magnets and radiation quiz

what are the uses for a magnet

• follow up

• trans-telophonic monitoring (TTM)

• monitor battery status and device function

TTM limitations

• no diagnostics (battery status and device function only)

• difficult to obtain good tracings

• limited by equipment

threshold margin test (TMT)

magnet turns off sensing and sets pacer to asynchronous mode. provides information regarding threshold.

can you change out a device before its ERI

no

what are the asynchronous modes

AOO, VOO, DOO

what is Medtronic’s fingerprint for battery status

ERI = 65ppm (VVI)

what is Soren’s fingerprint

70ppm = VVI

VVI 65 means SND patient will

feel symptomatic and need a change out

why do we need magnets during surgery

keeps pacer from over sensing bovie electricity

can you use a magnet for a left masectomy

yes you can sterilize magnet, but you will most likely have to reprogram for physician convenience

what does a magnet do during radiation treatments

protect sensing and keeps from POR

what is the #1 cause of power on reset

radiation

what happens during power on reset

pacemakers reprogram themselves

what are the problems with healthcare providers using the magnet vs the rep in teh hospital

• if pt moves around, we may have to tape to chest.

• could mistake jerks as shocks and be removed by family member

ionizing radiation uses

UV, Xrays, gamma rays (high energy)

non ionizing radiation uses

visible light, radio waves (low energy)

xray

used ionizing radiation for internal structures (bone, tissue)

fluro

uses xrays to produce real time moving images

fluro veiws from lowest to highest expose risk

AP - RAO - LAO

radiation sources

scatter, primary, leakage

what influences scatter radiation

field size, pt size, quality of xray beam

if you double your distance from radiation source

you fourth your exposure

Kerma

kinetic energy released per unit mass

Absorbed dose

radiation quantity absorbed per unit mass by tissue

equivalent dose

the absorbed dose in a tissue or organ multiplied by a weighting factor as an indication for potential biological impact

what organs have the highest radiation risk

breast, ovaries/testes, lungs, stomach, colon, bone marrow

what is justifiable exposure

no exposure unless potential benefit to pt

radiodensity scale

radiolucent (air) to radiopaque (bone, soft tissue and lungs)

ALARA

as low as reasonably achievable

STD (exposure)

shielding, time, distance

dose management

frame rate, last image hold, exposure monitoring, non-ionizing imaging

4 principles to reduce radiation exposure

1. limit time

2. limit radiation dose

3. increase distance

4. use shielding

collimnation

limitation of the primary xray beam by blade-type diaphragms on the xray tube. limits dose to pt by limiting amount of tissue exposed

radiation dose of cine is ____ as fluro

20-40 X

in fluro, you have a high risk of what

pneumothorax

what else can we use for axillary vein puncture besides fluro

ultrasound

what can we use “one shot film” for

leadless pacemakers to affirm all 4 tines are well visualized

dosimeter

used to record exposure (replaced with apps now)

7 ways we can reduce radiation dose

1. low frame rate (<2)

2. low image detector

3. high pt. table

4. avoid cine

5. avoid LAO

6. use collimation

7. avoid magnification and wedge filter

DRAPED

distance, receptor, angle, pedal, extremities, dose