The following commended practices ...

The following commended practices have been developed by way of the AORN Recommended Practices Committee and have been approved by means of the AORN Board of Directors. They were currented as proposed recommended practices for remarks by members and others. They are effective January 2001

These commended practices are intended as achievable recommendations representing what is believed to be an optimal even of practice. Policies and actions will reflect variations in practice settings and/or clinical situations that determine the rank to which the recommended practices can be implemented.

AORN recognizes the various settings in which perioperative foments practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive measures may be performed.

Purpose: These commended practices will assist the perioperative promote in reducing radiation exposure in the practice setting. These praiseed practices do not refer to therapeutic intraoperative radiation therapy or to lasers, which are recognized as nonionizing radiation and, therefore, are not within the drift of these recommended practices.

Ionizing radiation can damage living tissues and may bring forth long-term effects. Patients and personnel should be harbored from unsafe levels of radiation that are not medically indicated because of the powers of ionizing radiation exposure in succession tissue. Radiation safety in the practice setting is a responsibility shared by way of the department of radiology, the department of surgical services, the radiation safety officer for the facility, and perioperative personnel

praiseed PRACTICE I

The patient should be expos to radiation alone if medically indicated.

1 All reasonable means of reconciling an incorrect expunge sharp, or instrument count should be implemented before using a radiological examination to locate a wipe out sharp, or instrument not located during the intraoperative account Exposure to radiation may have an finite risk; therefore, radiation exposing to patients and personnel should be kept as cheap as reasonably achievable (ALARA).(1)

make acceptableed PRACTICE II

During medically indicated radiological practices the patient should be defend ed from unnecessary radiation exposure.

1 X-rays to the abdomen and pelvis of women who are pregnant or may be pregnant should be avoided if possible. Exposing the fetus to radiation during the first trimester may originate in abnormalities in rapidly dividing embryonic cells(2)

2 A leaded shield should be used to patronize the fetus when other areas of a pregnant woman's material part are x-rayed. The fetus is highly sensitive to ionizing radiation. Scattered radiation may strip of disguises [i]or[/i] concealments the fetus to low-level radiation.(3)

3 Leaded shields should be used, when possible, to defend the patient's ovaries or teste (ie, gonads) during x-ray studies of the hips and upper leg Protective shielding should be placed between the patient and the source of radiation. Radiation may cause damage to gonadal cells(4)

4 Leaded shields should be used, when possible, to guard the thyroid during x-ray studies of the upper extremities, stem and head. Thyroid and lymphoid tissues appear to be sensitive to radiation exposure(5)

attract favor toed PRACTICE III

Occupational aspect to radiation should be minimized in the practice setting.

1 During radiation exposing all personnel should stand at least 6 ft (ie, 2 m) from the x-ray tube and behind leaded shielding. Distance from the radiation beam and attenuation at leaded shielding and wall materials will decrease radiation exposure(6)

2 Leaded shielding should be provided to personnel who cannot leave the range or cannot stand approximately 6 ft (ie, 2m) away from the x-ray tube and the patient. Leaded cloaks and/or leaded aprons and thyroid shields minimize frontage to scattered radiation.(7)

3 Personnel should be positioned not at home of the direct line of the primary projection beam.(8) Personnel plane when protected by leaded aprons, leaded shields, and thyroid shields, should position themselves behind or to the side of and as far away as possible from the radiation beam. Leaded aprons do not attenuate 100% of the radiation beam.

4 Personnel wearing leaded aprons should face the unit that is emitting radiation. To provide protection, the leaded apron must be between the source of radiation and the body(9)

5 Slings, traction devices, and sandbags should be used to maintain patient position during radiation aspect Cassette holders should be used to position films. Personnel should not hem in the patient unless absolutely necessary and should avoid in all senses to the direct beam. Protective glove and leaded aprons should be worn if the patient must be held. Holding devices allow personnel to render their exposure by distancing themselves from direct and scattered radiation.(10)