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Abstract

RADIATION EXPOSURE TO CATH LAB PROFESSIONALS DURING DIFFERENT CARDIAC CATH PROCEDURES

Masroofa Syed(MSC), Tantry Tariq Gani(MD), Imran Hafeez(MD,DM), Farooq
Ahmad Ganie(MS,Mch)*, Mohd Iqbal Dar(MD) and Nissar Ahmad Tramboo(MD,DM)

ABSTRACT

Background: Many cardiac procedures can deliver high radiation doses to the clinical staff. This exposure may represent a significant health risk, resulting in deleterious clinical implications which can affect not only the personnel involved, but also their progeny. Radiation injuries have occurred as a result of prolonged interventional procedures with fluoroscopy times more than 30 minutes. Therefore safety of the patient and operator became utmost important. Methods: For a total of 200 patients undergoing different cardiac procedures, radiation exposure of cath lab professionals was recorded using the pocket dosimeters, calibrated from Atomic Energy Regulatory Board (AERB), accredited secondary standard dosimetry lab (SSDL). The radiation dose to the cath lab workers was obtained and recorded per procedure. Dosimeter readings in terms of exposure in milli Roentgens(mR) was converted to effective dose to the person as suggested by International Commission on Radiological Protection (ICRP) i.e. milli Seivert (mSv). The results obtained were compared with the limits of effective dose, set by the commission using standard methods of statistics. Results: It was observed that the average fluoro time for PTMC was maximum of 40 minutes, for PVBD; 33 minutes, for CAG+PCI; 33 minutes, for PCI; 30 minutes, for PPM 18; minutes and for CAG, it was about 8 minutes. It was reported that the interventionalist I.e. primary operator received the whole body dose; maximum of 0.25 mSv and minimum of 0.08 mSv in PTMC, in CAG + PCI, maximum of 0.2 mSv & minimum of 0.08 mSv, in PCI, maximum of 0.18 mSv & minimum of 0.07 mSv, in PVBD, maximum of 0.1 mSv & minimum of 0.03 mSv, in PPM, maximum of 0.08 mSv & minimum of 0.03 mSv and in CAG, maximum of 0.05 mSv & minimum of <0.01 mSv. The secondary operator received the following whole body radiation dose; in PTMC maximum of 0.18 mSv and minimum of 0.06 mSv, in CAG + PCI, maximum of 0.1 mSv & minimum of 0.03 mSv, in PCI, maximum of 0.11 mSv & minimum of 0.025 mSv, in PVBD, maximum of 0.08 mSv & minimum of 0.02 mSv, in PPM, maximum of 0.05 mSv & minimum of 0.01 mSv and in CAG, maximum of 0.03 mSv & minimum of <0.005 mSv. The whole body radiation doses for the Technologist and the Nurse were approximately same; in PTMC, maximum of 0.06 mSv & minimum of 0.03 mSv, in CAG + PCI, maximum of 0.07 mSv & minimum of 0.03 mSv, in PCI, maximum of 0.05 mSv & minimum of 0.02 mSv, in PVBD, maximum of 0.03 mSv & minimum of <0.01 mSv, in PPM, maximum of 0.02 mSv & minimum of <0.01 mSv and in CAG, maximum of 0.015 mSv & minimum of <0.005 mSv respectively. Conclusion: that radiation dose is directly proportional to fluoro time and the primary operator, who is solely handling the procedure receives the maximum whole body radiation dose in all the cath lab procedures. In our study, we found an increased radiation exposure using radial technique compared to femoral technique. A protective device could help to decrease this.

Keywords: primary operator, Fluoro time, Radiation dose.


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