
  • Single dosimeter use: should be placed outside shielded garment or thyroid collar
  • more than one dosimeter: one worn outside the lead apron and one at the waist level underneath the lead apron
  • Should be worn by all personnel working frequently in high-risk radiation exposure areas (fluoroscopy units)
101
Q

At what areas of the body should pregnant anesthesia providers wear protective lead?

A

Pregnant anesthesia providers should always wear wrap around lead which contains 1.0 mm of lead protection to the fetus.

102
Q

For pregnant anesthesia providers, what is the fetal dose limit recommended by the ICRP?

A

5 mSV (500 mrem) for the entire gestational period

103
Q

What areas of the body should pregnant anesthesia providers wear dosimeters?

A

Pregnant providers should wear 2 film badges(dosimeter)
Outside the lead at the collar level
Under the lead at waist level

104
Q

1Gy = _____rad.

A

1 Gy = 100 rad.

105
Q

1 rad = _____ Gy

A

1 rad = 0.01 Gy

106
Q

1 rem = ____ Sv.

A

1 rem = 0.01 Sv.

107
Q

1 Sv = ____rem

A

1 Sv = 100 rem

108
Q

What is the Wr for x-rays, gamma rays, B particles?

A

Wr for x-rays, Gamma rays, B particles = 1 (1 rad = 1 REM)

109
Q

What is the Wr for alpha particles?

A

Wr for alpha particles is 20 (1 rad = 20 Rem)