Table 3.

Evidence-based recommendations for surgeons, radiographers, and institutions for minimizing ionization radiation exposure in conventional fluoroscopy in trauma operating room

Personnel responsible	Recommendation	Reference
Surgeons	Reduce number of repeat fluoroscopic images required by consideration and clear communication No continuous fluoroscopy unless absolutely necessary Ensure adequate patient positioning to facilitate use of intra-operative fluoroscopy Raise awareness of radiation exposure during intra-operative fluoroscopy to junior surgeons	[7–10]
Radiographers	Limitation of field size to area of interest (collimation) Reduce exposure timer to minimum Utilize highest practicable wattage and lowest amplitude Ensure no staff in direct line with path of primary beam Ensure doors to operating room closed Always wear dosimeter and regular monitor personal exposure	[1, 8, 9]
Institutions	Provide and maintain personal protective equipment including lead gowns, thyroid shields, and eye goggles Regular audit of radiation exposure of radiographers and high-risk individuals Limit staff in operating room using fluoroscopy to those only essential personnel Regular maintenance of fluoroscopic equipment	[1]