Radiation Use in the Orthopaedic Theatre: A Prospective Audit

Gwynne‐Jones, David; Stoddart, Julian

doi:10.1111/j.1445-2197.1998.tb04676.x

Cited by 24 publications

(20 citation statements)

References 8 publications

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“…A surgeon performing 80 procedures a year receives an effective dose of 0.64 mSv/year. This exposure level is relatively low and corresponds to results from other studies on occupational exposure in orthopaedic surgery [7,10,12,13,20,22]. The low dose in this study is explained by personal shielding, short exposure time, and use of intermittent fluoroscopy.…”

Section: Discussionsupporting

confidence: 87%

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Radiation exposure to the orthopaedic surgeon during periacetabular osteotomy

Mechlenburg

Daugaard

Søballe

2008

International Orthopaedics (SICOT)

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The objective of this study was to directly measure the radiation exposure to the orthopaedic surgeon and to measure dose points to the surgeon's fingers, thyroid gland, and forehead during intraoperative fluoroscopy in periacetabular osteotomy (PAO). In a series of 23 consecutive periacetabular osteotomy procedures, exposure monitoring was carried out using thermo luminescent dosimeters. The effective dose received by the operating surgeon was 0.008 mSv per operation which adds up to a yearly dose of 0.64 mSv from PAO. The median point equivalent dose (mSv) exposure under PAO was 0.009 for the forehead and thyroid gland, 0.045 for the right index finger, and 0.039 for the left index finger. The effective estimated yearly dose received by the operating surgeon was very low. Wearing a lead collar reduces radiation exposure to the thyroid gland while the lead gloves did not protect the surgeon's fingers.

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Section: Discussionsupporting

confidence: 87%

“…In many situations, the effective whole body radiation dose is only a fraction of the dose to a single organ or tissue [7,10,12]. In these cases, the individual organs become the critical factors in the assessment of radiation hazards.…”

Section: Introductionmentioning

confidence: 99%

Radiation exposure to the orthopaedic surgeon during periacetabular osteotomy

Mechlenburg

Daugaard

Søballe

2008

International Orthopaedics (SICOT)

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“…6,7 The range of operative procedures requiring image intensifier screening has led to an interest by orthopaedic surgeons in their exposure to ionising radiation. [8][9][10][11] Studies have considered exposure during experimental operation set-ups on phantom patients, 12 during common trauma operations, [13][14][15] for different locations and personnel in the operating theatre, [16][17][18] for different parts of the body, 19 and also investigating methods to reduce exposure. 20,21 There is evidence, however, that actual practice of basic ionising radiation protection varies widely.…”

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confidence: 99%

Ionising Radiation Exposure to Orthopaedic Trainees: The Effect of Sub-Specialty Training

Oddy

Aldam

2006

annals

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INTRODUCTION We monitored image intensifier use by orthopaedic trainees to assess their exposure to ionising radiation and to investigate the influence of sub-specialty training.MATERIALS AND METHODS Five different orthopaedic registrars recorded their monthly image intensifier screening times and exposure doses for all cases (trauma and elective), for a combined total of 12 non-consecutive months. Radiation exposure was monitored using shoulder and waist film badges worn both by surgeons and radiographers screening their cases.RESULTS Registrars in spinal sub-specialties were exposed to significantly higher doses per case and cumulative doses per month than non-spinal trainees (P < 0.05), but significantly lower screening times per case (P < 0.05). There were no significant differences in cumulative screening times per month (P > 0.05). Regression analysis for all surgeons showed a significant relationship between shoulder film badge reading and cumulative dose exposed per month (P < 0.05), but not for cumulative screening time. Shoulder film badge recordings were significantly higher for spinal compared with non-spinal registrars (P < 0.05), although all badges were below the level for radiation reporting. Only one radiographer badge recorded a dose above threshold.CONCLUSIONS Whilst the long-term effects of sub-reporting doses of radiation are not fully understood, we consider that this study demonstrates that trainees should not be complacent in accepting inadequate radiation protection. The higher doses encountered with spinal imaging means that sub-specialty trainees should be alerted to the risk of their increased exposure. The principle of minimising radiation exposure must be maintained by all trainees at all times.

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“…By printing hard copies of intra-operative images, the need for postoperative departmental radiographs may be abolished. 9,10 . All medical radiation exposure should be kept to a minimum under the ALARA (as low as reasonably achievable) principle.…”

Section: Discussionmentioning

confidence: 99%

Effect of Introduction of Mini C-arm Image Intensifier in Orthopaedic Theatre

White

2007

annals

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INTRODUCTION Image intensifier screening is commonly used in orthopaedic theatres. There has been concern regarding the cumulative radiation dose to surgeons and theatre personnel. The mini C-arm intensifier has been reported to scatter less radiation and have a reduced radiation dose to patients and theatre staff.MATERIALS AND METHODS A 2-month prospective survey of usage of radiographer-operated large intensifier and surgeon-operated mini C-arm image intensifier in a district general hospital orthopaedic theatre department. RESULTS A total of 153 cases required image intensifier screening -63% used the large intensifier and 37% the mini C-arm intensifier. There were difficulties with equipment with the large intensifier in 16% of cases. There were delays in 11% of cases using the large intensifier. The total radiographer attendance time was 123 h. For the mini C-arm intensifier, there were no equipment difficulties or delays. The minimum radiographer time saved by using this machine was 21.9 hours.CONCLUSIONS The mini C-arm intensifier has saved 15% of the radiographer workload with its current pattern of usage in our department. There have been no problems or delays as a result of its usage in theatre. Usage of the large image intensifier resulted in a 16% problem rate and 11% delay rate. Other departments are encouraged to consider acquisition of a mini C-arm intensifier to facilitate theatre throughput, reduce risk to the patient and theatre personnel, and reduce demands on the radiology department.

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Radiation Use in the Orthopaedic Theatre: A Prospective Audit

Cited by 24 publications

References 8 publications

Radiation exposure to the orthopaedic surgeon during periacetabular osteotomy

Radiation exposure to the orthopaedic surgeon during periacetabular osteotomy

Ionising Radiation Exposure to Orthopaedic Trainees: The Effect of Sub-Specialty Training

Effect of Introduction of Mini C-arm Image Intensifier in Orthopaedic Theatre

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