Ensuring Safety with Portable Handheld X-ray Generators in Veterinary Practice

When using any x-ray equipment, the most important consideration for the user should always be safety.

Having safety protocols and measures in place is equally important when using both portable handheld X-ray generators and stationary machines. This article will review these safety considerations in veterinary practice.

Why choose handheld X-ray machines?

There are many benefits to using portable handheld x-ray generators and the demand is growing within the industry.

The fact that they are portable is brilliant for taking the X-ray machine anywhere, both in and out of the practice, and it provides lots of scope for field X-rays. As they are not fixed in a designated X-ray room, there are no installation costs or building adaptations required, therefore it is a bit more economical.

They are versatile and can take images of difficult locations and angles such as dentition and distal limbs etc. Sometimes this can prove extremely challenging and sometimes even impossible with fixed machines.

In the small animal veterinary field, there is a growing use and demand for handheld radiography equipment in dentistry cases and oral radiography is evolving. In an ideal scenario, every patient undergoing a dental procedure should have dental X-rays taken before the surgery.

This will allow for a more thorough assessment of specific dental diseases such as feline oral resorptive lesions (FORL).

However, it is important to be aware of the additional safety requirements.

Testing and training

Firstly, any X-ray equipment before use by veterinary professionals must be reviewed and tested to meet legal requirements.

Handheld radiography equipment is a real advance in both small and large animal practice, as it allows a much greater scope of diagnostic imaging.

With that, however, there is also more scope for inadvertent or excessive irradiation of staff and potentially patients.

As a result, proper and professional training should be undertaken by anyone who operates or is present for handheld X-rays. Once official protocols are set in place, these regulations must be strictly adhered to maximize user and patient safety. 

Personal safety and protection

Handheld X-ray devices are designed to have a hands-off approach to the patient by not requiring any form of manual restraint.

This allows radiographic images to be taken from a safer distance, without the veterinarian’s hands being directly exposed. Users should still always wear lead protective gloves that fully enclose the hands to reduce skin radiation exposure from scattered beams, as well as lead aprons and, where possible, thyroid neck shields.

There can be serious human health complications that can occur from overexposure to radiation. The carcinogenic effects of radiation exposure (especially high-dose radiation or repeated exposures) remain a huge topic of interest (scientific, medical, and legal) in both the human and veterinary fields which is why the relevant safety rules must always be adhered to.

In 2016, a survey was carried out among veterinary professionals, and it was discovered that 90% of participants were seeking alternative ways to manual restraint during X-rays, encouraging the need and demand for handheld devices. 

Alternative methods to manual restraint are positioning aids and sedation to allow a ‘hands-free’ approach. In general, there is no excuse for unshielded manual restraint of a patient, and relatively few patients are unsuitable for any form of chemical restraint. 

Integral protection

The safety of any handheld X-ray device lies in the operator’s hands. Handheld and portable X-ray devices are designed differently from other machines by encompassing some features to reduce radiation exposure.

Handheld machines have a lead shield incorporated into the device and often a lead shield close to the x-ray tube head to minimize radiation exposure through backscatter towards the operator.

Patient safety

As well as user safety considerations, we must always review patient safety and try to reduce their radiation exposure as much as possible. We must always abide by the specific safety distance between the handheld device and the patient. 

Dosage monitoring

Like all x-ray devices when they are in use, users should always wear personal dosimeter badges to monitor the user’s exposure to radiation. Every user should have their dosimeter badge and these badges should not be shared between colleagues.

This safety consideration is a strict regulation and dosimeter badges should be regularly checked to monitor radiation exposure levels.

Aging equipment 

Like any technical machinery, handheld X-ray machines and generators can have a reduced function and not work as well over time, especially after a lot of use.

Compliance audits and equipment servicing must therefore never be overlooked or forgotten about. As a general rule, all machines should be inspected by a qualified maintenance engineer or technician at least annually, and if in heavy use, this may need to be every 6 months, depending on the model.

To conclude, handheld X-rays are an exciting development within the veterinary profession.

They have many advantages for both the user and the patient, but these handheld machines do not come without their risks and safety should always remain the priority in every single individual case.

References

Ali, Y, F. Cucinotta, F, A. Ning-Ang, L. Zhou, G. 2020. Cancer risk of low dose ionizing radiation. Frontiers of physics. 8.

https://newvetequipment.com/#eapps-search-7455972f-926a-408a-9a16-b9db8da324fb-hand%20held%20x-ray

https://newvetequipment.com/dr-with-table-generator

https://handsfreexrays.com/about

https://www.celticsmr.co.uk/media/1490/nomad-pro-vet-brochure.pdf