3 Advantages Of Disposable Skin Markers In Mammography

Is your medical facility performing mammograms?

If so, are you using disposable skin markers during these exams?

Disposable skin markers are a must-have for mammography. Markers are placed over a nipple, mole, scar, area of concern or other features that could be confused with a lesion. When performing screening mammograms, skin markers can save time, improve accuracy, enhance communication and provide a better experience for the patient.

Low-Dose X-Ray System

A mammogram is an X-ray image of the breast. Mammography is a specific type of imaging that uses a low-dose X-ray system that emits ionizing radiation to create images of the breast, allowing the radiologist, a physician specially trained to supervise and interpret radiology examinations, to analyze the images and send a signed report to the primary care or referring physician, who will then discuss the results with the patient.

Reduce Repeat Examinations

Skin markers are an important tool in mammography. Costly repeat examinations can be reduced dramatically by clearly identifying the nipple with a lead ball nipple marker. For example, the Suremark Lead Ball Nipple Marker Label is one of our most popular marker labels for general use purposes. The Suremark label is ideal for distinguishing between a nipple shadow and a lesion.

Easily Locate Raised Moles

Suremark Mole Markers are uniquely designed to locate raised moles and other skin nevi with overshadowing microcalcifications. The radiolucent ring, when placed around a protuberance, prevents flattening due to compression. The mole markers are available with two reference points or three reference points. Ideal for mediolateral oblique view or MLO exams as well as dense breast tissue, these radiolucent mole markers will not burnout.

Improve Patient Comfort

Mammograms are uncomfortable enough for patients with the painful removal of nipple markers. Keeping patient comfort in mind, the Suremark Relief Tabs feature a unique adhesive-free center that won’t stick to sensitive areas of the skin. By using disposable skin markers, exam results will be more accurate and the overall patient experience will be improved.

Not familiar with the Suremark brand? Why not try a sample and compare them to your existing skin markers?

 

 

 

Evaluating Microorganism Levels On X-Ray Aprons And Lead Wearables: The Science Of ATP Testing

How Have Microorganisms and Bioburden Been Measured?

In the previous blog post regarding X-Ray lead aprons, we explored the history of healthcare associated infections or HAIs, and how transmission risks are posed to patients and staff via contaminated “high touch, non-critical surfaces,” including X-Ray aprons and protective lead wearables.  In laying out the content of this blog, I was reminded of the phrases, “things aren’t always as they appear” and “don’t judge a book by its cover.” Is it possible that newer (clean looking) X-Ray aprons can carry a higher level of biological contamination when tested in comparison to older X-Ray aprons (which are dirty looking & smelling)? It is completely possible and plausible due to the concept of bioburden.

What is Bioburden?

Bioburden is defined in numerous medical dictionaries as the number of microorganisms contaminating an object.  So how does one assess for bioburden?  The gold standard for assessing for bacterial/fungal contamination has been to assess for colony forming units or CFUs.  A CFU equals one viable bacterium that has the ability to spread and replicate.

3 Main Ways to Measure CFUs: 

  1. A scientist could dilute the sample and count the bacteria by microscopic examination or through the use of a cell counter.  However, if bacteria are too small or clump together, then this method is problematic.  This method will yield total bacteria counts, both living and dead.
  2. A scientist could use Optical Density (OD) to estimate the number of viable bacteria in a sample.  This is where the scientist measures how cloudy a liquid culture of bacteria is.  While the bacteria are actively growing the liquid culture should continually become more and more cloudy.  Again, this method will yield total bacteria counts, both living and dead.
  3. A scientist could make serial dilutions of a liquid culture and plate out the bacteria in known dilutions until they can count single colonies and extrapolate back to figure out total CFU in a sample. This method only yields viable bacteria totals.

4 Challenges Associated with Bioburden Assessment

Assessing for bioburden (microorganisms) by calculating CFUs is not as easy or straight forward as one might imagine.

