IPEM welcomes this report but would recommend that the document emphasises the need to consult with medical physicists, either via a Medical Physics Expert or Radiation Protection Adviser as appropriate, to assist with patient and staff dose optimisation.
IPEM has the following specific comments:
Chapter 3 – general aspects of radiological protection in paediatric diagnostic imaging
Paragraph 23 – referrer’s signature not always available now with electronic imaging requesting. Second sentence does not make sense – could state ‘the examination to be performed must be justified.'
Paragraph 33 - should this be ALARP and not ALARA?
Paragraph 37 – wrong reference, should be IPEM Report 91.
Chapter 4 - radiological protection in conventional paediatric radiography and fluoroscopy
Paragraph 47 – could mention wearing protective gloves when supporting patient, even if the hands are just exposed to scattered radiation, in order to keep dose ALARP.
Section 4.4.6 – this need to switch off automatic brightness control during procedures may be equipment dependent and as such this section could be misleading. The advice of the Medical Physics Expert should be sought with regard to optimizing equipment parameters for paediatric radiography.
Chapter 5 - radiological protection in paediatric interventional radiology
Paragraph 96 – should state that hand exposure to primary radiation should be avoided. Bullet point 5 (page 39) should state that gloves do not provide sufficient shielding from primary radiation. Bullet point 7 (page 39) could be clarified.
Section 5.3 – could note that users should be aware of the relative difference in dose rates between fluoroscopy & acquisition, perhaps with example ranges to empasise the need to keep acquisition runs to a minimum.
Page 41 – table 4 seems to be in the wrong place
Chapter 6 - radiological protection in paediatric computed tomography
Section 6.3 – this section may be too in depth. A description of Dose Length Product should be included.
Chapter 7 – summary & recommendations
Could add that the advice of an Medical Physics Expert should be sought to assist with setting imaging protocols and optimization.