AORN's recent update to its Guideline for Radiation Safety offers new ideas for protecting surgical personnel from imaging's invisible dangers.
Most recommendations and standards regarding radiation safety are rooted in common sense. For example, OR teams have subscribed for years to the concept of capturing images with ALARA (as low as reasonably achievable) exposure. The importance of shielding both practitioners and patients with protective coverings is widely known. And you likely know that personnel who routinely work around C-arms and other radiological devices should have their exposure levels monitored.
A common question is whether personnel in sterile attire need to leave the room when radiation-emitting devices are being used. The answer is no. Typically they need only be about 6 feet away from the source, or a little farther if the source isn't angled straight up and down. The collective evidence, taken from more than 20 sources, establishes that the radiation dose received by personnel decreases dramatically as the distance from the source increases. That's due to a principle known as the inverse square law, which states that when the distance between the person and the source is doubled, the exposure is decreased by a factor of 4 (2 squared) and when the distance is tripled, the dose is decreased by a factor of 9 (3 squared).
Six feet is considered the distance at which exposure is decreased to a safe level (but many state and local regulations require all personnel in the room to use some form of shielding). The bottom line: Personnel should always stay as far away as possible from the radiation source and limit the amount of time they spend close to it, but there's no need to leave the room and increase risks of outside sources contaminating the OR. If someone must leave during a procedure, rolling lead doors provide excellent protection and decrease the likelihood that the sterile field will be contaminated.
The attached checklist board designs effectively communicate to the facility staff when and what type of radiation or laser emitting devices are in use.