  1. The first challenge posed is that one needs to have a lab in which to grow bacteria, and depending on the bacteria one is dealing with there are different governmental regulations to follow.
  2. The second challenge presented is that of time, one needs to have the time and equipment to properly grow the bacteria/fungus.  Different species of bacteria or fungus grow at different rates, for example, culturing of bacteria on plates can take anywhere from overnight to multiple days.
  3. A third and very important challenge is posed by the bacteria and fungus themselves.  They are similar to people in the fact that not all of them grow and thrive under the same conditions.  In lab work, if only one kind of food source is used, one will only be able to assess for bacteria that grow on that particular food source.
  4. Finally, one needs to have a trained technician who knows how to assess which bacteria to grow under the correct conditions and then also how to properly count the bacteria.

While assessing for CFUs has traditionally been viewed as the gold standard for assessing bioburden, and it is vitally important for various microbial studies, it is not a good way to assess bioburden in real time.  It can be complicated.

What is ATP and How is it Evaluated?

What if there was an easier way to determine surface levels of biological contamination?

What if there was an easier way to assess for a molecule that is found only in living cells, both bacterial and human living cells?

There IS an easier way to evaluate for this molecule in real time (by using a simple swab and handheld reader), and it can be used by any hospital staff member as a surrogate for such complicated CFU work.  Let me introduce you to the molecule known as the “molecular workhorse,” called adenosine triphosphate (ATP).

Adenosine Triphosphate (ATP)

ATP is an energy molecule utilized by cells. It is present in humans, animals, plants and microbial cells.  ATP levels rise as a cell is undergoing apoptosis (programed cell death), but is generally consider to be completely degraded within 30 minutes of cell death (1).  This makes ATP a useful marker for the presence of unwanted biological contamination, including organisms that can cause infection and disease.

Okay – Get to the Point!

An increase in biological cells on a surface results in an increase in the amount of ATP present on that surface, thus making ATP an effective marker for the assessment of the hygienic status of an environmental surface. Simply stated, the amount of ATP present on a testing swab is a quantitative measurement of the cleanliness of the surface tested! In fact, ATP cell viability assays were determined to be the fastest, most sensitive, and least prone to artifacts, partially due to a lack of an incubation period (2).  The sensitivity of laboratory cell based ATP cell viability assays can detect fewer than 10 cells per well (2).  This technology has been modified to create a portable, ATP bioluminescence test, using a swab instead of plated cells.  This now allows for a real time assessment of bioburden on site.  These tests have been used to assess bioburden in many healthcare settings, including the ICU (3).  ATP measuring units, called luminometers, are handheld, user friendly, and display the results in seconds. (It doesn’t take a scientist to use an ATP luminometer!) The read out of an ATP bioluminescence test is not in CFUs, but is in relative light units or RLUs.  In the past, some scientists have questioned the validity of using a bioluminescence test instead of assaying for CFU.

Is There a Correlation Between CFUs & RLUs? 

Like most assessments, ATP bioluminescence assays also have limitations, but they are an excellent surrogate that allows the everyday staff member to assess bioburden in real time.  Those new to ATP bioluminescence testing often inquire about a correlation between CFUs and RLUs.  (Most laboratory microbiologists have the capability to perform CFU testing, and are not confined to real time assessment of bioburden.)  The most controlled way to achieve this is to look at different known amounts of CFUs and assess whether or not the RLUs increase accordingly.  That is exactly what Dr. Sciortino’s group did when they assessed three different portable ATP bioluminescence kits for their ability to detect various CFUs of two different HAI relevant bacteria (Staphylococcus aureus and Acinetobacter baumannii) and one strain of fungus (Candida albicans).

What they discovered was there was a linear relationship between bacterial CFUs and RLUs for all three luminescence kits, and for two of the three kits between fungal CFUs and RLUs (1).  Such research validates that the use of ATP luminometers can be used to assess for bioburden on surfaces in real time.  This research, plus Dr. Jaber’s study, in which 25 lead aprons were cultured for CFUs and showed that 21 were colonized with Tinea species (the family of fungus that causes ringworm) and 21 were colonized with Staphylococcus aureus, of which 3 aprons were colonized with MRSA (4), validates the ATP bioluminescence results for X-ray aprons and protective lead wearables.

