Answer to Question #12112 Submitted to "Ask the Experts"
The following question was answered by an expert in the appropriate field:
I have a question in regard to lead-lined operating rooms. I did verify that the state that the operating room is in requires this type of barrier protection to be in place. We are concerned about the use of a C-arm unit and a mini C-arm unit and the impact of scatter radiation to adjacent rooms and hallways. Years ago, the facility had one operating room installed with lead-backed drywall. Would using this lead-lined room for all C-arm and mini C-arm procedures in conjunction with current barrier protections be considered another level of achieving radiation doses that are as low as reasonably achievable (ALARA)?
To answer your question, using a C-arm or mini C-arm unit in a shielded operating room would be an ALARA practice; however, it may not be necessary (or practical) to do all of your x-ray cases in the same room if you have other rooms available to rotate the x-ray equipment through.
Each state regulates the use of x rays and has its own requirements for shielding design for medical facilities. For states in which we work, it is common that shielding plans and lead are not required for operating rooms, when multiple rooms are in use. This assumes that one or more C-arm and mini C-arm units are used in different operating rooms. If a C-arm or mini C-arm is used in one operating room only, many states will consider this the same as a "fixed installation" (even though the unit is on wheels and mobile) and will require a shielding plan and possibly lead in the walls.
Your question did not clearly indicate if your facility has multiple operating rooms with one room shielded, or if you have just the one shielded operating room. In either case, you must follow the requirements of the state you are in regarding shielding plans and room surveys. It is also important that you use a qualified medical health physicist or medical physicist to help you determine what requirements you have to meet regarding shielding design and surveys and equipment testing.
Kennith "Duke" Lovins, CHP