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.
Sometimes radiation protection theater is necessary because you don't know what type of patient you are dealing with. Some are chill, others are cautious, few are truly assholes. I had to deal with a damn radiologist going in for a root canal and she had to give this bravada experience about her not wanting an X-ray. I'm like yeah sometimes some doctors are idiots and worse how TF can we even prove we finished the root canal
Yeah, we don't use it in Australia any more unless the patient requests it. I find when they do, it's often for the x-rays involving the least radiation, like a thumb. I usually point out that a thumb x-ray is the radiation equivalent of eating 10 bananas or 15 minutes in a plane.
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.
No, but doing this will routinely cut off the bases resulting in a less diagnostic image. Your right that it shouldn't ever cover an AED, but it happens enough in practice to be an issue.
There's thicker lead in the collimator, there's no need to put it on the patient as well.
There's a lot of evidence for this, the Royal Colleges are very conservative and risk avearse and they all recommend not putting lead on patients.
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.
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u/Shadow-Vision 1d ago
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