Safety Code 35 Flashcards
does safety code 35 apply to denstistry, chiro, podiatry, mammo?
no
they have other safety codes for those
somatic effects vs genetic effects
somatic= changes in exposed individual genetic= gives rise to genetic effects
how are estimates of incidence of cancer at low dose determined?
- cannot b measured
- based on linear extrapolation from relatively high doses
linear no treshold hypothesis
health risk from exposure is proportional to dose
4 main aspects of radiation protection for diagnostics
- jutification for medical exam
- patient is protected from excess radiation
- staff are protected
- general public is protected
who is ultimately responsible for safety of facility?
owner
when does responsible personel investigate exposures received by personnel?
- if exposure is higher that usual dose received by that person
- > 1/20 of dose limit for radiation workers
when must staff wear personal dosimeter
-if they are likely to receive a dose in excess of 1/20 of dose limit for radiation worker (i.e. 1 mSv) (i.e. occupationally exposed person)
o CNSC Radiation Protection Regulations says that personnel dosimetry is required for NEWs who have a reasonable probability of receiving an effective dose greater than 5 mSv in a one-year dosimetry period
HL7
health level 7
standard for exchanging information between medical information systems.
DICOM
digital imaging and communications in medicine
general requirements for diagnostics
- x-ray room cannot be used for more than one radiological investigation simultaneously
- unless essential, everyone leaves room when irradiation comes on
- personnel should keep away from x-ray beam
- irradiating someone for traning or evaluation is not allowed
- all personnel must use available protective devices
- workers who are likely to receive > 1/20 of dose limit must be declare radiation workers and wear personal dosimeter
- personal dosimeters must be worn and stored according to recommendations of dosimetry service provider. When a protective apron is worn, personal dosimeter must be worn under the apron. If extremeties likely to be exposed, additional dosimeters should be worn at those locations
- personal dosimetry records must be maintained for lifetime of facility
- female operator must notify employer of pregnancy
- if weak persons need support, holding devices should be used (not staff)
- all entrance doors to xray room should be closed while patient in the room and during exposure
- energized xray machines must not be left unattended
rules regarding mobile x-rays
- only use if needed
- direct xray away from occuppied areas
- operator must not stand in front of direct beam and must be > 3 m away from x-ray tube unless wearing PPE or behind leaded shield
- residual charge must be fully discharged before unit is unattended
requirements of radioscopy
-all persons with possible exception of patient must wear leded apron (shields and curtains are not enough)
one of greatest sources of exposure to personnel in radiology
angiography
requires the presence of a considerable number of personnel close to the patient, radioscopy for extended periods of time and multiple radiographic exposures
recommendations for angiography
- use [protective devices such as shielded drapes etc
- The patient is the largest source of scatter radiation. To avoid this scatter, operate the equipment with the tube under the patient and, if the tube is horizontal, stand on the side of the image receptor.
- PPE (including glasses) and dosimeters must be worn
- personnel not required right by patient should stand behind shields
largest source of scatter radiation in angiography
patient
medical and dental x-rays account for what % of man-made dose to public?
90%
when is risk of pregnancy small? (for pelvic tests)
10 days following menstruation
recommendations for pregnant or potentially pregnant women
Only essential investigations should be taken in the case of pregnant or suspected pregnant women.
When radiological examinations of the pelvic area or abdomen are required, the exposure must be kept to the absolute minimum necessary and full use must be made of gonadal shielding and other protective shielding if the clinical objectives of the examination will not be compromised.
If a radiological examination of the foetus is required, the prone position should be used. This has the effect of shielding the foetus from the softer X-rays and hence reducing the foetal dose.
Radiography of the chest, extremities, etc., of a pregnant woman, for valid clinical reasons, should only be carried out using a well-collimated X-ray beam and with proper regard for shielding of the abdominal area.
xray beam size limit
size of image receptor or smaller
considerations to ensure patient exposure is kept to minimum
- use of an anti-scatter grid or air gap between the patient and the image receptor;
- use of the optimum focal spot-to-image receptor distance appropriate to the examination;
- use of the highest X-ray tube voltage which produces images of good quality;
- use of automatic exposure control devices designed to keep all irradiations and repeat irradiations to a minimum.
what should you do before taking long series of images?
check the first one to ensure correct setup
difference between radioscopy and radiography
radiography is an off-line, static examination technique, while radioscopy is a dynamic examination technique with the potential for on-line examination and process control.
radioscopy is more dose- only use when necessary
why does operator monitor tube current and voltage when using AEC?
both can rise to high values without the knowledge of the operator, particularly if the gain of the intensifier is decreased
when should cinefluorography be used?
