IR Radiation Exposure-Thoughts?

Specialties Radiology

Published

Hi all,

I was recently in IR with my patient and had a situation that left me a little confused and upset. I'm hardly ever in IR, so I'm not sure what standard procedure is down there, but I just wanted to get some feedback from people who work there often. Not much I can do about the situation now, but I just wanted some feedback.

My patient had an extensive lower extremity DVT that extended into the abdomen. We went to IR for an IVC filter and an EKOS catheter for tPA to the area. The procedure took ~4 hours total. When I arrived with my patient, I was handed a lead apron that only covered the front of me. I noticed everyone else had more lead attire on (like the kind that covers the front & back, neck, as well as a lead apron skirt), but I didn't think much of it or really think it was an issue. I was in the room the entire 4 hours with the IR nurse pushing meds and helping with patient-care.

Towards the last 30-40 minutes of the case, a guy who worked in IR came into the room and told me I was making everyone outside the room who could see me through the glass nervous. I was confused and asked why? He proceeded to tell me that my back was not protected and that every time I turned my back to the machine/table I was being exposed to radiation. The IR nurse who I was with the entire time was right there and heard this conversation. She quickly said she didn't realize I was given a lead apron that only covered the front of me. She went out and grabbed me the correct lead apron that everyone else had on. Then she said that usually they are supposed to educate people about turning their backs to the radiation but that she "forgot." She just kind of laughed it off as an "oops" moment on her part, like it was no big deal. She said that as long as I was 6 ft. from the table that I probably wasn't absorbing that much radiation anyways. Meanwhile, I had just spent the last 3.5 hours doing all sorts of stuff in the room, including being at the table administering IV medication.

This whole situation just left me very confused. I'm of child bearing age and was in that room for quite a bit of time. I feel like if it wasn't a "big deal" the guy wouldn't have come in and said something to me. I was also upset that the nurse said I was supposed to be educated but that she "forgot." My question is, should I be worried about what happened? I feel like I wasn't given the proper attire or education that I should have been given to safely protect myself from the amount of radiation for the period of time I was down there.

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Specializes in Complex pedi to LTC/SA & now a manager.

Have you contacted your employee health, risk management or safety committee? This should likely be an incident report for process failure. Those routinely in the room should have dosimeters so management should be able to estimate your exposure for employee health to accurately advise you.

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Specializes in OR, Nursing Professional Development.

In addition to what JBN said, it's not uncommon in my OR for the only lead available to visitors to be just the type that covers the front. The IR staff should have educated you not to turn your back to the field. However, it's perfectly fine to wear only the front covering lead as long as the lead is between you and the radiation source. Follow up with employee health or the radiation safety officer so that this event is prevented in the future. And if you go to IR again, you'll now know the difference and the expectations.

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Yes 6 ft is appropriate distance. Plus the actual source (tube) is not pointing at you. They should have given you a temporary film badge and you can find out how much were exposed. Question: was the button pressed the whole 3-5 hours because that's dangerous to the patient. The dose you have that procedure is less than what you deal with the cell phone and standing outside in the sun for 10mins. So you won't know how the damage is done. I know I have been working in radiology for 22 years and I expect to have cataracts by the age of 70 it is expected. Any damage to your future fetus after this exam will not carry on whenever you decide to have kids. Ask the technologists who work there about exposures be educated. It gets me so upset when nurses are saying oh you zap me uh I was not pointing the tube at you plus radiation does not come after you making curves after you hid in a corner. Do your evidence based research about radiation and make your own decisions about continuing with IR nursing

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I am a new grad RN but I have several years experience as a Radiologic Technologist/Nuclear Medicine Technologist. Any questions you have, I encourage you to contact your hospital's health physicist(s) (in oncology/radiation Therapy) and express your concerns with them. They can calculate your approximate radiation exposure from the allotted exposure time to the patient for that procedure and your exposure based on your location in the room. Personal protection is every staff members responsibility, and you have the right to feel safe and assured of your exposure's biological effects. For future reference, consider looking at the American College of Radiology website at Radiation Safety - American College of Radiology

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Don't worry about it. Just to be safe, though, wear the skirt and vest next time or avoid turning your back to the rad source just to make sure and definitely don't forget the thyroid guard.

The patient received far more radiation than you did and you undoubtedly have received far more over your life time than you did that day. I am assuming you don't spend a lot of time around radiologic care areas.

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Thanks for the info, everyone. I was just exposed yesterday (Friday) due to the clear ineptitude of the charge nurse who didn't notify anyone that a patient was carrying a warning that she received radiation one day before (Thursday). The patient had some kind of radiation therapy AND has beads (?) in her liver which emit radiation.

I encourage you to file an incident report about what happened in IR. My hospital only processes these types of things if filed as incident reports.

Can anyone comment on the amount of radiation I received from this woman with the radiation therapy on Thursday and the beads in her liver?

Thanks.

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Specializes in OR, Nursing Professional Development.
Can anyone comment on the amount of radiation I received from this woman with the radiation therapy on Thursday and the beads in her liver?

Thanks.

You will need to speak with your employee health department. They will be the ones to guide you. Depending on the type of seed used, there may not have been exposure at all- the patient does not become radioactive as the radiation is low enough to only target the tumor tissue. Other seeds may have a stronger radiation requiring precautions. Without the patient's medical history, no one here can give you accurate information. Before jumping to conclusions that the charge nurse was inept and you were exposed, be sure you have all the facts.

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Agree with the poster above.

Contact your Employee Health and the Radiation Safety Officer for the facility.

Any possible exposure would have to be calculated by the RSO, and proper forms submitted if there was indeed exposure.

I wish you only the best.

Closing this now.

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