Radiation safety in interventional nephrology

Table 1 Representative radiation doses received by patients and providers (with standard shielding garments) during common radiologic procedures

Intervention	Patient radiation dose (mSv)	Typical screening time (minute)	Primary operator radiation dose (mSv)
Diagnostic
Chest X-ray	0.02
Barium swallow	2
CT pulmonary angiogram	8
CT coronary angiogram	1
Interventional
Coronary angiogram	6	2	0.003
Percutaneous coronary intervention	15	10	0.006
Nephrostom	3	3	0.006
Percutaneous nephrolithotomy	4	2	0.013
Neurologic embolisation	40	30	0.02
Peripheral revascularisation	20	15	0.02
Dialysis access
Tunnelled haemodialysis catheter	0.1	1	0.0005
Percutaneous tenckhoff catheter	0.1	1	0.0005
Arteriovenous fistuloplasty	2	4	0.005

CT: Computed tomography.

Table 2 Key components of a fluoroscopy suite

Fittings	Description
Operating table	The patient is placed on the fluoroscopy table. The fluoroscopy table is radiolucent and lightweight to enable X-ray penetration
C-arm	A movable C-shaped semi-circular frame, usually mounted on a gantry, which girdles the patient. The X-ray tube is located on the lower arm and the flat panel detector and image intensifier are located on the top arm
Display monitor	Television or computer screens located within the suite which display fluoroscopic images for the proceduralist. Film was historically used but has been replaced by digital picture archiving and communication systems
Control console	Buttons and dials control various parameters, such as distance or acquisition. Many settings are computer-automated, which is often more efficient than manual controls
Shielding	Radiation shields skirt the underside of the operating table and are embedded within the external room walls. Transparent mobile protective shields can be mounted on wheels or fixed to the ceiling
Consumables	It is preferable that instruments, such as wires, catheters, and a portable ultrasound machine are easily accessible in or near the room. This prevents radiation breaches and maintains sterility