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  • Medical X-ray Safety
  • Health Worker Safety Module 7

  • Contents
  • • Introduction
    • Protection from X-ray Hazards

  • X-ray Safety for Health Workers
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  • X-ray Safety for Patients
  • Introduction to X-Rays
  • • X-rays are electromagnetic energy traveling as waves

    • X-ray exposure has been linked to cancer and
    developmental problems, and can cause burns

    • The risks from x-ray exposure are greatest for foetuses, so

    pregnant women should take extra precautions

    • Hospital x-ray machines produce relatively high x-ray

    exposures and they present a hazard unless adequate
    safeguards are in place

    • These devices should only be operated by trained personnel

  • Protection from X-Ray Hazards
  • Monitoring of exposure
  • • X-ray facilities are
    designed around the
    equipment and the source
    of radiation usually
    remains within a well
    defined area in the room

    • Radiation doses to workers

    are monitored using
    personal dosimeters

  • Protection From X-rays
  • • Radiation protection for technologists
    and physicians relies on
    1. the time spent near the machine

    while it is producing x-rays,
    2. the distance between the worker

    and the x-ray source, and
    3. the shielding used by the worker

    and that of the tube housing

    • Increasing the distance and the
    amount of shielding, and decreasing
    the time will decrease the amount of
    radiation exposure to a worker

  • Time
  • • When you need to use an x-ray system, work quickly and
    efficiently.

    • Examinations should be carefully planned and rehearsed

    beforehand to minimize the exposure (beam-on) time and
    consequently reduce the total radiation exposure in the
    room.

  • Distance
  • • Radiation is significantly reduced by distance
    – Move away from the x-ray system when in use
    – Standing at least 2 meters from an x-ray radiation

    source provides a great deal of protection

    • Note that many analytical x-ray systems use very narrow x-

    ray beams

    • Because narrow x-ray beams do not “spread” as much as

    broad beams, even being 6 feet away from the system may
    still result in much of the radiation beam being absorbed by
    your body if the beams are narrow

  • Shielding
  • • When a new x-ray system is being installed, ensure that
    each tube is protected by fixed shielding.

    • Shielding that is permanently in place is the most effective

    mechanism for protecting workers from unnecessary x-ray
    exposure.

    • Always operate these systems with all shielding and safety
    components in place and never tamper with system
    interlocks.

  • Safety Precautions and Guidelines
  • 1. Receive proper training from the person in control before
    operating analytic x-ray machines.

    2. Wear dosimeters between your shirt collar and waist on
    the side of your body that is facing the radiation source.

    3. Monitor radiation of newly installed machines, especially
    before and after modifying the machine for special
    experiments.

    4. Check the shielding before turning the unit on. Never
    assume a unit was left in a safe working condition by the
    previous user.

    X-ray Safety for Health Workers

  • Health Worker Safety from X-ray Exposure
  • • Radiation exposure to technologists, nursing staff,
    physicians, and to others must be kept as low as
    reasonably achievable.

    • Only personnel who are required for the x-ray procedures
    or training should be present in the x-ray room during
    exposures.

    • Health workers should use portable or fixed lead panels or
    use the following PPE:
    – Lead aprons
    – Lead safety glasses
    – Thyroid shield
    – Leaded gloves

    Health Worker Safety from X-ray Exposure
    (continued)

    • Keep the time of radiation exposure short, especially during
    fluoroscopy procedures.

    • Follow proper techniques to minimize the number of repeat

    exposures.

    • Staff should not routinely hold patients. Use mechanical
    holding devices when a patient or film requires added
    support. If that is not possible, patients should be held by a
    relative or friend who is wearing lead aprons and gloves.

    • If pregnant, notify the head of your department.

    X-ray Safety for Patients

  • Patient Radiation Safety Principles
  • • Patient exposure should be
    kept as low as reasonably
    achievable

    • The radiation exposure to

    the patient should be
    minimized without
    compromising the
    diagnostic quality of the
    exam

    • Obtaining a good quality

    radiograph while
    controlling radiation
    exposure of the patient is
    one goal of a viable quality
    assurance program

    • Follow the proper technique for each examination—this

    reduces the need to repeat the procedure

    • Obtain a good quality radiograph the first time and reduce

    the number of repeat examinations.

    • Collimate the primary x-ray beam to the area of interest to

    reduce scatter radiation.

    • When portable x-ray machines are used, ensure that other
    patients are located at least one meter from scatter
    radiation or utilize portable lead panels.

    Patient Radiation Safety Principles (continued)

    Patient Radiation Safety Principles (continued)

    • Use gonadal shields for patients as long as they will not
    interfere with the medical exam.

