[ RadSafe ] RE: Judgement

[Flanigan, Floyd]

Unfortunately, and to no fault of their own, the vast majority of
medical professionals have extremely limited knowledge base when it
comes to radiation health physics. The administrators of the hospitals
should be taking it upon themselves to procure and retain HP
professionals if for no other reason, to protect them in potential
litigation issues. Dose for medical x-ray should be monitored by an HP
Professional the same as radiopharmaceuticals. Internal or external,
dose is dose. I realize there is a shortage of us out there (HP types)
but that should not be an issue. The foremost concern should be the
safety of the patient, especially in the case of pregnancy due to the
high cellular division rate involved in fetal development. 

Floyd W. Flanigan B.S.Nuc.H.P.

-----Original Message-----
From: jjcohen at prodigy.net [mailto:jjcohen at prodigy.net] 
Sent: Tuesday, April 18, 2006 12:45 PM
To: Flanigan, Floyd; Keith Welch; radsafe at radlab.nl
Subject: Judgement

>From the questions posed by Keith Welch it would seem that the attending
physician might be oblivious to the potential dangers of radiation
exposure
and that perhaps we need definitive rules and guidelines that cover all
possible situations. What ever happened to sound medical judgment?


----- Original Message ----- 
From: "Flanigan, Floyd" <Floyd.Flanigan at nmcco.com>
To: "Keith Welch" <welch at jlab.org>; <radsafe at radlab.nl>
Sent: Tuesday, April 18, 2006 7:44 AM
Subject: RE: [ RadSafe ] In utero dose


There should be an HP on site at most hospitals. The general rule of
thumb for In Utero Dose is 500 millirem for the term of the pregnancy,
but of course all exposure should be kept ALARA. 10CFR20 has additional
federal limits.

Floyd W. Flanigan B.S.Nuc.H.P.

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of Keith Welch
Sent: Tuesday, April 18, 2006 8:49 AM
To: radsafe at radlab.nl
Subject: [ RadSafe ] In utero dose

I have some questions for you medical experts.  I'm curious what
guidelines are used when there is a case requiring x-rays of a pregnant
female.  Let me give you a hypothetical case.  Let's say a woman is
injured in an auto accidedent, has some internal injuries and broken
bones.  She's 12 weeks pregnant.  To treat her injuries, she needs
surgery and a series of radiographs.  Are there generally accepted and
well known standards that physicians refer to in order to advise
patients and determine a course of treatment?  ARe there risk-based
guidelines in place and widely known to general surgeons and
practicioners?  How common is it for a surgeon to seek the advice of an
HP or MP to assess the risks of such procedures?   My impression of the
handling of "routine" x-rays is that if a woman is pregnant, x-rays are
always postponed, just to be conservative.  But in a case where there is

a pressing need to preserve health, how is the decision to conduct the
x-rays arrived at?  How are these risks weighed?  What is the typical
"standard of care"?  Is there an agreed dose at which the patient is
advised to terminate the pregnancy?

Thanks.
Keith Welch

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