Hand Held Devices

What are hand-held x-ray devices?

Mobile or portable x-ray units that can be held by the operator during patient exposure

Approximately how much do hand-held x-ray units weigh?

Around 6 pounds

How are hand-held x-ray devices powered?

By a battery-powered x-ray generator

Who holds the device during x-ray exposure?

The operator

What legal requirement must hand-held x-ray devices meet in Washington State?

They must be FDA approved or cleared according to WA DOH guidelines for hand-held x-ray equipment

What is the mean annual radiation exposure to the hand extremity from a non-FDA cleared hand-held x-ray device?

40,000 microsieverts (40 mSv)

What is the mean annual whole body radiation exposure from a non-FDA cleared hand-held x-ray device?

30 microsieverts (0.03 mSv)

What is the patient entrance dose from a non-FDA cleared hand-held x-ray device?

Ranges from 0.85 to 9.34 milligrays (mGy)

What are the mobility advantages of handheld x-ray devices?

They are portable, can be brought directly to patients, and used in places like nursing homes, ORs, ERs, and disaster scene

How are handheld x-ray devices cost effective?

One device can serve multiple operatories, reducing the need for multiple wall-mounted units

How do handheld x-ray devices benefit operator-patient interaction?

The operator can stay with the patient, which is helpful for children and anxious patients and saves time

Is the radiation dose to the operator a major concern with handheld devices?

No, operator exposure is well below federal occupational dose limits and similar to wall-mounted units, assuming proper positioning

What factor has the most impact on patient dose when comparing to wall-mounted units?

Use of rectangular collimation

Why must operators be cautious of radiation to the public?

Bystanders may be inadvertently exposed if safety precautions aren't followed

How does image quality from handheld devices compare to wall-mounted units?

It is generally comparable

What is the function of internal shielding in handheld x-ray devices?

It encases the x-ray tube to eliminate leakage radiation

What is the purpose of the secondary backscatter shield?

It creates a protective zone around the operator where scattered radiation is negligible

How should the device and shield be positioned for maximum protection?

The shield should be close to the subject and parallel to the operator; the device should be horizontal and perpendicular to the operator

Is personal protective shielding required when using proper technique?

No, but new operators should use monitors to verify their exposure levels

How does beam energy from handheld devices compare to wall-mounted units?

It’s lower, so longer exposure times are needed

What happens to beam energy and output as the battery depletes?

They decrease, potentially affecting image quality

What are two physical challenges for the operator using handheld units?

Operator fatigue and risk of motion artifacts from holding the device still

What must be done between patients to ensure infection control?

Proper cleaning of the unit

Why is device security important?

To prevent unauthorized use or theft

Why should non-FDA cleared handheld devices be avoided?

They pose major safety hazards

What is the current role of handheld units in clinical practice?

They should supplement, not replace, conventional units (though this is evolving)

What ensures safety when using handheld x-ray devices?

Proper training and compliance with usage protocols

How does patient dose compare to conventional units?

It may be slightly lower, depending on the parameters used