    • Identify pregnant patients and notify the referring physician

    before they undergo any x-ray exams.

    • Use protective eye wear and aprons when appropriate.

  • Thank You
  • Bibliography
  • • Maxwell Adams, J. (1994, reprint 2004). Electrical Safety 2004: A guide to the causes and prevention of electrical

    hazards. London. The Institution of Electrical Engineers.

    • Central Board of Health (2003). Zambia Infection Prevention Guidelines. JHPIEGO Corporation. Baltimore, Maryland.

    • Damani, N.N. (2003). Manual of Infection Control Procedures: 2nd Edition. Cambridge. Cambridge University Press.

    • Emory University Environmental Health and Safety Office. (2009, September). Safety Toolbox Training: Avoiding
    Electrical Shocks. http://www.ehso.emory.edu/content-guidelines/ToolboxTraining_AvoidingElectricalShocks .

    • Kenyatta National Hospital (2006). Policy Guidelines on Antiseptics, Disinfection, Sterilization and Waste Disposal.

    • Muralidhar, S., PK Singh, RK Jain, M Malhotra & M Bala (2010). “Needle stick injuries among health care workers in a
    tertiary care hospital in India.” Indian Journal of Medical Research. Mar; 131: 405-10.

    • Office of Safety and Health Administration. (April 2009). OSHA Academy Course 715: Electrical Safety Basics Student
    Manual. http://www.oshatrain.org/courses/mods/715e.html.

    • Prasad, R., Z. Quezado, A. St. Andre, & N. O’Grady (2006). Fires in the Operating Room and Intensive Care Unit.
    Anesth Analg 2006;102:172–4.

    • PattersonW B., Craven DE., Schwartz DA., Nardell EA., Kasmer J. & Noble J. (1985) Occupational Hazards to Hospital
    Personnel. Annals of Internal Medicine. May; 102:658-68.

    • Tanzania Ministry of Health and Social Welfare. (2004). National Infection Prevention and Control Guidelines for Health
    Services in Tanzania.

    • Tanzania Ministry of Health and Social Welfare. (2003). Tanzania Waste Management Guidelines.

    • Tanzania Ministry of Health and Social Welfare. (2009). Injection Safety in the Context of Infection Prevention and
    Control, Participants’ Manual Tanzania.

    • Tanzania Ministry of Health and Social Welfare. (2006). Standards and Procedures for Healthcare Waste Management
    in Tanzania. Pul: Ministry of Health and Social Welfare, United Republic of Tanzania, 28pp.

    • Wenzel, RP, editor. (1994). Prevention and Control of Nosocomial Infections. Baltimore. Williams & Wilkins.

    http://www.ehso.emory.edu/content-guidelines/ToolboxTraining_AvoidingElectricalShocks �

    http://www.ehso.emory.edu/content-guidelines/ToolboxTraining_AvoidingElectricalShocks �

    http://www.ehso.emory.edu/content-guidelines/ToolboxTraining_AvoidingElectricalShocks �

    http://www.oshatrain.org/courses/mods/715e.html�

      Medical X-ray Safety
      Contents
      Introduction to X-Rays
      Protection from X-Ray Hazards
      Monitoring of exposure
      Protection From X-rays
      Time
      Distance
      Shielding
      Safety Precautions and Guidelines
      X-ray Safety for Health Workers
      Health Worker Safety from X-ray Exposure

    • Health Worker Safety from X-ray Exposure (continued)
    • X-ray Safety for Patients
      Patient Radiation Safety Principles

    • Slide Number 16
    • Patient Radiation Safety Principles (continued)�
    • Thank You
      Bibliography

    Topic: Radiation Protection

    Paper MUST have:

    · Title page

    · Half a page abstract

    ·

    4 written pages (introduction, separate headings for main topics).

    · References.

    · Abstract

    · Introduction 

    What is the x-ray

    The risk from x-ray

    · Protection from x-ray

    radiation protection from x-ray relies on:

    · Time: the time spent near the machine while it is producing x-ray.

    · Distance: distance between technologist and the x-ray source. Also, the distance between patients and the source.

    · Shielding: (lead apron, thyroid shield, glasses…) Used by technologists and patients.

    · X-ray safety for health workers

    Personal protection (film badge, TLD…)

    · X-ray safety for patients 

    Patient protection (gonad shielding)

    · Conclusion

    · References

    The paper MUST include separate headings for the introduction, and main topics.

    You must write about points you mentioned in your introduction.

    Need the source at the end of each paragraph

    NOTE:
     

    · Wikipedia, Dictionaries and Encyclopedias will NOT be accepted as reference sources. 

    · You MUST include a minimum of 5 reference sources
     

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