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Re: X-Rays at Podiatrist Office
Since the exposure is to an extremity, your estimated
doses, based on the "BERT," is too high. From
http://www.doseinfo-radar.com/RADARDoseRiskCalc.html
the effective dose for an extremity exposure is about
0.5 mrem. Again, there are no critical organs in the
foot.
I am not sure if the giving the patient a leaded apron
is a good idea. It probably reinforces patient fears.
--- David Englehart <davee@med-phys.com> wrote:
> Entrance skin exposure from various general x-ray
> units that I see are
> anywhere from 10 mR to 30 mR, based on their typical
> technique. That's
> about 8 to 25 days of background equivalent
> radiation time (BERT, background
> @ 300 mR/year via John Cameron). I survey only one
> true podiatry unit per
> year, and ESE for that unit is a little higher for
> their typical technique
> at 64 mR due to a source to image distance less than
> 40 inches. Still, only
> about 52 days worth of background. Our state does
> require that the exposure
> switch extend to at least 6 feet from the source.
> Regardless of the low
> exposure for extremity work, the "techs" should be
> trained to always reduce
> their exposure whenever possible. Somebody
> should've explained the
> difference between occupational exposure and patient
> exposure, and told them
> to stand at least 6 feet away when shooting a film.
>
> Given the public's fear of radiation an apron should
> have been offered, even
> though it wasn't necessary. This simple practice
> can alay fear in patients
> and prevent a lot of trouble for the x-ray provider
> in the future.
>
> The geometry of the machine I see is such that the
> tube head can move from
> 90 degrees perpendicular to the floor to only about
> 50 degrees. So the
> primary beam is, for the most part, pointed toward
> the floor. If the unit
> you saw is restricted to this type of movement,
> shielding in the walls is
> not likely necessary.
>
> Regards,
> David Englehart B.S.
> Diagnostic Imaging Specialist
> Medical Physics Services Ltd.
> Department of Radiation Oncology
> 6150 Oakland Ave.
> St. Louis, Mo.63139
> tel. (314)768-3608
> fax (314)768-5646
> ----- Original Message -----
> From: "Thomas M Lashley" <lashleyt@DTEENERGY.COM>
> To: "Parry, Don (CIS)" <dparry@michigan.gov>
> Cc: <radsafe@list.vanderbilt.edu>;
> <sloanpb@BELLSOUTH.NET>
> Sent: Wednesday, March 10, 2004 6:34 AM
> Subject: Re: X-Rays at Podiatrist Office
>
>
> > Were the technicians wearing dosimetry? Most
> states require the operator
> of x-ray machines to wear dosimetry. However, after
> talking to a dental
> student here in Michigan, the school doesn't monitor
> their students.
> >
> > Tom Lashley
> > mailto:LashleyT@DTEenergy.com
> >
> >
> > "Parry, Don (CIS)" wrote:
> >
> > > While the risk is low, the practice described is
> not good health physics
> and in most states would be contrary to their
> regulations. Most states
> would require operators to stand at least 6 feet
> away or behind an
> appropriate shield. The apron is likely not
> required by regulation since
> the primary beam is not in the gonadal region,
> however some states recommend
> their use in both podiatry and dentistry. Shielding
> is another issue
> dependent on the particular state regulations. If
> the primary beam is
> directed towards an interior occupied area, I
> believe most states would
> require some shielding in that wall.
> > >
> > > This machine would be regulated by the state
> government, if you have
> concerns I would contact them. links to various
> state programs can be found
> at www.CRCPD.org or at our web site below
> > >
> > > Don
> > >
> > > Donald E. Parry, CHP
> > > Health Physicist
> > > Radiation Safety Section
> > > Michigan Department of Community Health
> > > Phone : 517-241-1989 Fax: 517-241-1981
> > > mailto:dparry@michigan.gov
> > > Web Site: www.michigan.gov/rss
> > >
> > > -----Original Message-----
> > > From: owner-radsafe@list.vanderbilt.edu
> > > [mailto:owner-radsafe@list.vanderbilt.edu]On
> Behalf Of John Jacobus
> > > Sent: Tuesday, March 09, 2004 1:54 PM
> > > To: radsafe@list.vanderbilt.edu;
> sloanpb@BELLSOUTH.NET
> > > Subject: Re: X-Rays at Podiatrist Office
> > >
> > > I would suggest that you submit this question to
> the
> > > Health Physics Society's "Ask the Expert" Web
> site at
> > >
> http://hps.org/publicinformation/asktheexperts.cfm
> > >
> > > The short answer is that there is little if any
> risk,
> > > but I think you would like a more than that.
> > >
> > > --- iradi8 <sloanpb@BELLSOUTH.NET> wrote:
> > > > I recently had a series of foot x-rays done in
> a
> > > > podiatrist's office. The person doing the
> x-rays was
> > > > training a brand new assisstant. Neither
> seemed to
> > > > have any knowledge whatsoever about what they
> were
> > > > doing. I was not asked if I was pregnant -- I
> am a
> > > > woman of childbearing age. I was not offered
> an
> > > > apron which they do at the dentist (not that I
> feel
> > > > that I really needed it). They stood right
> next to
> > > > the head of the x-ray machine while taking all
> three
> > > > films. Actually, the head of the machine was
> within
> > > > 6 inches of her pelvis. The new assisstant was
> told
> > > > that they could stay in the room for all
> x-rays --
> > > > that the dose is so low that it is safe. That
> is
> > > > what the "x-ray guy who works on the machine"
> said.
> > > > I was taken aback by all of this! Could
> someone
> > > > please enlighten me as to whether this is
> okay? I am
> > > > sure it is not! Also, the machine is not in an
> > > > enclosed room -- the restroom door is within 6
> feet
> > > > of it and an exam room on the other side of
> the
> > > > wall. Shouldn't there be shielding -- I wonder
> if
> > > > there is?
> > > >
> > > > Thanks so much.
>
>
>
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=====
+++++++++++++++++++
""A fanatic is one who cannot change his mind and won't change the subject." Winston Churchill
-- John
John Jacobus, MS
Certified Health Physicist
e-mail: crispy_bird@yahoo.com
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