-
Revista Gaucha de Enfermagem 2022To reflect on the elements of nursing care management in radiological protection in interventional radiology.
OBJECTIVE
To reflect on the elements of nursing care management in radiological protection in interventional radiology.
METHODOLOGY
A reflection paper based on national and international articles and laws addressing the nursing care management issue and radiological protection in interventional radiology.
RESULTS
From the conceptions of nursing care management and professional practice, the following elements were perceived in this management: expertise and applicability of the radiological protection principles, biological effects of ionizing radiation, occupational dose monitoring, personal and collective protective equipment, patient safety, training in radiological protection, quality assurance program.
CONCLUSION
The management of nursing care in radiological protection in interventional radiology is implemented in an elementary way regarding care aimed at dose reduction, either for workers or patients. There is a need to recognize, understand and characterize the management of nursing care in this scenario.
Topics: Humans; Radiation Protection; Nursing Care
PubMed: 36477999
DOI: 10.1590/1983-1447.2022.20210227.en -
Zeitschrift Fur Medizinische Physik Jun 2015This work is a feasibility study of a radiation treatment unit with laser-driven protons based on a state-of-the-art energy selection system employing four dipole...
This work is a feasibility study of a radiation treatment unit with laser-driven protons based on a state-of-the-art energy selection system employing four dipole magnets in a compact shielded beamline. The secondary radiation emitted from the beamline and its energy selection system and the resulting effective dose to the patient are assessed. Further, it is evaluated whether or not such a compact system could be operated in a conventional treatment vault for clinical linear accelerators under the constraint of not exceeding the effective dose limit of 1 mSv per year to the general public outside the treatment room. The Monte Carlo code Geant4 is employed to simulate the secondary radiation generated while irradiating a hypothetical tumor. The secondary radiation inevitably generated inside the patient is taken into account as well, serving as a lower limit. The results show that the secondary radiation emanating from the shielded compact therapy system would pose a serious secondary dose contamination to the patient. This is due to the broad energy spectrum and in particular the angular distribution of the laser-driven protons, which make the investigated beamline together with the employed energy selection system quite inefficient. The secondary radiation also cannot be sufficiently absorbed in a conventional linear accelerator treatment vault to enable a clinical operation. A promising result, however, is the fact that the secondary radiation generated in the patient alone could be very well shielded by a regular treatment vault, allowing the application of more than 100 fractions of 2 Gy per day with protons. It is thus theoretically possible to treat patients with protons in such treatment vaults. Nevertheless, the results show that there is a clear need for alternative more efficient energy selection solutions for laser-driven protons.
Topics: Computer Simulation; Computer-Aided Design; Equipment Design; Equipment Failure Analysis; Feasibility Studies; Laser Therapy; Miniaturization; Models, Statistical; Proton Therapy; Radiation Protection; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Scattering, Radiation
PubMed: 25267383
DOI: 10.1016/j.zemedi.2014.09.002 -
Health Physics Mar 2023Worldwide, radiographers' radiation protection practices vary. In South Africa, evidence of diagnostic radiographers' suboptimal radiation protection practices has been...
Worldwide, radiographers' radiation protection practices vary. In South Africa, evidence of diagnostic radiographers' suboptimal radiation protection practices has been reported, but the reasons for these practices and suggestions to improve practices were lacking. Therefore, this study explored radiation protection among South African diagnostic radiographers. This study used an explanatory, sequential, mixed-method approach. Data were collected in three phases. Phase I, the quantitative phase, used an online questionnaire and respondents from Phase I interested in participating in Phase II, the qualitative phase, were interviewed, yielding 13 in-depth semi-structured telephone interviews. In Phase III, eight radiography managers co-constructed change strategies to optimize radiation protection in South Africa in two focus group interviews. Radiation protection was suboptimal despite diagnostic radiographers having a good attitude, subjective norm and perceived behavioral control toward radiation protection and optimal radiation protection knowledge. Varying attitudes to radiation protection, lack of resources, and support from radiography management and healthcare teams contributed to suboptimal radiation protection practices. Radiography managers suggested increasing radiation protection awareness, ameliorating the diminished stature of the radiographer in the healthcare team, and increasing the availability of optimal quality resources. South African diagnostic radiographers' radiation protection knowledge was optimal, but the implementation of radiation protection varied and was influenced by multiple factors. A radiation protection culture supported by management is advocated to optimize radiation protection. However, ultimately radiation protection practices are incumbent on the individual radiographers' choice to practice radiation protection.
Topics: South Africa; Radiation Protection; Radiography; Attitude of Health Personnel; Surveys and Questionnaires
PubMed: 36719936
DOI: 10.1097/HP.0000000000001655 -
Physica Medica : PM : An International... Mar 2023To evaluate the effectiveness of currently available radioprotective (RP) devices in reducing the dose to interventional cardiology staff, especially to the eye lens and...
