建立介入心血管手术中的电离辐射安全文化。

Establishing ionising radiation safety culture during interventional cardiovascular procedures.

机构信息

Department of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology Free State, Bloemfontein, South Africa. Email:

出版信息

Cardiovasc J Afr. 2021;32(5):271-275. doi: 10.5830/CVJA-2021-030. Epub 2021 Aug 18.

DOI:10.5830/CVJA-2021-030

PMID:34405852

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8756052/

Abstract

INTRODUCTION

The safety culture of an interventional laboratory was investigated in terms of the application of the three cardinal principles of radiation protection, namely distance, time and shielding.

METHODS

The application of these principles was observed and recorded with a radiation safety-culture checklist that was compiled by consulting international recommendations. The checklist evaluated the optimal compliance, especially with reference to monitoring of staff exposure, distance from the X-ray source, fluoroscopy techniques pertaining to frame rate, protective devices and personal shielding. The effective radiation dose was measured to the eyes, thyroid, hands and feet of the cardiologist, nurse, floor nurse and radiographer by means of finger dosimeters that were readily available from the local radiation-protection dosimetry service.

RESULTS

The results, after observing 11 procedures, indicated the absence of table and ceiling-suspended shields, and the distance of the cardiologist's and scrub nurse's feet from the X-ray tube were between 16 and 68 cm, with a mean distance of 59.7 and 58.5 cm, respectively. Most staff (91%) wore the dosimeter inside the lead apron at the collar level without eye protection. The highest dosimeter values recorded were 0.73 mSv to the hand of the cardiologist, 0.45 mSv to the eye of the cardiologist, 0.65 mSv to the hand of the scrub nurse, 0.54 mSv to the eye of the scrub nurse and 0.52 mSv to the foot of the scrub nurse. The dosimeter value to the radiographer's thyroid was 0.42 mSv.

CONCLUSIONS

The dosimeter readings confirmed the highest doses were to the scrub nurse and hand of the interventionalist. The safety culture was non-compliant in terms of staff distance being too close to the X-ray tube, the absence of ceiling and table screens, the theatre door not always being completely closed, and for staff without lead eye glasses, wearing dosimeters outside the lead apron at the collar level.

摘要

简介

本研究从辐射防护的三项基本原则，即距离、时间和屏蔽，调查了介入实验室的安全文化。

方法

通过咨询国际建议编制的辐射安全文化检查表，观察和记录这些原则的应用。该检查表评估了最佳合规性，特别是参考工作人员暴露监测、距 X 射线源的距离、透视技术的帧率、防护设备和个人屏蔽。通过当地辐射防护剂量服务处随时提供的手指剂量计，测量了心脏病专家、护士、巡回护士和放射技师的眼睛、甲状腺、手和脚的有效辐射剂量。

结果

观察 11 个程序后的结果表明，缺乏桌子和天花板悬挂的屏蔽，心脏病专家和洗手护士的脚距离 X 射线管的距离在 16 至 68 厘米之间，平均值分别为 59.7 和 58.5 厘米。大多数工作人员（91%）在衣领水平的铅围裙内佩戴剂量计，但没有眼部保护。记录的最高剂量计值为心脏病专家手部 0.73 mSv、心脏病专家眼部 0.45 mSv、洗手护士手部 0.65 mSv、洗手护士眼部 0.54 mSv 和洗手护士足部 0.52 mSv。放射技师甲状腺的剂量计值为 0.42 mSv。