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Session: Poster session 2 (Odd numbers)
Session starts: Friday 27 January, 10:00
Presentation starts: 10:00

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Teddy Vijfvinkel (Delft University of Technology)
Caroline Janssen (Reinier de Graaf Hospital)
Karlijn Scheepens (Reinier de Graaf Hospital)
Vincent Verhoeven (Reinier de Graaf Hospital)
Benno Hendriks (Delft University of Technology)
John van den Dobbelsteen (Delft University of Technology)
Maarten van der Elst (Delft University of Technology)

Abstract:
Introduction In current vascular and trauma surgery, imaging techniques using X-rays are an indispensable part of the workflow. At the same time, radiation creates a risk for both patient and medical staff. The ALARA principles provide measures to keep radiation exposure as low as reasonably achievable. However, procedure-specific radiation load is unknown and targeted feedback is non-existent. Therefore, this study aimed to determine the radiation exposure of medical staff in order to understand adherence to guidelines and target areas for improvement. Methods A single-site prospective observational cohort study was conducted. Data on scattered radiation exposure was collected using Philips DoseAware dosimeters during vascular and trauma surgery requiring X-ray. Surgeons were equipped with dosimeters on the forehead and on both wrists; all other staff wore dosimeters on top of the lead apron at chest height. The total radiation dose used during surgery was retrieved from the C-arm. A ratio between used and received radiation was then calculated to compare procedures. Results During this study, 84 procedures were included consisting of 71 trauma surgeries and 13 vascular surgeries. The dosimeter on the left wrist of the primary surgeon received the highest radiation dose compared to the other dosimeter locations: 23,58 µSv (SD ± 31,33) vs 3,81 µSv (SD ± 7,65), p<0,001. The average dose received by the primary surgeon was 12,12 µSv (SD ± 24,97) per procedure, whilst the secondary surgeon received on average 4,72 µSv (SD ± 7,11), p<0,001. The anaesthesia assistant was exposed to the smallest radiation dose with an average of 0,58 µSv (SD ± 1,43) per procedure. All staff members received significantly more radiation during vascular surgery compared to exposure during trauma surgery, although this difference reduced when correcting for the total radiation dose used. Discussion This study gives a unique insight in the distribution of scattered radiation during vascular and trauma surgery. It clearly shows that the primary surgeon, and specifically the left arm, receives the most scattered radiation throughout the procedures, albeit acceptable and still far from the annual threshold of 20 mSv. Furthermore, this study confirms a significantly higher radiation dose is used and received during vascular surgery in comparison to trauma surgery. With these insights, procedure-related feedback systems can be developed to take specific precautions and enhance radiation awareness and hygiene.