PURPOSE
To evaluate the effectiveness of currently available radioprotective (RP) devices in reducing the dose to interventional cardiology staff, especially to the eye lens and brain.
METHODS
The performances of five RP devices (masks, caps, patient drapes, staff lead and lead-free aprons and Zero-Gravity (ZG) suspended radiation protection system) were assessed by means of Monte Carlo (MC) simulations. A geometry representative of an interventional cardiology setup was modelled and several configurations, including beam projections and staff distance from the source, were investigated. In addition, measurements on phantoms were performed for masks and drapes.
RESULTS
An average dose reduction of 65% and 25% to the eyes and the brain respectively was obtained for the masks by MC simulations but a strong influence of the design was observed. The cap effectiveness for the brain ranges on average between 13% and 37%. Nevertheless, it was shown that only some upper parts of the brain were protected. There was no significant difference between the effectiveness of lead and lead-free aprons. Of all the devices, the ZG system offered the highest protection to the brain and eye lens and a protection level comparable to the apron for the organs normally covered.
CONCLUSION
All investigated devices showed potential for dose reduction to specific organs. However, for masks, caps and drapes, it strongly depends on the design, exposure conditions and staff position. Therefore, for a clinical use, it is recommended to evaluate their effectiveness in the planned conditions of use.
Topics: Humans; Radiation Protection; Radiometry; Radiation Dosage; Radiation Exposure; Cardiology; Occupational Exposure; Radiology, Interventional; Lens, Crystalline
PubMed: 36780792
DOI: 10.1016/j.ejmp.2023.102543 -
Endeavour Jun 2017In a nuclear laboratory, a glove box is a windowed, sealed container equipped with two flexible gloves that allow the user to manipulate nuclear materials from the... (Review)
Review
In a nuclear laboratory, a glove box is a windowed, sealed container equipped with two flexible gloves that allow the user to manipulate nuclear materials from the outside in an ostensibly safe environment. As a routine laboratory device, it invites neglect from historians and storytellers of science. Yet, since especially the Gulf War, glove boxes have put the interdependence of science, diplomacy, and politics into clear relief. Standing at the intersection of history of science and international history, technological materials and devices such as the glove box can provide penetrating insight into the role of international diplomatic organizations to the global circulation and control of scientific knowledge. The focus here is on the International Atomic Energy Agency.
Topics: History, 20th Century; History, 21st Century; Humans; International Agencies; Nuclear Energy; Radiation Protection; Safety Management
PubMed: 28318596
DOI: 10.1016/j.endeavour.2017.02.001 -
The Journal of the American Osteopathic... Mar 2014Ionizing radiation injuries and illnesses are exceedingly rare; therefore, most physicians have never managed such conditions. When confronted with a possible radiation... (Review)
Review
Ionizing radiation injuries and illnesses are exceedingly rare; therefore, most physicians have never managed such conditions. When confronted with a possible radiation injury or illness, most physicians must seek specialty consultation. Protection of responders, health care workers, and patients is an absolute priority for the delivery of medical care. Management of ionizing radiation injuries and illnesses, as well as radiation protection, requires a basic understanding of physics. Also, to provide a greater measure of safety when working with radioactive materials, instrumentation for detection and identification of radiation is needed. Because any health care professional could face a radiation emergency, it is imperative that all institutions have emergency response plans in place before an incident occurs. The present article is an introduction to basic physics, ionizing radiation, radiation protection, and radiation instrumentation, and it provides a basis for management of the consequences of a radiologic or nuclear incident.
Topics: Disease Management; Humans; Radiation Injuries; Radiation Protection
PubMed: 24567272
DOI: 10.7556/jaoa.2014.037 -
Journal of Korean Medical Science Feb 2016International Commission on Radiological Protection (ICRP), an independent international organization established in 1925, develops, maintains, and elaborates... (Review)
Review
International Commission on Radiological Protection (ICRP), an independent international organization established in 1925, develops, maintains, and elaborates radiological protection standards, legislation, and guidelines. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) provides scientific evidence. World Health Organization (WHO) and International Atomic Energy Agency (IAEA) utilise the ICRP recommendations to implement radiation protection in practice. Finally, radiation protection agencies in each country adopt the policies, and adapt them to each situation. In Korea, Nuclear Safety and Security Commission is the governmental body for nuclear safety regulation and Korea Institute of Nuclear Safety is a public organization for technical support and R&D in nuclear safety and radiation protection.
