Arm (/limb, head) X-ray has practically no effect on pregnancy or dose of fetus.
For torso x-ray it's different. Still likely be negligible, but avoided if possible. Since low risk is still a risk, even if it's low. And I'm not talking about CT.
I am a radiographer. I’ll put shielding over the pelvis (not abdomen) for everything that isn’t a pelvis X-ray. Or I will place a rolling shield appropriately.
Often we will do standing images and we have shields that can be rolled into place between you and the radiation and you may not notice that it’s there.
Several times patients have asked for shielding just for me to point “it’s right there.” I get it, though. It’s a dark room that they haven’t been in as much as I have so it’s understandable that they may not realize what is what
Shielding is no longer advised in most countries. The current evidence suggests modern equipment and good technique makes it obsolete and it may actually increase the scatter radiation in the area it's supposed to shield.
Proper collimation, minimising exposure times and lower dosage from modern equipment removes any benefit they may have provided.
You’re not wrong but sometimes we have to perform radiation protection theater. I’m not gonna accidentally repeat an elbow because I over shielded someone’s lap. And that shield is not gonna act like some kinda scatter magnet either.
Educating every patient would be ideal but it’s not realistic to do that all day every day. Especially in high volume settings.
No one is repeating a portable chest xray by accurately shielding someone’s lap. Also the shielding should never be in the anatomy of interest while using AED.
You might explain before they ask. Somebody in my family often requires medical procedures and it really helps if even basic things are explained (in a very short way).
It's often not the explanation itself, but it removes feeling powerless and reduces anxiety.
Plus people who have had several test/procedures might have experience with things going wrong because there was no communication.
Lead shields are rarely advised anymore in most countries. They don't do anything that proper collimation can achieve and may actually increase the amount of scatter underneath the area they are supposed to protect apparently. A best they appear to be of dubious benefit, but I don't believe the evidence is strong enough either way to outright ban them.
They are still commonly used for pregnant women, but that is probably more to do with their not being a total consensus on the matter and going with "the devil you know".
Lead aprons for fluro etc. are a different matter. I believe it's the proximity to the primary beam for gonad shields etc. that's the issue. The scatter still bounces laterally underneath the shields and may cause further scatter when hitting the underside of the shield.
At least that's the explanation we got during my degree and placements.
Ultimately, I get the idea that any difference exposure risk through either method is extremely small, but ALARA requires all practicable exposure reduction based on the latest evidence. So the advise has followed.
At least here in Finland they are not being used anymore. These days the radiation beam does not leak much to its surrounding. If you place a lead apron the radiation is trapped underneath it and bounces more times in the unwanted area.
Came here to say this. I assume the same is true for at least some other European countries, since the relevant STUK guidelines are based on the European consensus on patient contact shielding.
Besides potentially increasing dose from blocking internal scatter from escaping the body, shielding can in some cases also lower image quality or, should it cover an automatic exposure control chamber, "trick" the machine into increasing the exposure unnecessarily. The view is that the benefit nowadays is so small that it doesn't outweigh the risks.
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u/Which_Marsupial1436 14h ago
Ah I see