Radiation Safety

Principles from the AORN
Guideline for Radiation Safety

Copyright © 2015 AORN, Inc. All rights reserved. Used or adapted with permission.
Developed and originally presented by
Byron L. Burlingame, MS, BSN, RN, CNOR
Byron Burlingame has been a senior perioperative nursing specialist in the AORN Nursing
Department for 10 years. Byron serves as the lead author for various guidelines and as the staff
liaison to many task forces. He also serves as an AORN representative on the Healthcare
Guidelines Revision Committee and on the FDA Surgical Fires Group. Before coming to AORN,
Byron was the director of surgical services at a hospital with 13 operating rooms. In addition to
surgery, he managed the endoscopy department, sterile processing, day surgery, and the
postanesthesia care unit. For seven years prior to this, he worked as a perioperative manager in a
50-bed hospital. He spent the five preceding years as a surgical services staff nurse in a 350-bed
facility with 10 ORs.
His other experiences include being the director of nursing in a 22-bed hospital and more than 10
years as a charge and staff nurse in three different intensive care units. Byron’s education started
with a diploma from St. Lukes Hospital School of Nursing in Fargo, ND, followed by a
Bachelor’s degree in nursing from Moorhead State University in Moorhead, MN. His Master of
Science with an emphasis on Rural Health Nursing Administration was gained at the University of
North Dakota in Grand Forks, ND. In 1995, he sat for and successfully completed the CNOR
exam, and he has renewed his CNOR credential four times since then.
These slides taken from the webinar Principles of Radiation Safety found in the AORN Guidelines, presented May 13, 2015. To listen
to the webinar, visit https://www.aorn.org/Events/Webinars/Previously_Recorded_Webinars.aspx. These slides are made available
for educational use. Slides may be personalized for your facility and presentation. HOWEVER, THE VIEWS EXPRESSED IN THESE SLIDES
ARE THOSE OF THE PRESENTERS AND DO NOT NECESSARILY REPRESENT THE VIEWS OF, AND SHOULD NOT BE ATTRIBUTED TO AORN.
Objectives
• Describe the actions to take when applying the principles of
radiation safety to the patient, including the pregnant patient.
• Describe the actions to take when applying the principles of
radiation safety to the health care worker, including the
pregnant worker.
• State the recommendations for caring for radiation personnel
shielding devices.
Exposure Sources
• Primary radiation
• Leakage radiation
• Scatter radiation
Factors Affecting the Radiation Dose
• Patient positioning
• Image magnification
• Fluoroscopy duration
• Maintenance of a single beam angle
• Use of high-intensity mode
• Dose monitoring
• X-ray beam angulation
• Mechanical defects in the radiation source
Interprofessional Team
Responsibilities
• Create and maintain the radiation safety program
• Determine qualifications for the equipment operator for each
type of radiologic device
• Evaluate and select new radiology equipment
• Determine the unit of measure to be used for monitoring the
radiation dose and the peak value for notifying the operator
Radiation Safety Program
MUST include
• List of the approved equipment operators
• Documentation and record retention requirements
• List of measures for protecting patients and personnel from
unnecessary exposure to ionizing radiation
• Procedures for handling and disposing of body fluids and tissue
that may be radioactive
• Requirements for using radiation monitoring devices (eg,
dosimeters)
Radiation Safety Program
SHOULD include
• Processes and requirements for the selection of equipment at
the time of purchase
• Requirements for personnel education and competency
assessment
• Quality assurance and improvement program
• Frequency of and processes for testing of protective devices
• Requirements for patient education
• Processes for sterilization of radiation seeds when seed
sterilization is required
Radiation Safety Officer
• Oversees the radiation safety program
• Monitors compliance with Nuclear Regulatory Commission
regulations
• Assists in creating and enforcing policies and procedures
• Determines methods for monitoring and recording occupational
exposure
• Determines which individuals require monitoring devices
• Identifies radiation safety problems
• Stops unsafe practices
• Initiates, recommends, provides, and verifies implementation of
corrective actions
• Is present before and during radionuclide therapy
• Controls and maintains the radionuclide surveillance program
Radiation Safety for Patients
Patient Safety
• Move extraneous body parts out of the path of the

radiation beam
• Collaborate regarding the use and placement of
shielding
• Assess the pregnancy status of all premenopausal
patients
• Place shielding between the fetus and the source of
radiation
Patient Safety
Reprinted with permission from Guidelines for Perioperative Practice. Copyright © 2015, AORN, Inc, 2170 S. Parker Road, Suite 400, Denver, CO 80231. All rights reserved
Patient Safety
A perioperative team member (eg, radiation

technologist, nurse, other designated person) should
• Monitor the radiation dose received by the patient
• Inform the operator when the peak value for
notification has been reached
• Use the values recorded by the fluoroscopy unit and
not only fluoroscopy time for peak values
Radiation Safety for Staff
Question
Should you leave the OR when radiation is being used?

