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    NCRP Report 133 Index

    Uploaded by

    Eng.Ayman
    This document discusses radiation protection for medical workers performing radiologic examinations and procedures outside of radiology departments. It covers examinations done in cardiac catheterization labs, operating rooms, and other areas. The document outlines sources of radiation exposure for workers from various types of equipment and procedures. It recommends methods to minimize exposure, such as limiting radiation field size, increasing distance from the patient, and using protective shielding. Personal monitoring of workers is also discussed to track radiation doses and ensure they remain within safe limits.

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    Download as PDF, TXT or read online from Scribd

    NCRP Report 133 Index

    Uploaded by

    Eng.Ayman
    498 views4 pages
    This document discusses radiation protection for medical workers performing radiologic examinations and procedures outside of radiology departments. It covers examinations done in cardiac catheterization labs, operating rooms, and other areas. The document outlines sources of radiation exposure for workers from various types of equipment and procedures. It recommends methods to minimize exposure, such as limiting radiation field size, increasing distance from the patient, and using protective shielding. Personal monitoring of workers is also discussed to track radiation doses and ensure they remain within safe limits.

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    NCRP report 133 index

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    This document discusses radiation protection for medical workers performing radiologic examinations and procedures outside of radiology departments. It covers examinations done in cardiac catheterization labs, operating rooms, and other areas. The document outlines sources of radiation exposure for workers from various types of equipment and procedures. It recommends methods to minimize exposure, such as limiting radiation field size, increasing distance from the patient, and using protective shielding. Personal monitoring of workers is also discussed to track radiation doses and ensure they remain within safe limits.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    498 views4 pages

    NCRP Report 133 Index

    Uploaded by

    Eng.Ayman
    This document discusses radiation protection for medical workers performing radiologic examinations and procedures outside of radiology departments. It covers examinations done in cardiac catheterization labs, operating rooms, and other areas. The document outlines sources of radiation exposure for workers from various types of equipment and procedures. It recommends methods to minimize exposure, such as limiting radiation field size, increasing distance from the patient, and using protective shielding. Personal monitoring of workers is also discussed to track radiation doses and ensure they remain within safe limits.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4
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    The document discusses radiologic examinations performed in various clinical departments like cardiology, operating rooms and others as well as sources of radiation exposure to workers and methods to monitor their exposure.

    Some radiologic examinations performed outside the radiology department include angiography, angioplasty and electrophysiology studies in the cardiology lab as well as fluoroscopy-guided procedures in the operating room and interventional radiology suites.

    Sources of radiation exposure to workers during radiologic procedures include scatter radiation from the patient, leakage radiation from the x-ray tube, and radiation from improperly collimated or shielded beams. Techniques to reduce exposure include minimizing time, increasing distance, improving shielding and decreasing total radiation used.

    Contents

    Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
    1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    2. Radiologic Examinations Outside the Radiology
    Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    2.1 Cardiac Catheterization Laboratory . . . . . . . . . . . . . . . .
    2.1.1 Angiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    2.1.2 Coronary Angioplasty . . . . . . . . . . . . . . . . . . . . . .
    2.1.3 Electrophysiology Studies . . . . . . . . . . . . . . . . . . .
    2.1.4 Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    2.2 Operating Room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    2.2.1 Urological Procedures . . . . . . . . . . . . . . . . . . . . . .
    2.2.1.1 Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . .
    2.2.1.2 Nephrostomy Tube Placement . . . . . . . .
    2.2.1.3 Stone Removal . . . . . . . . . . . . . . . . . . . . .
    2.2.2 Orthopedic Procedures . . . . . . . . . . . . . . . . . . . . .
    2.2.2.1 Hip Pinning and the Orthopedic
    Placement of Rods and Nails . . . . . . . . .
    2.2.2.2 Fracture Reduction . . . . . . . . . . . . . . . . .
    2.2.3 Operating Room Cholangiography . . . . . . . . . . . .
    2.2.4 Operating Room Angiography . . . . . . . . . . . . . . .
    2.2.5 Placement of Permanent Pacemaker Lines . . . . .
    2.2.6 Endoscopy Examinations . . . . . . . . . . . . . . . . . . .
    2.3 Miscellaneous Examinations and Location . . . . . . . . . .
    2.3.1 Facet Block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    2.3.2 Catheter Placement . . . . . . . . . . . . . . . . . . . . . . .
    2.4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    3. Sources of Exposure to Workers . . . . . . . . . . . . . . . . . . .
    3.1 Total Radiation Exposure During the Procedure . . . . . .
    3.1.1 Equipment Selection, Quality Control, and
    Preventive Maintenance . . . . . . . . . . . . . . . . . . . .
    3.1.2 Establishment of Appropriate Radiological
    Technical Procedures . . . . . . . . . . . . . . . . . . . . . .
    v

