Radiation Quiz

Radiation

(or ionizing radiation) is simply a form of energy capable of producing ions (free radicals) directly or indirectly as it passes through matter. Two types: natural or background and man-made

Natural or background radiation

generated from three sources: terrestrial radiation, cosmic radiation, and internal radiation.

terrestrial radiation

from naturally occurring radionuclides found in the earth. These radioactive materials (including uranium, thorium, and radium) exist in soil and rock and emit ionizing radiation as they decay into stable materials.

Cosmic Radiation

From the sun and stars. Differences in elevation, atmospheric conditions, and the Earth’s magnetic field can change the amount or dose of cosmic radiation we receive.

Internal Radiation

is from elements found naturally in our body. Essentially all air contains radon, in addition, water contains small amounts of dissolved uranium and thorium, and all organic matter (both plant and animal) contains radioactive carbon and potassium. Some of these materials are ingested as or with food and water while other (such as radon) are inhaled. These radioactive materials are then taken up by the body’s own tissues.

Man-Made Radiation

Radiation produced in devices like x-ray machines or CT scans, or artificial radiation made in a nuclear reactor. This type of radiation is used in both medicine and industry to create electricity, diagnose or treat medical problems, or create and improve consumer products. Main users or man-made radiation include: medical facilities, research institutions, nuclear reactors found in industry and nuclear submarines, and federal facilities involved in nuclear weapons production. Elements that have unstable atoms seek to lose energy by emitting various types of radiation. These elements are called radioactive materials and are found in the healthcare environment. For example, they can be used for therapeutic or diagnostic purposes. Radioactive materials may emit gamma, x-ray, alpha, or beta particle radiation. They may be in liquid, solid, or gaseous forms and can be particularly harmful if ingested.

Radiation Warning Signs

The tri-foil is the international symbol for radiation. It’s typically magenta or black on a yellow or white background. In these areas, they must be restricted and limit exposure to employees by wearing radiation monitors.

Areas utilizing ionizing radiation

diagnostic radiology, angiography, OR, invasive cardiology, nuclear medicine, dental unit

Equipment that produces radiation

fluoroscopy, mammography, CT, general radiography, dental panography, portable x-ray

Ways to be exposed to radiation

inhalation, ingestion, absorption

_____% of total population exposure to radiation is due to medical procedures

48

A rise in exposure to radiation from medical procedures is due to:

more utilization of CT and cardiac nuclear exams and a lack of awareness about protective measures of radiation

This population are most exposed to medical procedures:

elderly and in poor health

ALARA stands for

As low as reasonably achievable

ALARA

a radiological protection philosophy based on making reasonable effort to maintain exposures to ionizing radiation as far below the dose limits as is practical and consistent with the purpose for which the exposure is undertaken.

The degree of exposure depends on three measures:

time, distance, shielding

Time: degree of exposure

The amount of radiation exposure is directly related to time. Methods to reduce the time spent near a radiation source: use of remote equipment, work at an arm’s length, stay away from signs posted unless it is necessary to enter to perform duties

Distance: Degree of exposure

The most effective means of reducing exposure. Ways to maximize distance: plan the job, perform mock-up training, perform as much work as possible outside of the radiation area, properly stage for work, leave radiation area during work delays.

Shielding: Degree of exposure

having something that will absorb radiation between you and the source. Fixed: Lead or concrete walls, or portable: lead apron, thyroid shield, lead glasses or gloves.

Gamma Radiation

Goes through paper, glass, and aluminum. Not concrete or lead

How much radiation exposure is safe?

None

What happens to the body when energy is deposited in body tissue?

Cell damage or death. Body attempts to repair, but may be too widespread to be repaired. Extent of damage is dependent on the time and dose of exposure and the organs exposed. There may be no effect or abnormalities which are permanent like genetic defects in children of exposed parents or mental retardation in the children of mothers exposed during pregnancy.

