Introduction:
As the availability and use of medical imaging has increased, ionizing radiation has become a significant occupational exposure. Staff in the cardiac catheterization laboratory are among those with the highest exposures.
Hypothesis:
Changing equipment defaults to decrease patient radiation exposure would also decrease staff radiation exposure.
Methods:
In October 2013 we made equipment adjustments to decrease patient radiation exposure in all 3 cardiac catheterization laboratories at Eastern Maine Medical Center. We changed fluoroscopy defaults to low dose option and low frame rate (7.5 frames/sec from 15 frames/sec) while maintaining the option for operators to use higher settings as needed. We analyzed staff radiation exposure for 8 physicians and 14 nurses by comparing total collar dosimeter dose (in mRem) between the 3 months before and 3 months after the intervention controlling for procedural volume using standard statistical methods.
Results:
For physician operators, mean dosimeter dose decreased by 41.6% (346.8 ± 264.8 pre vs 202.5 ± 135.9 post intervention, p=0.042). For nurses whose roles are to assist during procedures or to circulate in the room, the mean dosimeter dose decreased by 25% (65.9 ± 49.4 pre vs 50.2 ± 53.5 post intervention, p=0.038). There was no significant difference between the number of cases performed by physicians (p=0.598) and nurses (p= 0.866) before and after the intervention. Procedural success did not decline post-intervention. Compliance with wearing collar dosimeter is required and reported as excellent at our institution.
Conclusions:
Setting fluoroscopy defaults to low dose and low frame rate to improve patient radiation exposure also significantly decreased radiation exposure for both physician and ancillary staff working in the cardiac catheterization laboratory. If widely adopted this intervention would help to mitigate the long term adverse effects of occupational exposure to ionizing radiation.
ASSOCIATION BETWEEN CORONARY ARTERY PROCEDURES IN THE CARDIAC CATHETERIZATION LABORATORY AND PROCEDURAL COMPLICATIONS AS RELATED TO COEXISTING CHRONIC KIDNEY DISEASE AND DIABETES MELLITUS
