Ask the EP Editorial Board

Douglas Beinborn, Laurie Potter, Jose Nazari
Douglas Beinborn, Laurie Potter, Jose Nazari
I have a question concerning some issues here at our EP lab thought you may be able to steer me in the right direction. I am looking for some information on the protective measures everyone else is using to reduce the radiation exposure to EP doctors. I just need to find some means (preferably not something that takes an act of Congress to install!) to keep my EP doctors from glowing in the dark. We have state of the art fluoro, but are concerned about exposure. We have adjusted the fluoro. Also, I had some folks attend a conference that mentioned the possibility of a shield with arm inserts allowing for almost complete protection. Has anyone seen or heard about this? Any information or contacts you could provide would be much appreciated. Sincerely, A concerned reader Dear concerned reader, We are trying to utilize more technology that requires less fluoro time. By using Acuson intracardiac ultrasound, Biosense, ESI, this helps lower exposure. Besides the transceptal that uses high resolution, we adjust to lower resolution and decreased frame rate on the fluoroscopy to decrease dosing. Douglas Beinborn, MA, RN Mayo Clinic, Rochester, Minnesota Dear concerned reader, I did see a protective shield in the slides during a lecture on a different subject at NASPE. The only mention made was that it was used in place of wearing lead for the purpose of comfort. The old standby of less time on the pedal, more distance between you and the machine, and bringing the eye down close to the patient are still what we depend on. We also periodically x-ray our lead to make sure that no cracks or holes have developed; in addition, the doctor wears lead glasses to protect his eyes during the longer cases. We also use a clear lead shield on a boom on top of the patient between the doctor and the x-ray. This can be manipulated into position no matter where the doctor is working from. Lead skirting is also available to fit on the side of the table down towards the floor to assist with scatter from there. Some of the innovative things that I have seen at the conferences are lead-shielded gloves, and something called a rad-pad. This rad-pad is laid on the patient to help also block scatter. Unfortunately, I don't remember the name of the company. Laurie Potter, RN St. Mary s Hospital, St. Charles, Michigan Dear concerned reader, In our lab, we use a lead skirt under the table, a protective shield by the image intensifier and protective lead skirts, thyroid shields, etc. These are all standard measures in most labs, which is why we didn't come up with earth-shattering solutions. Buying excellent fluoro equipment, with pulsed capabilities is also important, if the hospital will acquire it. Jose Nazari, MD Cardiac Arrhythmia Consultants, Ltd., Chicago, Illinois Please post your question to , and your question may appear in a future issue of EP Lab Digest.