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Submitted by Graciano Paulo, EFRS
   Commenting on behalf of the organisation
Document Radiological Protection in Fluoroscopically Guided Procedures Performed outside the Imaging Department


August, 2011

Draft Report for Consultation

Radiological protection in fluoroscopically guided procedures performed outside the imaging department


The EFRS strongly supports this report, as it will be a very important tool to promote awareness about radiological protection issues in fluoroscopically guided procedures performed outside the imaging department, mainly if it reinforces the importance of having a permanent contribution of a radiographer/technologist whenever a radiological procedure is performed.


Once this report assumes an international perspective, EFRS would suggest always the use of the word “Radiographer/Technologist”, whenever the text refers to a “Radiographer” or “Technologist”.


The EFRS Board, after hearing the EFRS group of experts, would like to contribute with the following comments:


Line 368 – Once Radiographers/Technologists are familiar with the fluoroscopy units used in the facility, their contribution for equipment operation should be always considered in order to protect patients and staff from radiation exposure.

Paragraph 1.6 – We consider that a minimum level of training should be recommended for non-radiologist or non-radiographer professionals (following RP 116 recommendations)


Line 569, table 2.2: The threshold of tissue reactions during fractionated exposure of the lens is a bit unclear. The threshold dose for detectable opacity is higher than for cataract, which means it is possible to get cataract without a detectable opacity.


Line 774: Suggest a new sentence. “When using over couch geometry, fingers in the primary beam will typically receive doses that are 100 times higher in comparison when using under couch geometry.”


Line 813: Suggest a new sentence. “In addition to the greater thickness, the source to skin distance will decrease giving an increase of the skin dose.”


Line 861: Suggest a new sentence. “The scatter will increase linear with the increase of the area of the radiation field. A primary beam that is partly outside the patient will increase the staff doses, since there is no tissue to attenuate the scatter.”


Line 994: Suggest a new sentence. “The dosimeter gives the estimate for the lens dose, if it is worn on the collar closest to the X-ray tube.”


Line 2421: Is it the relative risk of incidence of childhood cancer that is mentioned on line 2421? Later on line 2423 is there mentioned the risk of fatal childhood cancer. ? or statement