A: Yes
B: No
Question
Should you leave the OR when radiation is being used?

A: Yes
B: No
Staff Safety
•Time
•Distance
•Shielding
Staff Safety Distance & Time
Reprinted with permission from Guidelines for Perioperative Practice. Copyright © 2015, AORN, Inc, 2170 S. Parker Road, Suite 400, Denver, CO 80231. All rights reserved
Staff Safety Distance & Time
• Radiation equipment operator should alert personnel present in

the treatment room before activating the source
• Use slings, traction devices, sandbags to maintain
the patient’s position during radiation exposure
• Use cassette holders to secure films
• No need to leave the OR
Photo by Byron L. Burlingame
Question
Which of the following roles is it safe for the pregnant worker

to perform?
A. Circulator
B. Scrub person
C. First assistant
D. Anesthesia care provider
E. All of the above
F. None of the above
G. A & D
Question
Which of the following roles is it safe for the pregnant worker

to perform?
A. Circulator
B. Scrub person
C. First assistant
D. Anesthesia care provider
E. All of the above
F. None of the above
G. A & D
Pregnant Staff Safety
• Follow standard radiation protection techniques

• Declare the pregnancy to the radiation safety officer or through
other appropriate facility channels
• Wear radiation monitors at the waist under shielding during
times of exposure to radiation
Pregnant Staff Safety
Photos by Byron L. Burlingame
Shielding Devices
Shielding Devices
• Architectural (ie, fixed) shielding

• Equipment-mounted or mobile shields
• Personal protective devices
• Composed of :
– Lead
– Lead-equivalent material (eg, tungsten antimony, bismuth antimony)
Shielding Devices
Equipment-mounted and mobile shields

• Suspended personal radiation protection systems
• Mobile hanging shields
• Under-table skirts
• Table-mounted side shields
• Rolling shields
• Sterile drape shields
Shielding Devices
Personal protective devices

• Aprons
• Thyroid shields
• Leaded eye protection
• Protective gloves
• Sterile radiation shield drapes
• Protective caps
Shielding Devices
Combine the devices
Shielding Devices
Protective devices should be

• Visually inspected
– At the time of purchase
– Before use
• X-rayed
– At the time of purchase
– At least annually for defects related to wear
– Whenever damage is suspected
• Labeled with the last test date
Shielding Devices
Photos by Byron L. Burlingame
Shielding Devices
• Clean and disinfect protective devices

according to the manufacturer’s instructions for
use
• Frequency determined by an interprofessional
team
Monitoring Devices
• Wear as prescribed by regulatory requirements

• Wear in a consistent location (eg, one inside
and one outside the apron)
• Finger dosimeters
• Store in a radiation free location
• Dosimeter reports
Photo by Byron L. Burlingame
Therapeutic Radiation
• Handling of source
• Use under supervision
• Counting of seeds
• Sterilization processes
• Disposal
Radiation Exposure Education
Perioperative Team
• Minimizing exposure to radiation (ie, as low as reasonably
achievable [ALARA])
• Dosimeter use and monitoring
• Care of patients receiving radioactive nuclides
• Handling radioactive nuclides
• Controlling and providing security for the material (ie,
constant surveillance)
• Emergency response to spills
Radiation Exposure Education
Patients
• Collaborate with the physician
• Advise the patient to
– Stay away from crowded places, such as movie theaters
– Double flush urine and stool
– Wipe up spills of body fluids immediately
– Wear protective clothing (eg, shorts, breast shields)
• Advise female patients not to breastfeed for 1 week after
treatment
• Advise family members, caregivers, and visitors to stay a
distance of 3 ft (1 m) from the patient
• Timeframe for precautions
Reference
Guideline for radiation safety. In: Guidelines for Perioperative

Practice. Denver, CO: AORN, Inc; 2015.

Radiation Safety

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Radiation Safety

Uploaded by

Copyright:

Available Formats

Principles from the AORN

Guideline for Radiation Safety

• Move extraneous body parts out of the path of the

A perioperative team member (eg, radiation

Should you leave the OR when radiation is being used?

Should you leave the OR when radiation is being used?

• Radiation equipment operator should alert personnel present in

Which of the following roles is it safe for the pregnant worker

Which of the following roles is it safe for the pregnant worker

• Follow standard radiation protection techniques

Photos by Byron L. Burlingame

• Architectural (ie, fixed) shielding

Equipment-mounted and mobile shields

Personal protective devices

Combine the devices

Protective devices should be

Photos by Byron L. Burlingame

• Clean and disinfect protective devices

• Wear as prescribed by regulatory requirements

Guideline for radiation safety. In: Guidelines for Perioperative

You might also like