Radiation Safety for all radiological procedurs in SGVPHH.pptx

The matter of X ray radiation safety is always a primary concern for RSO.

1. RADIATION SAFETY AWARENESS RAM EKBAL SINGH, RADIATION SAFETY OFFICER, SGVP HOLISTIC HOSPITAL

2. OBJECTIVE To understand: Safe practices with radiation for Health worker, public and patients Reporting mechanism

3. Radiation Areas in SGVPHH Radiology (A) CT Scan Machine (B) X Ray Machine (C) Mammography (D) DEXA Scan Cath Lab OT ( C Arm) Ward Radiography (Portable X Ray Machine) (a) ICU, PICU (b) ER, In Ward Dental Department (A) X Ray

4. Radiation W orker Regular X Ray Exposed Professionals “Health Care Worker” Interventional Radiologist Cardiologist Orthopedic Surgen Dentist Radiographer CT Scan Technician C Arm Technician Cath Lab Technician Other OT/ Cath Lab Staff

5. Protection Of Radiation Workers X Ray

6. ALARA “As Low as Reasonably Achievable” Alara is a principal, It States that “Avoid exposure to radiation that does not have a direct benefit to you, even if the dose is small .” Minimum Dose Optimum Output

7. Basics of ALARA Exposure from X ray is reduced if: FACTOR RADITION Time Distance Shielding

8. Time Less time Less radiation exposure Exposure from radiation source is directly proportional to time Avoid Repetition of X Ray and procedures Radiation work should pre planed the procedure to minimize the exposure

9. Distance Effective and easy to follow More distance less radiation exposure Inverse Square Law

10. Shielding Proper shielding less radiation exposure Use large shielding thickness (High Z Atomic Number materials e g. Lead, Steel, Concrete, etc.) - reduce the exposure rate of gamma/X-ray radiation.

11. Shielding Through Protective Devices Examples of protective devices Lead apron Thyroid Collar Gloves Eye protector Mobile lead barrier Lead Glass

12. Pregnancy And Radiation ICRP recommends total fetus exposure during pregnancy to be less than 5.0 mSv (500 mrem ).  The fetus radiation dose below 50 mrem /Month is considered safe and not cause any harm . Pregnant female staff can be posted in Non Radiation area during her pregnancy period. In case of pregnant patient decision should be taken Risk Vs Benefit basis. The effect of radiation exposure during pregnancy also depends on the gestational age of the fetus. The embryo/fetus is most susceptible to radiation during organogenesis (2 to 7 weeks gestational age) and in the first trimester. The fetus is more resistant to the radiation during the second and third trimester. Dose between 0.05 to 0.5 Gy is generally considered safe for the fetus during the second and third trimester. Even though the fetus is more resistant to the radiation during the second and third trimester, a high dose of radiation (greater than 0.5 Gy or 50 rad) may result in adverse effects including miscarriage, growth reduction, IQ reduction, and severe mental retardation. 

13. Lead Apron Usage Lead aprons are shielding apparel recommended for use by radiation workers. These are classified as secondary barriers to minimize effects the of ionizing radiation

14. Correct Way to Store Aprons When not in use All protective apparels should be hung properly designed racks Protective apparel should also be radiographed for defects such as internal cracks and tears at twice a year

15. Lead Apron S can

16. TLD Badges For Radiation Workers Measurement and Reporting Mechanism TLD : Thermoluminescent Dosimeter

17. TLD Badge – Personnel Monitoring Device TLD should be worn at chest level or waist level If a protective apron is worn the TLD badge should be worn under the apron Do not store TLD badges in radiation area TLD badge is changed every 3 month TLD badge is send concerned laboratory to read radiation received by that badge and report is informed to RSO.

18. TLD Badge It is the responsibility of individuals to wear TLD Badge while working in Radiation area. If you are a radiation worker and have not applied for TLD badge then please contact your HOD/RSO to fill the TLD application form Loss or accidental exposure to the TLD badges should be immediately reported to the RSO

19. Radiation Protection For Patients

20. Use collimation Avoid Repetition Apply correct Exposure factor (ALARA) Apply Lead apron to the unexposed area (Especially in case of Pediatric X-ray) Read the Prescription carefully before taking X ray Extremity X-rays are commonly mistaken due to lack of site marking(Lt/ Rt ) Ask for pregnancy status in case of child bearing aged female patients Radiation Safety measures for Patient

21. Maximize the Tube Distance and Minimize Distance From The Patient

22. Radiation Protection For Public

23. …Public Could Be Patient’s Relatives Supporting Staff (Attendant, House Keeping, Relatives) Contractors electricians painters plumbers

24. Radiation Area Signage X Ray radiation area must have AERB approved sign banners/boards. It is mandatory to place sign on door to avoid public entrance Red light must be placed at entrance door to indicate running X ray procedure.

25. Means to Prevent Public Exposure Access restriction Shielding Warning signs Lights Interlocks ( e.g. door) Written massage

26. Take Home Message Be careful while operating X Ray generating systems Follow the basic principles of ALARA for radiation safety Special care should be taken for pregnant patient and health care worker Use radiation shielding device Use TLD properly For any radiation related matter contact RSO

27. For your Attention

28. What is Radiation

29. X Ray – Ionizing Radiation

30. Radiation Dose

31. Biological effect Probabilistic Non Probabilistic

32. Deterministic Effect The main mechanism of deterministic effect is Cell killing. It has threshold dose This effect occurs only at high dose. It can be avoided.

33. Stochastic Effect The main mechanism of this effect is cell modification. It has no threshold dose. It occurs at even at low doses. The stochastic effect is further classified into SOMATIC and GENETIC effect .

34. Effect on Body

35. Radiation Unit