I have written several blogs about the current shielding practice errors over the last two years as the shielding debate has led to multiple erroneous new shielding policies… or I should say the lack of new shielding policies.
I have seen and heard multiple stories that facilities are removing shielding for all procedures and are telling students and technologists that shielding is no longer necessary. It has been extremely interesting how quickly imaging departments adopted or implemented the “no shielding” concept. On the other side, not as many departments have pushed to implement proper collimation and the use of high kVp/low mAs as the best practice for digital. Some technologists are routinely using post process “cropping” instead of collimation, and many department managers do not think this is bad practice. (Somebody Stop Me! Post Processing Radiographic Images, August 2018)
In July 2019, ASRT published their statement regarding the shielding controversy identifying what most radiologic technologists have known, believed, or been taught about shielding a patient for safety. This has now been codified into a completed guideline that is easy to read and utilized by radiologic technologists to guide their practice. It also can be utilized by department directors and compliance officers to design their best practice policies for the department.
You can view the official ASRT update on the gonadal and fetal shielding here, but we have included the statement below:
ASRT Update on Gonadal and Fetal Shielding
Jan 15, 2021
On Jan. 12, 2021, the ASRT Board of Directors released a statement supporting the discontinuation of the use of gonadal and fetal shielding specifically during abdominal and pelvic radiography.
Significant advances in technology have resulted in reduced patient radiation dose during radiographic procedures, opening the door to this change in clinical practice. However, the radiation protection methods implemented by registered and certified radiologic technologists remain an essential component of high-quality and safe medical imaging procedures. While shielding placed outside of the exposed field may offer only limited additional reductions to patient exposure, this low-risk practice is an important component of our comprehensive efforts to reduce excess radiation dose during our procedures.
The ASRT Board supports the continued use of lead shielding during radiographic procedures where shield placement is appropriate and aligned with minimizing patient radiation exposure. For example, the placement of a lap shield during a radiographic extremity procedure carries little-to-no risk of exam interference or error, but may significantly increase patient comfort and confidence, thus helping to reaffirm our profession’s commitment to maximizing safety. The elimination of all patient shielding from standard practice could exacerbate the radiophobia that exists among the public and our patients due to widespread media coverage of the published risks associated with medical radiation exposure.
Before considering the elimination of all patient shielding as a standard practice during radiographic procedures, it is essential that we educate our patients and health care colleagues on the recent advances in technology that have dramatically reduced patient radiation dose, as well as the indispensable role that radiologic technologists serve in the provision of safe and high-quality medical imaging procedures.
The ASRT will explore partnering with key stakeholders to collaboratively develop and disseminate educational materials to inform the public about the safety of our procedures.