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Cath Lab Changes to Cut Radiation Exposure

Radiation dose received by patients during invasive cardiology procedures has the potential to cause skin damage and is assumed to include a small cancer risk. To help ensure patient safety, it is desirable to minimize patient radiation dose to patients undergoing these procedures. An inherent benefit of reduced patient dose is reduced dose to physician operators and staff. Previous studies have tested patient radiation dose-reduction initiatives for radiofrequency ablation and invasive coronary artery procedures. Few studies, however, have explored the effects of using sustained patient radiation dose-reduction initiatives in larger, diverse invasive cardiovascular settings. A Progressive Movement on Patient Radiation In an issue of JACC: Cardiovascular Interventions, Kenneth A. Fetterly, PhD, and colleagues had a single-center study published that investigated the effects of sustained practice and x-ray system technical changes on radiation doses administered to adult patients during invasive cardiovascular procedures. Data were categorized to include all procedures, PCIs, coronary angiographies, noncardiac vascular angiographies and interventions, and procedures to treat structural heart disease. Under the guidance of a cardiovascular invasive labs radiation safety committee convened by the Mayo Clinic, several clinical progressive changes were implemented from 2008 to 2010 to elevate radiation awareness and reduce patient radiation dose. The changes included: [polldaddy poll=6965513] Establishing a multidisciplinary catheterization laboratory radiation safety committee. Announcing radiation doses during procedures at 3,000 mGy intervals to increase awareness and minimize high-dose procedures. Documenting the radiation dose in final reports upon conclusion of procedures. Mandating that fellows be trained on x-ray imaging and radiation safety. Standardizing x-ray protocols. Increasing spectral filtration for acquisition imaging. Setting the default fluoroscopy program to a low dose rate. Reducing...

Discussions on Medical Imaging Risks

A national survey has found that 71% of physicians reported that they educated patients 25% of the time or less about radiation risks when they ordered CT tests. Only 27% reported feeling comfortable educating patients about risks associated with ionizing radiation for medical imaging. Time limitations were cited as a top obstacle to adequately educating patients. Abstract: Archives of Internal Medicine, July 9,...

Screening Recommendations for Osteoporosis

Over half of all postmenopausal women will develop a fracture related to osteoporosis during their lifetime, including 15% who will suffer hip fractures. Although fewer men than women develop osteoporosis, more than one-third of men who sustain a hip fracture die within 1 year. A new statement issued by the United States Preventive Services Task Force (USPSTF) aims to provide clinicians with current, evidence-based recommendations for osteoporosis screening. These recommendations, published in the January 2011Annals of Internal Medicine, are designed to assist clinicians on the appropriate time to initiate osteoporosis screening based on patient characteristics and clinical data. Major Modifications to Osteoporosis Recommendations In 2002, the USPSTF recommended to routinely screen women aged 65 and older for osteoporosis and screen women between the ages of 60 and 64 with an increased risk for osteoporotic fractures. Since 2002, a wealth of data has emerged on risk among younger women. Accordingly, the new recommendation extended screening for osteoporosis to women aged 65 or older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old Caucasian woman who has no additional risk factors. The current guidelines contain no recommendation for or against osteoporosis screening in younger women. “Validation studies on tools to predict osteoporosis risk have been completed, and these investigations have revealed that risk assessment tools can accurately identify potential osteoporosis risk.” In 2002, a single osteoporosis screening tool was not recommended for universal use. Since that time, validation studies on tools to predict osteoporosis risk have been completed, and these investigations have revealed that risk assessment tools can accurately identify potential osteoporosis risk. The World...
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