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Presenter: Dr Colin Martin
Date of broadcast: 15 May 2018, 3 pm CET
There is a wide range in the types of incident involving overexposure of patients that can occur in diagnostic or interventional radiology. These may be accidental or unintended resulting from errors made by staff, sometimes they occur through failures to fully optimize exposures or may be due to equipment faults.
The more serious incidents involving skin doses that have been high enough to produce tissue reactions have occurred in interventional radiology and computed tomography. However, the majority of incidents only result in relatively small additional doses, but may nevertheless lead to increased risks of stochastic effects in the longer term. Such incidents can take place in any X-ray procedure and if the risks are to be minimized in the future, it is important to learn from errors that occur.
A major factor that has contributed to high skin doses has been deficiencies in staff knowledge in operating the equipment and optimization techniques, and this needs to be addressed through ensuring staff have completed adequate training. In addition, the use of checklists and time outs before procedures commence, and dose alerts when critical dose levels are reached can provide safeguards to reduce the risks of such effects. For dealing with lower dose incidents such as ones involving wrong examinations, procedural errors, or equipment faults, hospitals should have policies that define clearly staff responsibilities when an incident occurs. Procedures should set out requirements for the investigation to identify causes and have systems to make sure that deficiencies are addressed. It is important to derive an estimate of the dose incurred through any overexposure, but in most cases simple approaches can be used as approximate values are all that will be required.
The webinar will discuss approaches to reducing risks, systems for investigation of incidents, and methods for dose assessment.
Dr Colin Martin worked as a hospital-based Medical Physicist in Radiation Protection for over 30 years. He has carried out research many aspects of radiation protection and radiation dosimetry. He is Vice-Chairman of ICRP Committee 3, and a member of several ICRP Task groups, IAEA committees, UK working parties, and COMARE, which advises the UK government on medical uses of radiation. He has co-authored/edited several textbooks on radiation protection, written over 200 articles including 130 papers in peer reviewed scientific journals. Colin is a member of Editorial Boards for the Journal of Radiological Protection and Radiation Protection Dosimetry.