Protection of C-arm X-ray radiation
1. In the field of modern medicine, ionizing radiation technology plays a unique role in the localization, diagnosis, and conduct of minimally invasive surgeries and treatments in orthopedic surgery. However, the potential danger of medical ionizing radiation causing organic damage to healthcare workers is increasingly being emphasized. During the surgical process, the awareness of protection against ionizing radiation should be raised among the surgical personnel, and proper protective measures should be implemented for the operating medical personnel and the patients to minimize the hazards of ionizing radiation as much as possible. The protection experience of using C-arm X-ray machine during surgery is summarized as follows: The protection status of ionizing radiation in the operating room I use C-arm X-ray machine (single-balloon C-arm machine) is mainly used for orthopaedic surgery, most of the medical and nursing staff in practice think that the operation is cumbersome, in order to shorten the time of using C-arm X-ray machine, focusing on their own protection and light on the protection of others. The exposure time is long, the number of exposures is high, and the phenomenon of not paying attention to or not using the protective equipment correctly. In addition, patients and nurses as well as other personnel require a weak sense of protection, forming a weak status quo of ionizing radiation protection.
2. The adverse effects of ionizing radiation on the human body ionizing radiation damage to the human body is mainly due to the characteristics of ionizing radiation a biological effect. Ionizing radiation irradiation of the body, can make the living tissue cells and body fluids to occur obstacles, and even cell destruction, and the degree of damage suffered is directly proportional to the amount of ionizing radiation. Low-dose ionizing radiation affects important cellular responses leading to changes in gene expression and the induction of cancer. The most noticeable change in peripheral blood cells after prolonged low-dose irradiation is leukopenia of varying degrees. Radiation damage leads to a higher than normal incidence of gestational teratology, miscarriage and ectopic pregnancy. It can make the lens turbid and produce radioactive cataract. Can inhibit bone marrow hematopoiesis.
3 protective measures against ionizing radiation
3.1 When the surgical department issues the surgical notification form, it should indicate on the notification form that the c-arm x-ray machine and its irradiation site are to be used during the operation. So that the operating room on the surgical arrangements and make preparations for the protection of supplies and personnel.
3.2 Surgical nurse preoperative visit to inform the patient of the significance of intraoperative examination, to obtain the patient's understanding and cooperation. At the same time to understand the patient's general condition, such as whether the body with pacemakers, plates, screws, intramedullary needles. Tell the patient to remove the metal objects before the operating room to prevent artifacts.
3.3 Intraoperative protection includes the protection of medical, nursing, and patient personnel: the surgeon carefully examines the patient and reads the X-rays and C-rays before surgery. Understand the characteristics of the anatomical site and familiarize themselves with the bony structure images. Any exposure that does not bring diagnostic and therapeutic significance to the patient should not be carried out, and all exposures should be kept at a reasonable and as low a level as possible, taking into account the patient's diagnosis and benefit. Improve operating skills to minimize the number of exposures and exposure times. It is advisable to choose a larger operating room for the mobile C-arm machine, and the walls and doors need to be protected with additional layers of protection. Wear protective items such as lead caps, lead collars, and wrap-around lead suits before the operator washes his/her hands during surgery. Those who can leave should leave as far as possible, and those who cannot leave should stay away from the source of radiation as far as possible to minimize the radiation dose. Items in the operating room should be neatly arranged, should not be placed too many items, too many items will cause the refraction of X-ray scattering rays, producing secondary rays, the dose and intensity of X-rays and the human body to receive irradiation of the time is directly proportional to the time, i.e., the distance increased by a factor of 1, the intensity of X-rays for the original 1/4, in the work of the protection of external radiation should be observed in accordance with the three principles of the shortening of irradiation time, increase the distance from the source of X-rays, and set up a shielded Protection. The roving nurse should check the special line of the C-arm machine and reasonably arrange the placement of the relevant instruments. Pay attention to the aseptic operation during the operation, remove the metal instruments and developing gauze from the surgical field before irradiation, and put a sterile protective cover on the C-arm and a sterile towel over it to prevent contamination of the surgical field. In the case of photographic or electro-optical direct visualization surgery, under the guarantee of sterility and full exposure of the operating field, protective equipment is used to cover the parts that are not related to disease entry and filming, and special attention is paid to the protection of the patient's thyroid, thymus, and gonads. In addition, when such surgery, the door of the operating room should be hung "danger" sign to prevent unrelated personnel from entering.
3.4 The operating room nurses work at a fast pace, busy tasks, mental stress, irregular life, and at the same time in a variety of risk factors, posing a great threat to physical and mental health, and the protection of ionizing radiation is an important factor. Therefore, on the one hand, surgical nurses should be regularly trained in radiation protection knowledge. Learning about radiation health laws and regulations; on the other hand, we should rationalize the arrangement of surgical personnel, to avoid receiving large doses of radiation exposure within a short period of time, and those who often participate in such surgeries should undergo regular medical checkups, especially pregnant nurses, nurses who have had many abortions should temporarily avoid or detach themselves from the possibility of being irradiated.
3.5 C-arm X-ray machines are used in surgery, whether doctors, nurses and patients are unclear about the dose of radiation exposure, there is no means of health monitoring, which is not based on the diagnosis of radiation sickness and protection. It is recommended that when C-arm X-ray machines are used intraoperatively, the personnel concerned should wear personal dose monitoring meters. Protective goggles, neck scarves, lead gowns, lead caps, and lead screens are all indispensable protective gear for the operating room. Managers should not be bound by the concept of cost accounting in the department, but should update their concepts to the health of personnel, provide sufficient protective gear, and encourage the correct use.