Hey X-Ray Techs, Are You Keeping Up With The Changes?

I recently posted a blog on “Change”, and I figured this was a nice follow up blog article which you can implement at your institution if you haven’t done so already. There are some new recommendations in the world of XRAY which are primarily aimed at eliminating the routine use of gonadal shielding. It can still be used in select cases, such as parental refusal or patient request, but it should be explained to your patients, that things have changed. I will have a link to the NCRP (National Council On Radiation Protection and Measurements) website so that you can download all the appropriate materials and double check everything I’m saying. If your institution hasn’t changed their shielding policy already, hopefully you can use this as an opportunity to do so and make yourself look pretty good at the same time. In addition, it will demonstrate to your department manager that you are a go-getter and might be a contender for some sort of leadership position. We never want to stop our advancement of delivering exceptional patient care, but if we can do so and look awesome at the same time, then that’s a WIN-WIN!

Here are the talking points you can use with your patients which I took directly from the NCRP recommendations, their statement number 13 and companion statement, January 12, 2021.

1. The dose to the gonads from a modern x-ray beam is too low to cause harm. The dose nowadays is about 5% of what it used to be when gonadal shielding was introduced in the 50s. And overall, the medical community has recently reviewed the use of gonadal shielding and determined that it is not as effective as once thought. The much better technology that we have nowadays can make high-quality images using only very small amounts of radiation.

2. The gonads are considered to be less sensitive to radiation than what was previously thought.

3. Shielding can cover up clinically important anatomy that the doctor needs to see. If we can’t see the anatomy, we can’t comment on it. The position of the gonads varies considerably among patients making accurate positioning of the shields very challenging. Shielding fails to fully cover the gonads in 52% of male patients and 85% of female patients when imaging the pelvis.

4. If the shield covers clinically important anatomy, this can really lead to repeat films, which substantially increases the radiation dose.

5. If the shield partially or completely covers the automatic exposure control (AEC), this can lead to an increase in dose of radiation to the patient. And automatic exposure control is very effective at producing diagnostic quality images at a well-managed/low-dose.

I hope you found this helpful. See, I’m not always trying to sell you something. I know these statements were just released, but we already updated our policy regarding gonadal shielding at my institution and many of you should consider doing the same. Talk soon.