Does Total Radiation Exposure And Screening Time Increase With Trainees Present?

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Introduction

Measures should be used to limit radiation exposure to staff and patients during fluoroscopy guided procedures. The FDAs revised guidance in 2005 recommends that the total radiation energy delivered to patients [Dose Area Product (DAP)] and Total Screening Time (TST) are recorded during every Fluoroscopy Guided (FG) endoscopic procedure.

Aims

To evaluate if Trainees Present (TP) during therapeutic endoscopy increase the TST and total DAP.

Methods

Record TST and DAP from FG endoscopic procedures performed between June 2016-17, excluding ERCPs within the Belfast City Hospital and categorise procedures into trainee present or not.

Results

Total Number N=134. Group 1 (N=76 oesophageal stents): Average Total Screening Time (ATST) of 9.9min (TP) vs 3.21 min (NTP) with average DAP of 1397.89 vs 1050.43 respectively. Group 2 (N=27 Bougie Dilatations): ATST 3.05min(TP) vs 1.89 (NTP) with average DAP 862.07 vs 374 respectively. Group 3 (N=13 duodenal stents), 21 USG AUTUMN MEETING 2017 and Group 4 (N=10 pneumatic dilatations) showed no significant difference between ATST and DAP. Group 5 (N=7 stent assessments and 1 oesophageal stent removal) ATST 3.4 min (TP) vs 1.95 (NTP) and DAP 1517:819.41 respectively.

Conclusion

An average increase of 1.2 minute/procedure ATST was identified
with a trainee present in our study. TST And DAP depends on a
number of variables including technical difficulty of procedure,
technician experience, and patient size. Previous reports have
demonstrated a linear relationship between TST and DAP and as a
result, the shortest possible screening time is recommended to reduce
potential risk to patient and technicians during procedures.