Biological effects of radiation exposure

nausea, fatigue, hair loss, diarrhea, hemorrhage, internal bleeding, loss of consciousness, death. With low doses over a log period of time, there is a delay in health effects and may not show up for months or years. A large dose may result in effects immediately or delayed.

Common occupational exposure

medical, aviation, government, education and research, industry, nuclear power

What material best protects from gamma or x-rays?

Lead

Radiation Monitoring

Wear a badge with a radiation monitor: thermoluminescent dosimeter (TLD). May be posted outside radiology rooms as well. If pregnant, workers are required to wear a TLD throughout.

Dosimetry Reports

Generated and reviewed by state regulations. They are available for employee review. If a level is high, an investigation may be initiated. Limits of 3 rem per qtr and 5 rem per year. Fetus protection: .5 rem during entire pregnancy

Radiation Safety Officer (RSO)

ensure staff member exposure does not exceed limits, implement and enforce policies, contact for employee questions about radiation, maintain and monitor reports, update radiation safety manual

What is the source of radiation for an SLP during a VFSS?

The patient is the source after the beams hit them

Scatter Radiation

Radiation that interacts with the patient’s tissue and changes direction

Inverse Square Law

Radiation exposure decreases as distance from the source decreases

Primary purpose of radiation safety during a VFSS

Minimizing radiation exposure for both the patient and the clinician while obtaining the information needed for clinical examination

Beam on time

The amount of time the fluoroscopy beam is activated.

Ways to Reduce Beam-On Time

Prepare before activating the beam, plan the examination, practice maneuvers when possible, minimize unnecessary panning, and avoid unnecessary continuous fluoroscopy.

Collimation

Restricting the radiation beam to the anatomical area being examined; it reduces scatter radiation and improves image contrast.

FEES

An alternative or interval swallowing examination that can help reduce cumulative radiation exposure when appropriate.

Secondary Barrier

A protective barrier, such as the radiology technologist's control station, that reduces radiation exposure.

When Should a Clinician Increase Distance During VFSS?

Whenever feasible during beam-on time, including during esophageal screening or when another person is administering the bolus.

When might a clinician need to remain close to a patient?

When assisting medically fragile patients, patients who are difficult to position, or patients with cognitive or language impairments.

Wraparound or coat-style apron

An apron style that provides additional protection to the back when the clinician turns or bends.

Thyroid Shield

A protective device fitted around the neck to reduce radiation exposure to the thyroid.

Lead Glasses

Protective eyewear used to reduce radiation exposure to the lens of the eye.

Apron Inspections

Protective aprons should be inspected for damage because damaged aprons may provide less effective protection.

Hands in primary beam

Hands should never be placed in the primary radiation beam, whether gloved or ungloved.

Lead gloves and automatic exposure control

The article cautions against placing lead gloves in the beam because their added density may cause automatic exposure control to increase the dose rate.

Ring Dosimetry

A method of monitoring radiation exposure to the fingers when repeated hand exposure is a concern.

Dosimeter Placement

Depending on the monitoring protocol, dosimeters may be worn at the collar, waist under the apron, or on a finger as a ring dosimeter.

Communication During VFSS

Clear, positive, and confident communication with the radiologist and radiology technologist supports an efficient examination.

Factors that may make VFSS take longer

Difficult positioning, medical fragility, cognitive or language impairments, the need for assistance, and complex clinical questions.

Radiation and Thyroid Cancer

Research indicates an association between radiation exposure at a young age and increased risk of differentiated thyroid cancer.

What Are Possible Explanations for the Increased Incidence of Thyroid Cancer?

Increased detection through ultrasound and fine-needle aspiration, a true increase in thyroid cancer cases, and possibly medical radiation exposure. The extent of each contribution is unclear.

Who is most vulnerable to radiation?

Children

______during childhood is associated with an increased risk of developing thyroid cancer.

Radiation exposure

What has more radiation? CT or x-rays

CT

What kind of cancer is most likely following radiation exposure?

Papillary Thyroid

Other thyroid issues that can be caused by radiation:

• Hypothyroidism

• Benign thyroid nodules

• Secondary thyroid cancers