Sunday, March 6, 2011

Shielding Issues


I have had a rough weekend.  I have been sick with a rather ugly cold, but I still had to work my two 12-hour shifts at the hospital.  I suffered through it though and will hopefully get to sleep it off tonight and tomorrow so I can get back into full swing before my next rotation starts on Tuesday...

I ran into an interesting situation today with a patient in the ER.  I had a female patient in her mid 20's, so I followed the standard protocol of finding out if she could be pregnant.  I asked her if there was any possibility she could be pregnant.  She simply responded with YES.  It turns out that she's a week late on her menstrual cycle.  She was in for a chest x-ray, so I stopped what I was doing and went back to visit the ER doctor who had ordered her x-ray.  He told me to shield her really well and make the images, so that's what I had to do.

I have issues with this decision.  In my humble opinion, shielding a patient for a chest x-ray has only minimal effect of keeping radiation away from the places you don't want it to go.  The central ray is not passing through the pelvic region, but a lot of scatter is.  The shielding I provided would have little or no effect on that scatter radiation passing from the chest region down through the pelvis.  I know that this scatter has changed direction at least 90 degrees for this to happen, and it loses a lot of energy in that process.  Losing energy in that direction also means that a larger majority of that scatter will be absorbed in the body rather than passing on through.  So what effect does the front, side, and rear shielding I provided for my potentially pregnant patient have since the radiation is coming from directly above? 


  1. Hey, I agree with you.

    It's one thing to do a hand or another extremity, but a chest x-ray is pretty close to the "fetus."

    Always a tough call though...

  2. Hey there. When the issue of a pregnant patient comes to mind, were I work we usually explain to the patient the potential risks of having a chest x-ray done at such an early stage of pregnancy, and it all comes down to her decision in getting the x-ray or not. If she does agree, she needs to sign a paper stating that we explained everything to her, and that she is willing to participate in the procedure.

    *Sorry if I may had seem intrusive, and sorry if my grammar is a bit off since english is not my language. I like your blog =)

  3. But, these risks can be minimized be following certain safety procedures like the blocking of vulnerable body parts with lead sheets or walls while the x-rays are being taken. Click here