O C T O B E R 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 7 3
ing surgery effectively and safely. Getting surgical images with as little radiation
exposure as possible, and magnifying images only when it's clinically
necessary, will improve the safety of everyone in the room. There are several
ways to adhere to the ALARA principle:
• Use fewer shots. Pulsed fluoroscopy captures 1 to 6 images per second
and, when clinically appropriate, is preferable to continuous fluoroscopy, which
captures 30 images per second.
• Have a plan. Mark anatomical landmarks on the patient or on the surgical
drapes to let surgeons and radiology techs focus on targeted anatomy with
fewer fluoroscopic shots. Using tape to mark where the C-arm should be posi-
tioned and repositioned when multiple images are needed can also help limit
the shots taken and will shorten case times.
• Direct the beam. Collimation involves adjusting the size of the C-arm's aper-
ture to reduce the size of the X-ray beam and focus it on the targeted anatomy.
The adjustment limits the radiation dose required to capture images and subse-
quent radiation scatter.
2
Wear protective equipment
The maximum annual dosage limits for radiation exposure are 20 mSv
for the body, 150 mSv for the thyroid and eyes, and 500 mSv for the
hands, according to the International Commission on Radiological Protection.
The importance of wearing gear that protects against radiation exposure might
seem obvious, but personal protective equipment, from eyewear to gloves to
thyroid protection, is often overlooked and underused.
• Lead aprons. Make sure aprons have a lead-equivalent thickness of at least
0.5 mm, which protects wearers from 95% of scattered radiation. One-piece
aprons can offer frontal or wrap-around protection, but two-piece vest-skirt
combinations better distribute the weight of the garments and might be more
comfortable to wear. Inspect lead aprons annually for cracks and general wear