A new radiation protection system designed to protect physicians and staff in the electrophysiology (EP) lab was introduced at the NASPE-Heart Rhythm Society 2004 meeting in San Francisco. The system is a new line of radiation protective drapes and shields that absorbs radiation and stops as much as 97% from reaching the physician and staff members. Todd Cohen, MD, in collaboration with Worldwide Innovations & Technologies, Inc. (WIT), designed these products. The new products are called Prometheus™ radiation protection drapes and shields, and they have been specifically created for the EP lab.

       With over 15 years in the EP lab, Dr. Cohen is quite familiar with the challenges and radiation exposures that exist. Dr. Cohen, who personally performs a very large volume of EP procedures, began using the RADPAD^® radiation protection products approximately two years ago. As a result, he has reduced his exposure significantly (over 50%). After using these products, Dr. Cohen decided that specially designed drapes and shields for the EP lab were needed. EP procedures are known for long fluoroscopy times and significant radiation exposures. Thus, the operator and the support technologist are greatly exposed to scatter radiation. Dr. Cohen wanted to address this problem by expanding the coverage area and increasing the attenuation levels. He worked with WIT to bring improved radiation protection products and new designs to the EP lab in the form of Prometheus^™ radiation protection drapes and shields.
       These Prometheus^™ radiation protection products are the latest in a growing list of WIT radiation protective products. The following are some important questions and answers regarding these new products.

Figure 1.

Dave Hopkins, President of Angio Systems, Inc. and John Cadwalader, CEO of Worldwide Innovations & Technologies, Inc., show two of the Prometheus™ products (full-length angiography drape and an “L” shield) in the NASPE-Heart Rhythm Society exhibit hall in San Francisco, May 2004.

What are Prometheus^™ drapes and shields?
       The Prometheus^™ drapes and shields are part of the rapidly growing RADPAD^® line of radiation protection products, all of which are sterile, disposable, and lead free. The products come in full patient drapes as well as special stand-alone shields that block secondary (or scatter) radiation as it emanates from the patient. The Prometheus^™ products are different from other RADPAD^® shields and drapes in that they have been developed specifically for the electrophysiology lab with especially high attenuation capabilities. However, these drapes and shields will also work well in interventional radiology and interventional cardiology.

How do they work?
       The shields and drapes are placed on the patient to create a barrier between the patient and the physician. When the secondary radiation leaves the patient’s body, the special radiation-attenuation material absorbs it. This is important because secondary radiation is the primary source of radiation that the EP staff and physicians receive during interventional EP procedures.

What is the radiation absorbing material?
       The material contains a number of high-attenuation metals that are embedded in a film matrix. The material in the Prometheus products will attenuate or absorb over 97% of a direct 90kVp beam. The RADPAD^® and Prometheus^™ products are not intended to be placed in the path of the primary beam, but adjacent to the primary beam to block the scatter radiation.

Figure 2.

RADPAD Prometheus “L” Shield (Cat. #4910).

Figure 3.

RADPAD Prometheus Left Side Pacemaker/ICD Drape (Cat. #4920).

What makes these products different?
       The primary focus of the current RADPAD^® products has been to provide the physician with good protection from scatter radiation. In addition, the staff also receives some degree of protection with the current RADPAD^® products. The new Prometheus^™ products are different in that they provide an even higher attenuation level (up to 97%) and the protective material covers a larger area of the patient. Thus, the Prometheus^™ products are designed to provide more protection for the whole EP lab team.

What studies have been performed that prove the effectiveness of these products?
       The basic RADPAD^® products have been studied extensively not only in the EP area, but also in Cardiac Cath and Interventional Radiology. The results of these studies have been published in numerous abstracts and articles. Dr. Cohen performed an excellent EP study that was presented at NASPE 2003.¹ Dr. Wendy Shear performed an extensive cardiac catheterization study that was presented at the Society of Cardiac Angiography & Interventions in 2002.² A peer review journal article by Dr. Jerry King was published in the American Journal of Roentgenology in January 2002.³ Recently, in the June 2004 issue of PACE,4 an article by Dr. Grant Simons was published that showed he received an 80% reduction in his radiation exposure during pacemaker and cardioverter defibrillator implantations by using the RADPAD^® products. The Prometheus^™ products will be effective in all of the medical disciplines that use fluoroscopy, as future studies will prove.

Where does the name “Prometheus” come from?
       Prometheus was a god from Greek mythology; his name means “forethought.” He is sometimes known as the “Protector of Man” because he stole fire from Zeus and gave it to mortal man, along with many other gifts such as brickwork, woodworking, healing drugs, and art. It is fitting that the radiation protection products would be named after the “Protector of Man.”

Is the cost for the Prometheus^™ products reimbursable to the hospital?
Unfortunately, the answer is no, because the benefit is to the physician and staff instead of to the patient. However, the cost is very reasonable for the high level of protection provided. Furthermore, the hospital has a responsibility from both an ALARA (As Low As Reasonably Achievable) perspective and state regulatory perspective to protect everyone from radiation, including interventional EP physicians and staff.

What are the consequences of not using the radiation protection devices and methods available?
       Japanese atomic bomb survivor data shows that long-term health problems are associated with excessive radiation exposure. Health issues such as leukemia, cancer, cataracts, dermatitis, neurological disorders, etc. have been found to occur with radiation workers who were exposed to greater than minor amounts of radiation.

What other perspective regarding radiation protection can you provide?
       Before these new devices and methods were available, physicians and staff accepted the risks and just did the best they could. Now, with these new and greatly improved protection devices, the medical community needs to break through the “we’ve always done it this way” mindset and protect our valuable employees as much as reasonably possible. It is never too late to reduce radiation intake levels. In addition, over the next few years, hospitals will be subject to significant criticism if they do not provide radiation protection in line with the ALARA principle. In every other industry there are safety requirements that must be met for employees, third-party contractors, customers, and the general public. Radiation safety applies in the hospital setting just as much as any other safety issue.

Where can we find the Prometheus drapes and shields?
       Worldwide Innovations & Technologies, Inc., located in Overland Park, Kansas, manufactures and markets the Prometheus^™ and the other RADPAD^® products. The company can be reached via its website, www.radpad.com, or by calling its toll-free number, 1-877-772-3723. Further, the company has distributors throughout the United States, and they most likely have a representative near your hospital.

Final Comments.
       As Prometheus is the protector of man in ancient Greek mythology, the Prometheus^™ drapes and shields are the true protector of man in the EP labs and hospitals today.