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PERIOP BRIEFING
GUIDELINE FIRST LOOK
New radiation safety guideline to be released
Carina Stanton, Contributing Writer
The new Guideline for radiation safety,1 which will be electronically released in June, provides guidance for preventing
injury to patients and health care workers from ionizing radiation exposure during therapeutic, diagnostic, or interventional procedures performed in the perioperative setting. As an update to the Recommended practices for reducing radiological exposure, published in 2006, this guideline provides new evidence demonstrating the risks of radiation exposure to patients and personnel, along with current evidence-based practices for protection during radiation exposure. The guideline also provides guidance for low-dose-rate and high-dose-rate brachytherapy using ionizing radiation.
Perioperative team members and patients are exposed to radiation across varied perioperative specialties (e.g., orthopedics, cardiac surgery, urology) and from various radiation sources (i.e., primary, leakage, scatter).1 Evidence shows ionizing radiation can have adverse effects on the human body, which are classied as deterministicor stochastic. Deterministic effects of radiation (e.g., skin erythema, hair loss, cataract formation, infertility, circulatory disease) can appear between 24 hours and four years after exposure, while stochastic effects (e.g., cancer, genetic effects) typically appear after several years. Radiation canbe used safely in the perioperative setting when the radiation protection principles of time, distance, and shielding are practiced in accordance with evidence-based principles to protect patients and healthcare personnel, said Byron Burlingame, MS, RN, CNOR, perioperative nursing specialist at AORN and lead author of the guideline.
According to the guideline, several factors affect the radiation dose that is delivered to the patient and personnel, including patient positioning, image magnication, uoroscopy duration, maintenance of a single beam angle, use of high-intensitymode, dose monitoring, x-ray beam angulation,
and mechanical defects in the radiation source.1
It is the responsibility of the perioperative team to control these factors in order to decrease the dose of radiation received by the patient and team members, Burlingame said. The following are highlights from the new guideline.
Establishing a radiation safety program
The guideline provides a comprehensive overview of considerations for establishing a radiation safety program, which is required in every facility that administers diagnostic or therapeutic radiation. This program should be established by an interprofessional team composed of a radiation safety ofcer, a perioperative RN, physicians from...