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RE: NRC Information Notice 2002-28/fluoroscopy
I totally disagree with you regarding these patient exposures. Our
jobs as RSOs is to maintain exposures ALARA. Although I do agree that we
can't nor shouldn't interfere with patient treatment, we MUST ensure our
education programs for physicians are weighted heavily on patient exposures.
Unless you have medical physicists on staff, which a lot of facilities
don't, our job in addition to providing radiation safety is to ensure image
quality and appropriate training. Personally, our facility doesn't have a
medical physicist and I'm deeply involved in ensuring image quality with all
users of x-ray equipment. If I observe a physician, and I often watch
cases, that is overly heavy on the pedal, I will talk with them about
patient exposure, using pulsed fluoro and other techniques to minimize
exposures to their patients. I am usually received well. In general
physicians are not aware of the significant exposures they're delivering and
appreciate the information.
At my facility I attempt, within the constraints of my staffing, to
provide radiation safety to everyone affected including staff, the general
public, AND THE PATIENTS.
Louie Tonry, CHP
Eisenhower Army Medical Center
Ft. Gordon GA
-----Original Message-----
From: desegnac [mailto:desegnac@SWBELL.NET]
Sent: Friday, October 04, 2002 3:28 PM
To: Jacobus, John (NIH/OD/ORS); 'RadSafe'
Subject: RE: NRC Information Notice 2002-28/fluoroscopy
Re: NRC-fluoroscopy-overexposure
If I am not mistaken, we are missing the target. OCCUPATIONAL EXPOSURES is
an NRC-Agreement State business, thus RSO's domain, while exposure of
patients is exempted from regulations, thus irrelevant. That is, an RSO's
business is to secure that the exposures of those who are required to wear
personal dosimetry badges, are within the occupational limits. That is why
NRC says that there shall be a functional RSO. Patients' exposure is, as of
now, between a doctor, patient and their God.
Dusan Radosavljevic
Austin, TX
desegnac@swbell.net
-----Original Message-----
From: owner-radsafe@list.vanderbilt.edu
[mailto:owner-radsafe@list.vanderbilt.edu]On Behalf Of Jacobus, John
(NIH/OD/ORS)
Sent: Friday, October 04, 2002 12:15 PM
To: 'RadSafe'
Subject: RE: NRC Information Notice 2002-28/fluoroscopy
Mike,
Gary is partly correct in that a lot of overexposures was due to poor
training of the physicians with regard to the risk of skin exposures. (Of
course, in some situations, the patients presented difficult cases, and in
some repeat exams.)
There is interest paper and really nasty case shown in paper that can be
found at
http://ojps.aip.org/journals/doc/JACMFG-home/top5.jsp
Enter the search item as: protecting patients by training
Set the search field: TITLE
If that does not work, let me know and I will send a copy of the article as
a pdf file.
Have a good weekend.
-- John
John Jacobus, MS
Certified Health Physicist
3050 Traymore Lane
Bowie, MD 20715-2024
E-mail: jenday1@email.msn.com (H)
-----Original Message-----
From: Michael G. Stabin [mailto:michael.g.stabin@vanderbilt.edu]
Sent: Friday, October 04, 2002 12:02 PM
To: Gary Isenhower
Cc: William V Lipton; radsafe; carmine_mhp@YAHOO.COM
Subject: Re: NRC Information Notice 2002-28/fluoroscopy
. . .
> It is true that some overexposures occur due to lack of experience in the
physician
> performing the procedure.
I thought a big part was due to the fact that there is poor "live time"
knowledge of the cumulative dose.
. . .
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