Table 1.
Knowledge and Safety practice by Interventional Cardiologists.
| Knowledge based question | Awareness | Lacking awareness |
|---|---|---|
| 1. Advantage of using collimation: Reduced area of exposure to the patient; Reduced scatter radiation to the operator and staff; Improved quality of image | 151 (82%) | 34 (18%) |
| 2. Left anterior oblique cranial (LAO cranial) was mentioned as the most hazardous for radiation exposure (others mentioned different views) | 97 (52%) | 88 (48%) |
| 3. Optimal frequency for equipment calibration (once in 6 months to one year) | 141 (76%) | 44 – not done (24%) |
| 4. The most useful predictor of radiation exposure to patient and the staff is DAP (Dose area product), Air Kerma compared to fluoroscopy time | 128 (69%) | 54 fluorotime (29%), 3 not aware (2%) |
| 5. Annual occupational dose limits for cath lab personnel? International recommendations: 20mSv/year averaged over defined periods of 5 years with no individual annual exposure to exceed 30 mSv. Lens of the eye 100 mSv 5 years (20 mSv/year) Skin 500 mSv/year Hands and feet 500 mSv/year |
Only 4 correct (2%) others aware 169 (91%) |
12 (6%) |
|
Safety measures or techniques |
Practiced |
Not practiced |
| 1. Low Fluoroscopy mode | 79 always (43%) 76 not always (41%) |
30 (16%) |
| 2. Frame rate selection for fluoroscopy and cine angiography | 60 routinely (32%) 86 whenever I remember (46%) |
40 (22%) |
| 3. Timely termination of Cine recording | 156∗ (84%) | 28 (16%) |
| 4. Collimation | 56 always (30%) 108 not always (59%) |
21 not using (11%) |
| 5. Moving away from X-ray unit | 32 always (17%) 74 whenever I remember (40%) |
79 (43%) |
| 6. Positioning image detector closer to patient's chest | 168 (91%) | 17 (9%) |
| 7. Proper use of table and ceiling mounted shields | 91 (49%) 76 not always (41%) |
18 – never or Not available (10%) |
| 8. Use of dosimeters/Thermoluminescence Dosimetry (TLD) badge | 75 (40%) Whenever remembered 68 (37%) |
42 (23%) |
| 9. Placement of dosimeters | ||
| Chest underneath the lead apron | 119/143 – (83%) | |
| Collar dosimeter | 19/143 –(13%) | |
| Ring badge/forearm dosimeter | 5/143 (4%) | |
| 10. Follow up of dosimeter readings | 71/143 always, (50%) 64/143 occasionally (45%) |
8/143 (5%) |
| 11. Use of PPE (Personal protective equipment) | ||
| Lead apron (0.5 mm or 1.0 mm) | 185 (100%) | |
| Thyroid shield | 164 (87%) | |
| Lead goggles | 65 (35%) | |
| Lead cap | 84 (45%) | |
| Lead apron + Thyroid shield + Lead cap + Leg shield and/or forearm shield | 1 (0.5%) | |
| Leg and or forearm shield | 10 (5%) |