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Maybe NICU X-ray Rooms Need Lead Gloves

September 5, 2012
Written by: , Filed in: Chest Radiology, Diagnostic Imaging, Pediatric Radiology
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Adult fingers strayed into the X-ray beam during an astonishing 42 percent of neonatal intensive care unit chest X-rays at a Canadian hospital, according to a study published online last month in the Canadian Association of Radiologists Journal.

The study authors, all from Royal University Hospital in Saskatoon, Saskatchewan, say that at their facility, a chest X-ray of an infant typically involves a nurse immobilizing the baby with one hand on the infant’s pelvis and the other holding the infant’s arms above the head.

The authors audited 230 consecutive NICU chest X-rays at their hospital from December 2010 to March 2011. Of the images, 30 (13 percent) included adult fingers directly in the X-ray beam that were visible on the PACS. An additional 22 (10 percent) contained fingers that were cropped from the image before the image was sent to PACS, and 44 more (19 percent) involved fingers in the coned area.

Altogether, during 96 of the 230 images, or 42 percent, adult fingers were inappropriately exposed to X-ray radiation. Usually the fingers belonged to nurses; sometimes they were attached to technologists or family members. You’d think that nurses and technologists, at least, would know better. As the study drily notes:

Avoiding unnecessary exposure to diagnostic radiation is both a professional standard for medical radiation technologists and an internationally recognized safety requirement, as outlined by the International Commission on Radiological Protection.

Addressing possible reasons for the extraneous irradiation, the study speculates, “A challenging patient population, time constraints, an incomplete understanding of the shielding provided by image coning, and an absence of equipment to aid in the acquisition of portable radiographs in the NICU may all be contributing factors.” It also wonders about lack of communication between technologists and nurses and inadequate collimation of the X-ray beam.

The study doesn’t mention simple carelessness, which might be the most likely contributing factor. Even so, 42 percent. Wow.

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Related seminar: Pediatric Radiology


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