- when absolutely needed
- produces the highest patient doses in diagnostic radiography because the X-ray tube voltage and current used are generally higher than those used in radioscopy
recommendations for angiography
- shield eyes and thyroid if possible
- minimize irradiation time
- use more tube filtration (reduce low E xrays)
- use lower time frequency in pulse radiography
- produces the highest patient doses in diagnostic radiography because the X-ray tube voltage and current used are generally higher than those used in radioscopy
- in children and small adults, removing grid will reduce dose
- magnification may increase dose to patient
- use automated injection if possible
- if procedure is long, reposition tube so that same area of skin is not exposed to xray beam
- for each interventional procedure, document images, radioscopy time, air kerma rates, and resulting skin doses
what ia angiography
Angiography is a type of X-ray used to check blood vessels.
Blood vessels do not show clearly on a normal X-ray, so a special dye needs to be injected into your blood first. This highlights your blood vessels, allowing your doctor to see any problems. The X-ray images created during angiography are called angiograms.
reducing dose in CT
-reduce number of slices and overlap b/w adjacent scans as much as possible given quality required
where does radiation have most impact
reproductive cells and rapidly dividing cells
factors for reducing dose to sensitive tissues
- correct collimation of x-ray beam
- examine kids and adolescents really if only necessary..
- use gonads shields if clinical objectives not compromised, patient is of reproductive age, gonads aer within or near beam
- use proper technique
- maintain sensitivity of imaging system
what technique reduces dose in radioscopy?
use of higher tube voltage and filtration and lower tube current will almost always reduce the gonad dose
diagnostic reference levels
for typical procedures, the difference in radiation doses can be as wide as a factor of 50 to 100
- reference levels to help optimize techniques, rather than max dose limits
- better control of patient exposure to x-rays
- AVERAGE of population should meet thiese targets, not necessarily each patient
what are DRLs based on?
CTDIw
- at least 10 patients for sample size, ~ 70 kg
- preferable to use phantoms
-measure entrance dose with TLDs, dose-area-product meters
entrance surface dose chest (PA)
0.2-0.3 mGy
entrance surface dose chest (LAT)
0.7-1.5 mGy
entrance surface dose thoracic spine (AP)
5-8 mGy
entrance surface dose thoracic spine (LAT)
7-10 mGy
entrance surface dose lumbar spine (AP)
7-10 mGy
entrance surface dose lumbar spine (LAT)
15–30 mGy
entrance surface dose abdomen (AP)
7-15 mGy
entrance surface dose pelvis (AP)
5-10 mGy
entrance surface dose skull (AP)
4-5 mGy
entrance surface dose skull (LAT)
2-3 mGy
dose-area-product for abdominal radioscopy
20-70 Gycm2
dose-area-product for coronary angio
35-75 Gycm2
dose-area-product for barium enema
30-60 Gycm2
CTDIw and dose-length product for head CT
60 mGy
930-1300 mGycm
CTDIw and dose-length product for face and sinuses
35 mGy
360 mGycm
CTDIw and dose-length product for chest
30 mGy
580-650 mGycm
CTDIw and dose-length profuct for abdo-pelvis
35 mGy
560-1100 mGycm
CTDIw and dose-length product for liver and spleen
35 mGy
470-920 mGycm
3 considerations for designing and planning an x-ray facility
- prepare facility plans
- consider room design and layout
- determine parameters governing shielding requirements
weekly dose limit for operator for diagnostics
0.4 mSv/week
where should control booth be located?
whenever possible, such that the radiation has to be scattered at least twice before entering the booth
typical workloads for xray facilities
cardiac angio- 4800 mA min/wk other vascular angio- 2000 mAmin/wk chest radiography - 100 mAmin/wk other radiography- 320 mAmin/wk radioscopic- 400 mAmin/wk
use factor for ceiling for diagnostic x-ray
1/16
not routinely exposed to direct radiation beam
assumptions in NCRP 147 for shielding calcs
- The attenuation of the radiation beam by the patient is neglected.
- The incidence of the radiation beam is always perpendicular to the barrier being evaluated.
- The calculation does not take into account the presence of materials in the path of the radiation other than the specified shielding material.
- The leakage radiation from the X-ray equipment is assumed to be an air kerma of 0.876 mGy h-1.
- The minimum distance to the occupied area from a shielded wall is assumed to be 0.3 m.
storage for radiographic film
< 0.1 mG over stored period of film
-Once films are loaded into cassettes, radiation exposure levels should be less than 0.5 µGy and the resulting increase in the base-plus-fog should be less than 0.05 O.D
control booth is secondary or primary barrier?
shpuld be secondary as xray should never be directed to control booth
primary barrier walls for radiography equipment
wall behind the vertical image receptor, or “wall or chest bucky”, and the floor under the radiographic table. For dedicated chest radiographic equipment, the wall behind the image receptor is considered a primary barrier.
barrier types for radioscopic x-ray
only secondary
but typically radiographic is also in the room and need to shield for that
shielding for CT
only secondary
doesn;t rely on W
use NCRP 147