Introduction:
Justification for medical radiation exposure to patients is balanced against the potential for medical benefit. Healthcare workers (HCWs) do not receive these benefits. Current lack of real-time radiation monitoring limits the opportunity for HCWs to identify unrecognized risky behavior. This study analyzes whether implementation of a real-time radiation dose monitoring system (rtRDMS) can significantly decrease occupational radiation exposure to HCWs conducting diagnostic cerebral angiography (DCA).
Methods:
A rtRDMS was implemented and radiation exposure data was collected prospectively in two phases during DCA for the following HCW roles: Physician-A, Physician-B, Circulating Technician (CT), Scrub Technician (ST), and Nurse (Figure 1). 120 consecutive procedures were performed, 30 per physician per phase. In Phase I, HCWs were blinded to their real-time radiation exposure. In Phase II, HCW were unblinded and had the opportunity to modify their behavior and potentially reduce their exposure. A "Red-Event" (RE) was defined as a radiation exposure event >2.0 mSv/hr. The dose area product (DAP) was recorded to standardize between cases. REs and total radiation exposure per participant per case were recorded. Means were compared (Mann-Whitney U test) between Phase I and Phase II.
Results:
A significant decrease in mean radiation dose divided by DAP (units = Sv/Gy-cm2) was achieved for all roles between Phase I and Phase II except Physician-A. Physician-B decreased from 24.3x10-8 to 6.9x10-8 (p< 0.0001). Nurse decreased from 6.8x10-8 to 3.0x10-8 (p=0.020), CT decreased from 3.3x10-8 to 1.5x10-8 (p=0.005) and ST decreased from 4.5x10-8 to 2.0x10-8 (p< 0.0001) (Figures 2-4, Table 1). RE/DAP between Phase I and Phase II similarly decreased for all HCW roles except Physician-A and was significant for Physician-B, CT, and ST (Table 2).
Conclusions:
rtRDMS implementation can lead to a significant reduction in occupational radiation exposure to HCWs during DCA.
Patient Care:
This study demonstrates that a real-time radiation dose meter system can reduce occupational radiation exposure to healthcare workers during neuroangiography. As radiation safety practices among healthcare workers improve by utilizing this system, reduction in radiation exposure to healthcare workers may translate into a reduction in radiation exposure to patients undergoing neuroangiography.
Learning Objectives:
By the conclusion of this session, participants should be able to: 1) Describe the functionality of the newly available real-time radiation dose meter system 2) Discuss the importance of real-time radiation dose monitoring as a method to decrease occupational radiation exposure during neuroangiography for healthcare workers