Radiation exposure to the orthopaedic surgical team during fluoroscopy: "How far away is far enough?"
Radiation exposure to the orthopaedic surgical team during fluoroscopy: "How far away is far enough?"
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DOI：
10.1097/00005131-199708000-00002
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发表时间：
1997-08-01
影响因子：
2.3
通讯作者：
DiPasquale, TG
中科院分区：
文献类型：
--
作者：
Mehlman, CT;DiPasquale, TG
目的：在模拟透视辅助骨科手术过程中，根据骨科手术团队成员的相对位置，将其辐射暴露量与骨科手术团队成员的辐射暴露量相关联。（目镜透镜），“浅”（手/皮肤）和“深”（全身）辐射暴露。设置：一级创伤中心的标准医院手术室。参与者：剂量测定标记在离荧光透视X射线束指定距离处聚集。代表性位置为直接射束接触、外科医生（12 in/30.5 cm）、第一助理（24 in/70 cm）、擦洗护士（36 in/91.4 cm）和麻醉师（60 in/152.4 cm）。干预：剂量测定徽章通过旨在最大化辐射散射的方案系统暴露。连续使用荧光镜的最长时间设定为10 minutes.Main结果Measurements：由市售的剂量测定服务处理的剂量测定徽章的辐射暴露读数。直接光束接触导致约4000 mrem/min（40 mSv/min）的辐射暴露。外科医生和第一助理的深度曝光分别为20 mrem/min（0.2 mSv/min）和6 mrem/min（0.06 mSv/min）。外科医生的浅表暴露量为29 mrem/min（0.29 mSv/min），第一助理为10 mrem/min（0.1 mSv/min）。外科医生的眼睛暴露量为10 mrem/min（0.1 mSv/min），第一助理为6 mrem/min（0.06 mSv/min）。在洗手护士位置，未检测到深部或眼部暴露。在洗手护士位置观察到一个浅暴露阳性标记，反映了2 mrem/min（0.02 mSv/min）的暴露率。经过10分钟的连续曝光，徽章分配给麻醉师的位置从来没有注册任何积极readings.Conclusions：这些结果表明，无保护的个人工作二十四英寸（70厘米）或更少的透视光束接收大量的辐射，而那些工作三十六英寸（91.4厘米）或更大的光束接收极低的辐射量。
Objectives: To correlate the amount of radiation exposure to members of the orthopaedic surgical team based on their relative positions during a simulated fluoroscopically assisted orthopaedic procedure.Design: Experimental study using commercially available fluoroscopic units and dosimetry badges designed to measure "eye" (ocular lens), "shallow" (hands/skin), and "deep" (whole-body) radiation exposure.Setting: Standard hospital operating room at a level one trauma center.Participants: Dosimetry badge clusters at specified distances from a fluoroscopic x-ray beam. Represented positions were direct beam contact, surgeon (12 in/30.5 cm), first assistant (24 in/70 cm), scrub nurse (36 in/91.4 cm), and anesthesiologist (60 in/152.4 cm).Intervention: Dosimetry badges were systematically exposed by a protocol intended to maximize radiation scatter. A maximum time for continuous fluoroscope use was set at ten minutes.Main Outcome Measurements: Radiation exposure readings from dosimetry badges processed by a commercially available dosimetry service.Results: Maximum readings are reported. Direct beam contact resulted in approximately 4000 mrem/minute (40 mSv/min) of radiation exposure. Deep exposure for the surgeon and first assistant was 20 mrem/min (0.2 mSv/min) and 6 mrem/min (0.06 mSv/min), respectively. Superficial exposure was 29 mrem/min (0.29 mSv/min) for the surgeon and 10 mrem/min (0.1 mSv/min) for the first assistant. Eye exposure was 10 mrem/min (0.1 mSv/min) for the surgeon and 6 mrem/min (0.06 mSv/min) for the first assistant. At the scrub nurse position, no deep or eye exposure was detected. One positive badge for shallow exposure was noted at the scrub nurse position, reflecting a 2 mrem/min (0.02 mSv/min) exposure rate. After ten minutes of continuous exposure, badges assigned to the anesthesiologist position never registered any positive readings.Conclusions: These results indicate that unprotected individuals working twenty-four inches (70 cm) or less from a fluoroscopic beam receive significant amounts of radiation, whereas those working thirty-six inches (91.4 cm) or greater from the beam receive an extremely low amount of radiation.