Holes in Current Shield Safety and Operator Protection

Patient Obesity and Operator Dose

Obese Patients exponentially increase operator dose versus patient dose.

  • Compared with a BMI <25, a patient BMI ≥40 was associated with a 2.1-fold increase in patient radiation dose, VERSUS A 7.0-fold increase in physician radiation dose…
  • Patient BMI remained independently associated with physician radiation dose (dose increase, 5.2% per unit increase in BMI; P<0.0001).”

Citation: Madder RD, and Jacoby ME et al. Patient Body Mass Index and Physician Radiation Dose During Coronary Angiography. Is the Obesity Epidemic Impacting the Occupational Risk of Physicians in the Catheterization Laboratory? Circ Cardiovasc Interv. 2019;12: e006823. DOI: 10.1161/CIRCINTERVENTIONS.118.006823.
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False Sense of Security with Leaded Eyeglasses

Limitations of leaded eyeglasses and head and neck exposure

  • Leaded eye wear does not protect the right eye and provides only 25-60% reduction in scatter to the left eye, leaded caps provide 3% benefit and there is significant exposure to unprotected brains, carotid arteries and lens.
  • …average radiation doses to the unprotected brain, carotid arteries, and ocular lenses were 8.4%, 17%, and 50% of the dose measured at the left collar, respectively.
  • Two representative types of leaded glasses reduced dose to the ocular lens on the side of the physician from which the scatter originates by 27% to 62% but offered no protection to the contralateral eye”

Citation: Fetterly K, Schuler B, and Gulati R et al. Head and Neck Radiation Dose and Radiation Safety for Interventional Physicians. JACC: Cardiovascular Interventions 10, 5, 2017 MARCH 13, 2017:520–8.
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False Sense of Security with Wall Mounted Pages

Lack of protection from Mavig wall mounted leaded shielding and disposable scatter radiation pads: Standard shielding in most labs

  • A Mavig Shield placed 5 cm off of a patient’s body and 20 cm from access site (7 inches approx.) will lose 80% effectiveness for upper body protection of operator.

Fetterly K et al. Effective Use of Radiation Shields to Minimize Operator Dose During Invasive Cardiology Procedures. J Am Coll Cardiol Intv 2011; 4:1133–9.
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False Sense of Security with Horizontal Pads

  • Only 20% radiation reduction from the RadPad disposable radiation drape.
  • 40% increase in radiation dose to operator when using Sham RadPad.
  • Demonstrates the false sense of safety and increased use of fluoroscopy versus RadPad placement in the fluoroscopy field; Hence hurting not helping

Vlastra W et al. Efficacy of the RADPAD Protection Drape in Reducing Operators’ Radiation Exposure in the Catheterization Laboratory A Sham-Controlled Randomized Trial. Circ Cardiovasc Interv. 2017;10: e006058. DOI: 10.1161/CIRCINTERVENTIONS.117.006058.
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