Your x-ray unit is something you use frequently—probably every day, or multiple times per day—in your practice.
You know radiation safety is important. But recently, if you’ve had to reduce the number of team members in the building at any given time, maybe it feels like there aren’t enough hands on deck for patient restraint and positioning.
The good news is, some of the same principles that reduce radiation exposure can also help your team operate more efficiently.
Here are some tips to maintain safety, even when you’re shorthanded…
A.L.A.R.A.: A Brief Reminder
A.L.A.R.A. stands for “As Low As Reasonably Achievable,” and it’s the guiding set of principles that help you reduce radiation exposure to yourself, your staff, and your patients.
This is important because ionizing radiation from x-rays can damage cells, and cumulative exposure can lead to health risks such as cancer and genetic damage to reproductive cells.
To minimize exposure, there are 3 principles to keep in mind:
Time
Distance
Shielding
Decreasing exposure times, increasing the distance between your team and the x-ray source, and using PPE, all can help to decrease radiation exposure.
Tips for Radiography Safety and Efficiency
Hands-Free Restraint
Increasing the distance between your team members and the x-ray source is one of the most effective ways to decrease x-ray exposure.
Think of the inverse square law, which states that doubling your distance away from the x-ray source results in ¼ of the dose of x-ray radiation.
That’s a significant decrease!
Also, scatter radiation comes from the patient—so by not touching the patient, you’re reducing your exposure.
This can be accomplished by using:
Chemical restraint.
Positioning aids such as sandbags and tape.
A combination of both.
In addition to contributing to safety, hands-free restraint also increases staffing efficiency.
Especially for large or wiggly patients, it takes fewer staff members to position the patient when hands-free restraint is used.
Patient Comfort
A patient who wiggles at the last moment can lead to a crooked radiographic image—and thus, the need to retake that view.
The more shots you take, the higher the x-ray exposure to your team members.
Keeping a dog or cat’s comfort in mind can help you get the shot you need the first time—and decrease the need for retakes.
Here’s how you can do this…
Minimize fear and pain (for example, pain from stretching a sore leg to get the right position) by using chemical restraint.
Use a trough or other aid for comfort. Lying with their back on a cold, hard table can cause even the most cooperative of pets to squirm. Giving them a cozy place to settle into can really help.
Play white noise or background music. This helps make the big buzzing and beeping sounds from the x-ray machine less startling to a dog or cat.
In addition to a better patient experience and less x-ray exposure, these methods help save your staff time by getting your views more quickly.
Getting Things Right the First Time
The fewer images you take, the less radiation exposure there will be.
In addition to the measures listed above, here are some ideas for taking the fewest views possible…
Good planning. Be sure to know exactly which views you need ahead of time and what position the patient needs to be in for those views. Communicate these expectations clearly with your staff.
Proper measurement. Measure the patient in the position they will be in during the shot (lying down rather than standing).
Have a technique chart, or use appropriate settings in your digital unit. Teach team members how to make quick and accurate adjustments in settings, too.
Use collimation. In addition to producing a higher-quality image, collimation decreases scatter radiation.
A thorough understanding of x-ray positioning and machine settings will save your staff time and headaches—in addition to minimizing radiation exposure.
Who Should Be in the X-Ray Suite?
Only the team members taking the radiographs should be near the machine. Clients shouldn’t be in the x-ray suite, and other team members should be fulfilling other duties—especially when you’re shorthanded.
Rotating the staff you have on x-ray duty can also help minimize their cumulative exposures.
So, it’s smart to invest in training multiple team members. That way, you’ll also avoid delays if your “go-to” x-ray staff member ever needs to call out sick or otherwise miss a day.
PPE Care and Use
Even though the nature of your daily practice may have changed, it’s still important to keep up with x-ray safety measures, such as making sure your PPE is in good condition.
Experts recommend checking PPE every six months, and this includes radiographing your aprons, gloves, and thyroid shields to check for cracks. Of course, check and replace sooner if there are any notable defects.
Uncertain times may be stressful, but you and your team can continue to help the patients who need you while keeping yourselves safe.
Written by: Dr. Tammy Powell, DVM