Topics: History, 20th Century; Humans; International Agencies; Radiation Injuries; Radiation Protection; Radiation, Ionizing
PubMed: 26908987
DOI: 10.3346/jkms.2016.31.S1.S4 -
Annals of the ICRP Dec 2020The International Commission on Radiological Protection (ICRP) developed effective dose as a quantity related to risk for occupational and public exposure. There was a...
The International Commission on Radiological Protection (ICRP) developed effective dose as a quantity related to risk for occupational and public exposure. There was a need for a similar dose quantity linked to risk for making everyday decisions relating to medical procedures. Coefficients were developed to enable the calculation of doses to organs and tissues, and effective doses for procedures in nuclear medicine and radiology during the 1980s and 1990s. Effective dose has provided a valuable tool that is now used in the establishment of guidelines for patient referral and justification of procedures, choice of appropriate imaging techniques, and providing dose data on potential exposure of volunteers for research studies, all of which require the benefits from the procedure to be weighed against the risks. However, the approximations made in the derivation of effective dose are often forgotten, and the uncertainties in calculations of risks are discussed. An ICRP report on protection dose quantities has been prepared that provides more information on the application of effective dose, and concludes that effective dose can be used as an approximate measure of possible risk. A discussion of the way in which it should be used is given here, with applications for which it is considered suitable. Approaches to the evaluation of risk and methods for conveying information on risk are also discussed.
Topics: Humans; International Agencies; Nuclear Medicine; Radiation Dosage; Radiation Protection
PubMed: 33147998
DOI: 10.1177/0146645320927849 -
Journal of Medical Imaging and... Jun 2022This article presents the findings of phase three of a mixed-method study. Phases one and two explored South African radiographers' radiation protection intention and...
BACKGROUND
This article presents the findings of phase three of a mixed-method study. Phases one and two explored South African radiographers' radiation protection intention and practices and found that even though radiographers reported a high intention to perform radiation protection, varying practices were observed. Phase three of the study explored optimising radiation protection among radiographers in South Africa.
OBJECTIVE
The research objective guiding phase three of the study was to explore co-constructed change ideas to facilitate optimal radiation protection.
METHODS
A qualitative research approach using focus group interviews collected data from eight purposively selected radiography managers. The collected data was analysed using thematic analysis.
RESULTS
Two themes and related categories were identified. Radiographer managers defined radiation protection correctly and concurred that they observed suboptimal radiation protection practices. They attributed suboptimal practice with diminished stature of the radiographer within the healthcare team, ionising radiation being an unseen harm and radiographers' attitude. Radiography managers envisioned their ideal radiation protection environment and suggested ways to attain it. Among the suggestions was a strong collaboration between stakeholders, continuous education, research, national standardised policies, and radiography organisational structures.
CONCLUSION
To rectify suboptimal radiation protection, radiography managers co-constructed ideas to optimise radiation protection practices. Fundamental to change was healthcare organisations embedding radiation protection within their safety culture; thereby, all stakeholders would be invested in upholding the organisation-wide impetus. However, ultimately compliance and accountability is an individual choice.
Topics: Allied Health Personnel; Humans; Leadership; Radiation Protection; Radiography; South Africa
PubMed: 35367167
DOI: 10.1016/j.jmir.2022.03.007 -
International Journal of Environmental... Oct 2022The current geopolitical situation and the war on Ukraine's territory generate questions about the possible use of a nuclear weapon and create the need to refresh...
The current geopolitical situation and the war on Ukraine's territory generate questions about the possible use of a nuclear weapon and create the need to refresh emergency protective plans for the population. Ensuring the protection of public health is a national responsibility, but the problem is of international size and global scale. Radiological or nuclear disasters need suitable decision making at the right time, which determine large effective radiation protection activities to ensure public health is protected, reduce fatalities, radiation disease, and other effects. In this study, a simulation of a single nuclear weapon detonation with an explosion yield of 0.3 and 1 Mt was applied for a hypothetical location, to indicate the required decision making and the need to trigger protocols for the protection of the population. The simulated explosion was located in a city center, in a European country, for the estimation of the size of the effects of the explosion and its consequences for public health. Based on the simulation results and knowledge obtained from historical nuclear events, practical suggestions, discussion, a review of the recommendations was conducted, exacerbated by the time constraints of a public health emergency. Making science-based decisions should encompass clear procedures with specific activities triggered immediately based on confirmed information, acquired from active or/and passive warning systems and radiometric specific analysis provided by authorized laboratories. This study has the potential to support the preparedness of decision makers in the event of a disaster or crisis-related emergency for population health management and summarizes the strengths and weaknesses of the current ability to respond.
Topics: Decision Making; Disaster Planning; Nuclear Weapons; Public Health; Radiation Protection; Radioactive Hazard Release
PubMed: 36232066
DOI: 10.3390/ijerph191912766