Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
, Tel Aviv, Israel.
Cardiovasc Intervent Radiol. 2020 Aug;43(8):1114-1121. doi: 10.1007/s00270-020-02517-2. Epub 2020 May 20.
Over recent years, an increasing number of fluoroscopically guided interventions (FGIs) have been performed by radiologists and non-radiologists. Also, the number of complex interventional procedures has increased. In the late nineties, first reports of skin injuries appeared in the literature. The medical community responded through increased awareness for radiation protection and public authorities by recommendations and legislation, for example, the European Basic Safety Standards (EU-BSS) which were published in 2014, or the international Basic Safety Standards (BSS). Implementation of the EU-BSS requires concerted action from interventionalists, radiographers, medical physics experts and competent national authorities. Interventionalists should play an important role in this project since implementation of the EU-BSS will affect their daily practice. This paper discusses some important issues of the EU-BSS such as unintended and accidental radiation exposures of patients, the meaning of significant dose events and how to deal with patients who were exposed to a substantial radiation dose with the risk of tissue injuries. In addition, this paper provides practical advice on how to implement alert and trigger levels in daily practice of FGIs in order to increase patient safety.
近年来，越来越多的放射科医生和非放射科医生进行了荧光透视引导介入（FGI）。此外，复杂的介入性手术数量也有所增加。在 90 年代后期，文献中首次出现了皮肤损伤的报告。医学界通过提高对辐射防护的认识以及公共当局的建议和立法做出了回应，例如，2014 年发布的欧洲基本安全标准（EU-BSS），或国际基本安全标准（BSS）。实施 EU-BSS 需要介入医生、放射线技师、医学物理专家和有能力的国家当局的共同努力。介入医生在这个项目中应该发挥重要作用，因为 EU-BSS 的实施将影响他们的日常实践。本文讨论了 EU-BSS 的一些重要问题，例如患者非故意和意外的辐射暴露、有意义剂量事件的含义，以及如何处理因辐射剂量过大而有组织损伤风险的患者。此外，本文还就如何在 FGI 的日常实践中实施警报和触发水平以提高患者安全性提供了实用建议。
