Medical Imaging Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Child Life Therapy Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2022 Feb;66(1):25-33. doi: 10.1111/1754-9485.13304. Epub 2021 Jul 31.
Carers and comforters frequently remain with children during paediatric general radiographic examinations. As well as improving the likelihood of overall success of the procedure, this can be important for minimising stress and anxiety of the child. Wearing lead aprons can contribute to additional stress and anxiety about the procedure for both carer and child, specifically due to radiation risk. It also introduces some practical challenges for radiographers. This study quantified a carers exposure to scattered radiation for general radiographic examinations when remaining with a child to assist in positioning or to comfort them.
Scattered radiation was measured at four common locations where a carer may stand, with a range of tube potentials (40 kV to 100 kV ) and PMMA thicknesses of 2.5-22.5 cm. This was then matched to our clinical protocols to estimate the radiation dose a carer could be exposed to while assisting a patient during general radiographic examinations.
The effective dose received by a carer standing 20 cm from the centre of the patient varies from 11 min of Australian natural BERT for a finger radiograph on a patient <3 kg and up to 62 h for a swimmers view radiograph performed on a patient >70 kg.
This dosimetric data allowed an evidence-based assessment of radiation protection requirements for the carer using the ALARA principle. At our institution, it was decided that a lead apron is not required if the carer is unlikely to receive more than 2 µSv. A new policy, presented here, was developed to implement this decision.
在儿科普通放射检查中,护理人员和安慰者经常陪伴在孩子身边。除了提高手术整体成功率的可能性外,这对于减轻孩子的压力和焦虑也很重要。佩戴铅围裙会给护理人员和孩子带来额外的压力和对手术的焦虑,特别是因为辐射风险。这也给放射技师带来了一些实际挑战。本研究量化了护理人员在陪伴孩子协助定位或安慰孩子时,在接受普通放射检查时受到散射辐射的暴露量。
在四个常见的护理人员可能站立的位置测量散射辐射,管电压范围为 40kV 至 100kV,PMMA 厚度为 2.5cm 至 22.5cm。然后将其与我们的临床方案相匹配,以估计护理人员在协助患者进行普通放射检查时可能受到的辐射剂量。
距离患者中心 20cm 处站立的护理人员所接受的有效剂量,从小于 3kg 患者的手指射线照相的 11 分钟澳大利亚自然 BERT 到大于 70kg 患者的游泳者视图射线照相的 62 小时不等。
这些剂量学数据允许根据使用 ALARA 原则的辐射防护要求对护理人员进行基于证据的评估。在我们的机构中,如果护理人员不太可能接受超过 2µSv 的辐射,则不需要铅围裙。这里提出了一项新政策,以实施这一决定。