In healthcare, so much of safety and reference materials emphasize how to protect the patient, but there are far fewer resources dedicated toward helping protect you, the provider, over the course of time.
While patients may be exposed to radiation only when they come in for an imaging exam or undergo a surgical procedure utilizing a C-arm, the providers who use these systems over the course of years are exposed again and again and again. Steps can certainly be taken to minimize the risk and lower the dose to ALARA (As Low as Reasonably Achievable) standards, but the ongoing exposure can still take its toll.
In addition to providing imaging equipment service, our earliest years were focused on selling general X-ray and imaging consumables (things like the actual film that X-rays used to be imprinted on, if you can remember those days). By 1998, we began to focus on digital imaging, which ultimately propelled our growth and our ability to connect our customers with cutting-edge technology.
This danger was recently highlighted in a documentary called Scattered Denial: The Occupational Dangers of Radiation. This 6-part docuseries, which aired on PBS and can be seen in its entirety on Youtube, explores in vivid detail, using data and anecdotal evidence, how years of working in and around radiation systems can create occupational work hazards and result in serious injury.
We wanted to provide some C-arm radiation exposure prevention tips to help you protect yourself just as you would your patients. By making adjustments both minor and major, you can keep you and your team safer over the long run and provide a healthier environment for all who enter it.
Switch Places So as Not to Favor Any One Side Near the Detector
One insight that gets brought up in Scattered Denial is the tendency for healthcare providers who stand near a C-arm to develop skin cancer on the side of their body closest to the radiation emitter. 
This makes sense intuitively. If one part of your body is in close proximity to a radiation source, the risk of cancer in that area will go up accordingly. At low levels and limited windows of time, this risk remains relatively low. But if you continue to stand in the position day after day, week after week, year after year, etc., even that low dose can be dangerous.
So what can be done? If you or a team member typically position yourselves in the same spot, favoring one side of your body close to the C-arm, consider swapping to the other side if possible. For some, such as the surgeon, this could be easier said than done. But if you can start with just one or two case types where you can move your body further from the C-arm, it can go a long way toward reducing long-term damage to that body part.
However, if it’s not possible and, due to your unique case mix, you’ll always need to have a portion of your body close to the C-arm, then you have to take other steps.
Rotate Team Members Around the Labs and Throughout the Facility
When repositioning isn’t possible, you could also consider protecting your team by regularly rotating staff into different roles and different stations.
Of course, this is only going to work if you’re a facility of a certain size. Office-based labs and ambulatory surgery centers often don’t have the luxury of assigning team members to different positions each day of the week or on a weekly basis.
But for those hospitals and health systems who are able to meet certain staffing criteria, you might consider not dedicating personnel exclusively to in-lab positions where they’re always in close proximity to the C-arm. In these instances, you might adopt a policy where they work one day in the lab and the next in an administrative capacity. Or, you could rotate them further away from the radiation source.
Again, this may not be possible in all facilities, which is why you’ll need to pair it with other measures…
Never Ignore Regular Maintenance and Calibration
This can be one of the biggest overlooked factors affecting how much radiation you’re exposed to on a regular basis.
If your C-arm is outdated and/or has been in use for a significant number of procedures, it might be emitting more radiation than would be considered safe by modern standards. Safety features could have deteriorated over time or, at the very least, they could simply be eclipsed by modern technology. Radiation numbers can creep up slowly, and it might not be much, but again, even slight radiation increases can have a long-term deleterious effect.
Hopefully, your organization has a radiation safety officer or department responsible for monitoring C-arms and other systems over time to make sure dose remains as low as possible. If not, one of your first steps should be inquiring with your administration about what steps they’re taking to manually monitor the dose of systems. At the very least, they should have a third-party provider, such as an equipment vendor or other outside entity, to regularly monitor dose and engage staff when adjustments need to be made.
To this end, it’s important that your C-arms (and all imaging systems) undergo regular calibration and preventive maintenance. When your systems receive regular software updates and are maintained by a certified expert, you can be confident in the knowledge that radiation dose is kept to a minimum. Without this kind of ongoing attention, your C-arm could, over the course of years, be exposing you and your team to heightened radiation doses without you realizing it.
Wear Lead Vests and Other Materials
The most obvious preventive measure is one that you’re no doubt familiar with: lead-based protective clothing options.
This is probably the most common method of protecting from radiation in the OR. But it also has some serious drawbacks. First, it creates musculoskeletal strain, leading to long-term damage over the course of years and decades. Lead-based aprons and other materials also experience wear and tear over time. And they might not always be the best fit for everyone on your team.
So, when using lead vests and protective clothing, take a few precautions. Make sure you purchase a variety of different sizes so that each member of your team can wear the item that fits them, neither being too large nor affording too little protection. Also make sure that you’re replacing the products over time so that you always have full protection from each item.
Invest In Some Kind of Shielding System
The option that has grown in popularity the most in recent years is a shielding system that actually limits radiation by blocking it at the source.
A variety of shielding products have hit the market in recent years. Whether they surround the patient or surround the emitter, the end goal is the same: to limit radiation’s ability to directly impact healthcare providers during a procedure.
Radiaction Medical is one such option. It proactively blocks radiation at the source. An accessory to your existing C-arm, the Radiaction system encapsulates the imaging beam, providing a dynamic barrier of protection to the entire medical team.
Shielding systems truly do seem like the next frontier of radiation protection.
Protection for the Long-Term
Radiation risk shouldn’t be taken lightly, nor should healthcare providers simply assume that the risks have been mitigated by their organization or the technology they use. ALARA is helpful, but it’s also murky, and you can never be fully confident that all reasonable safety measures have been taken.
By being more proactive about the steps you take to reduce radiation exposure for you and your team, you can help create a better working environment and minimize the potential risk you face for decades to come.
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