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    vi / CONTENTS
    3.1.2.1 Tube Voltage . . . . . . . . . . . . . . . . . . . . . .
    3.1.2.2 Tube Current and Exposure Time . . . . .
    3.1.2.3 Filters and Grids . . . . . . . . . . . . . . . . . . .
    3.1.2.4 Projections and Patient Thickness . . . . .
    3.1.2.5 Image Receptor . . . . . . . . . . . . . . . . . . . .
    3.1.2.6 Minimization of Radiation Field Size . . .
    3.2 Personal Protection Techniques . . . . . . . . . . . . . . . . . . .
    3.2.1 Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    3.2.2 Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    3.2.3 Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    3.2.4 Reduction of X-Ray Field Size . . . . . . . . . . . . . . . .
    3.2.5 Shielding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    3.2.6 Decreasing the Total Amount of Radiation
    Used in a Procedure . . . . . . . . . . . . . . . . . . . . . . .
    3.3 Equipment Evaluation, Maintenance and Monitoring . .
    3.3.1 Acceptance Testing . . . . . . . . . . . . . . . . . . . . . . . .
    3.3.2 Quality Control . . . . . . . . . . . . . . . . . . . . . . . . . . .
    3.3.3 Equipment Maintenance . . . . . . . . . . . . . . . . . . . .

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    4. Personal Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    4.1 Rationale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    4.2 Who Should Be Monitored? . . . . . . . . . . . . . . . . . . . . . . .
    4.3 Methods of Monitoring Workers . . . . . . . . . . . . . . . . . . .
    4.3.1 Film Badges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    4.3.2 Thermoluminescent Dosimeter Badges . . . . . . . .
    4.3.3 Optically Stimulated Luminescence Devices . . . .
    4.3.4 Pocket Ionization Chambers . . . . . . . . . . . . . . . . .
    4.3.5 Digital Personal Dosimeters . . . . . . . . . . . . . . . . .
    4.4 Individual Responsibility for Personal Monitoring
    Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    4.5 Where Should Personal Dosimeters Be Worn? . . . . . . . .
    4.5.1 Procedures Not Requiring a Lead Apron or
    Other Shielding Devices . . . . . . . . . . . . . . . . . . . .
    4.5.2 Procedures Requiring a Lead Apron or Other
    Shielding Devices . . . . . . . . . . . . . . . . . . . . . . . . .
    4.5.3 Pregnant Workers . . . . . . . . . . . . . . . . . . . . . . . . .
    4.5.4 Procedures During Which Extremities are
    Exposed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    4.6 Personal Monitoring Records . . . . . . . . . . . . . . . . . . . . . .
    4.7 Periodic Evaluation of Workers Doses . . . . . . . . . . . . . .

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    5. Administrative Responsibilities . . . . . . . . . . . . . . . . . . . 41

    CONTENTS

    / vii

    Appendix A. Medical X Rays, Their Biological Effects,


    and Philosophy of Radiation Protection . . . . . . . . . . . .
    A.1 Interactions of Medical X Rays with Tissue . . . . . . . . . .
    A.2 Quantities and Units Relevant to Ionizing Radiation . .
    A.2.1 Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    A.2.2 Absorbed Dose . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    A.2.3 Equivalent Dose . . . . . . . . . . . . . . . . . . . . . . . . . . .
    A.2.4 Effective Dose . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    A.3 Biological Effects of Ionizing Radiation . . . . . . . . . . . . .
    A.3.1 Deterministic Effects . . . . . . . . . . . . . . . . . . . . . . .
    A.3.2 Stochastic Effects . . . . . . . . . . . . . . . . . . . . . . . . .
    A.3.3 Heritable Effects . . . . . . . . . . . . . . . . . . . . . . . . . .
    A.4 Sources and Magnitude of Ionizing Radiation
    Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    A.5 Risk and Risk Assessment . . . . . . . . . . . . . . . . . . . . . . .
    A.6 Philosophy of Radiation Protection . . . . . . . . . . . . . . . .
    A.7 Dose Limits and Their Bases . . . . . . . . . . . . . . . . . . . . .
    Appendix B. The X-Ray Imaging Process . . . . . . . . . . . . .
    B.1 Image Production . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    B.2 Image Receptors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    B.2.1 Screen Film . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    B.2.2 Grids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    B.2.3 Image Intensifier . . . . . . . . . . . . . . . . . . . . . . . . . .
    B.2.4 Equipment Use and Design . . . . . . . . . . . . . . . . .
    B.2.4.1 Portable and Mobile Radiographic
    Equipment . . . . . . . . . . . . . . . . . . . . . . . .
    B.2.4.2 Fluoroscopy with Image Intensifier . . . .
    B.2.4.3 Fluoroscopic Procedures in the
    Operating Room . . . . . . . . . . . . . . . . . . .
    B.2.4.4 Pulsed and Digitally Filtered
    Fluoroscopy . . . . . . . . . . . . . . . . . . . . . . .
    B.2.4.5 Cinefluorography . . . . . . . . . . . . . . . . . . .
    B.2.5 Spot Films . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    B.2.5.1 Spot Films with Image Intensification . .
    B.2.5.2 Digital Spot Films . . . . . . . . . . . . . . . . . .
    B.2.5.3 Spot Films with No Image
    Intensification . . . . . . . . . . . . . . . . . . . . .
    B.2.5.4 Serial Radiography . . . . . . . . . . . . . . . . .
    B.2.5.5 Digital Subtraction Angiography . . . . . .

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    Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

    viii / CONTENTS
    References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
    The NCRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
    NCRP Publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
    Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101

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