New Regulations on Radiation Exposure to Patients Heading Our Way
Recent articles in Cardiology Today as well as the U.S. Department of Health & Human Services made reference to an initiative proposed by the Food and Drug Administration to reduce the radiation exposure patients receive from medical imaging.(1-2) An article in the San Diego Union-Tribune on February 17, 2010, stated, “The use of high-tech diagnostic imaging in emergency rooms has quadrupled since the mid-1990’s. The frequency of the medical scans nearly tripled at doctor offices and outpatient clinics.”(3) The FDA sees the benefits medical imaging has resulted in, such as early diagnosis and treatments, but is concerned about the risks involved.
The three imaging procedures being looked at are CT, nuclear medicine, and fluoroscopy. The FDA stated, “These procedures are the greatest contributors to total radiation exposure within the U.S. population and use much higher doses than other radiographic procedures. These procedures expose patients to ionizing radiation, which can increase a person’s lifetime cancer risk.”
The FDA plans to have a public hearing on March 30-31, 2010 on the topic.
If the initiatives get approved, it will mean changes for all who work in the cath lab. We will have to start keeping records of the radiation levels patients are exposed to and also equipment will have to have to display doses and settings. What is the best way to accurately measure a patient’s radiation exposure during a procedure? I am sure questions like this and more will be asked in the months to come.
References
1. FDA Unveils Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging. U.S. Food and Drug Administration Press Release. February 9, 2010. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm200085.htm. Accessed March 24, 2010.
2. FDA aims to reduce unnecessary radiation exposure with new initiative. Cardiology Today: News & Perspective for the Cardiovascular Specialist; February 9, 2010. Available online at http://www.cardiologytoday.com/view.aspx?rid=60744. Accessed March 24, 2010.
3. Stobbe M. CDC: MRIs, other medical scans in ER quadruple. San Diego Union-Tribune. February 17, 2010. Available at http://www.signonsandiego.com/news/2010/feb/17/cdc-mris-other-medical-sc.... Accessed March 24, 2010.
Since we knew this was coming, I have kept an electronic fluoroscopy log of all patients/procedures for nearly three years now. Life has been made so much easier since we moved into our new Heart and Vascular Institute, and both our X-Ray and Hemodynamic systems are the same vendor. Exposure data is pulled directly into the electronic record, and I can query that information to format a daily log.
Information includes: Patient ID, name, date, weight, pregnancy status, hx of exposure last 30 days, attending physcian, procedures performed, fluoroscopy time, dose area product, skin dose.
Kenneth A. Gorski, RN, RCIS, RCSA, FSICP
Reply to this comment »It’s about time that the Department looked into this serious issue of radiation exposure to patients who are advised for medical imaging so often now!! It has become second nature for doctors to recommend medical imaging in spite of the high risks involved and it is about time that some new regulations are being planned in order to protect the patients interest as many times we see that these three imaging procedures are being done when it isn’t really required!!
Reply to this comment »Mark
iuhealth.org
@Gregg - I completely agree with your statement "It’s about time that the Department looked into this serious issue of radiation exposure to patients who are advised for medical imaging so often now!"
They should also begin paying more attention to these 'clinics' that are in mini malls where people can go to and get a CAT scan, the amount of radiation that can accumulate in the persons body over the years could become a major problem - Chuck Broes
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