In fact, these X-ray aprons and protective lead wearables, which are worn throughout many different areas within a healthcare system, including the operating rooms, cath labs, radiology/imaging areas, emergency rooms and beyond are regularly testing with RLU readings in the THOUSANDS to HUNDREDS OF THOUSANDS (5), which is scary. The bottom line is regardless if you are a classically trained microbiologist used to looking at CFUs or a hospital staffer looking at luminometer readouts in RLUs, when surfaces inside an OR or Cath Lab are testing in the hundreds of thousands range, it is a problem!

Is ATP Testing Growing in Use?

Through utilization of ATP luminometer testing systems, companies like Radiological Care Services (Indianapolis) are able to enter a facility’s Cath Lab, OR or Radiology Department and test lead apron inventories on site, providing real time numbers (bioburden levels) in a matter of seconds. An advocate for ATP luminometer testing, Dr. Sciortino even states, “ATP system monitoring may uncover the need for new disinfectant designs that adequately remove hospital surface biofilms, rendering used hospital equipment to its native state whereby a zero reading by ATP monitoring can be achieved” (1).  If you look back at the first blog post, “Contaminated X-Ray Aprons and The Risk of HAIs”, I positioned that “using wipes alone” was insufficient and through the use of ATP testing, Dr. Sciortino could be inferring a similar position.

Looking Ahead…

In the next blog post, we’ll specifically look at the science/methodology behind the use of sanitizing wipes and we’ll further explore the differences between true “cleaning” and “sanitization.” We’ll later examine what the governing bodies, such as AORN, CDC, HFAP and JCAHO state regarding their expectations of such surfaces within healthcare facilities. Understanding the science behind HAIs, testing for biological contaminants on surfaces, biofilms, and the difference between “cleaning” and “sanitization” will help us understand that current healthcare protocols in regards “non-critical, high touch surfaces” need to be changed in order to better protect hospital patients and staff.

About The Author:

Kathleen R. Jones received her BS from Purdue University (West Lafayette) in Biology specializing in Genetics and Microbiology.   After working for five years in Quality Control she then completed her MS at Purdue University in Indianapolis.  Her growing interest in Infectious Diseases lead her to the Uniformed Services University of the Health Sciences where she obtained a Doctorate in Emerging Infectious Diseases.  Kathleen has a passion for progressive sciences and initiatives, and employs her keen understanding of the biofilm formation and elimination processes into her research and work.

Sources:

  1. Sciortino, C. V. and R. A. Giles.  2012. Validation and comparison of three adenosine triphosphate luminometers for monitoring hospital surface sanitization: A Rosetta Stone for adenosine triphosphate testing.  AJIC.  40 (e233-9)
  2. Riss T.L., R.A. Moravec, A. L. Niles, H.A. Benink, T.J. Worzella, L. Minor. Minor, L, editor.  2013,  Cell Vialblity Assays. In: Sittampalam G.S., N.P. Coussens, H. Nelson, et al., editors. Assay Guidance Manual [Internet]. Bethesda (MD): Eli Lilly & Company and the National Center for Advancing Translational Sciences; 2004-. Available from: http://www.ncbi.nlm.nih.gov/books/NBK144065/
  3. Moore, G., D. Smyth, J. Singleton, P. Wilson. 2010. The use of adenosine triphosphate bioluminescence to assess the efficacy of a modified cleaning program implemented within an intensive care setting.  AJIC. 38(8):617-622 DOI: http://dx.doi.org/10.1016/j.ajic.2010.02.011
  4. Jaber, M., M. Harvill, E. Qiao.  2014.  Lead aprons worn by interventional radiologists contain pathogenic organisms including MRSA and tinea species.  Journal of Vascular and Interventional Radiology.  25:3:S99-S100.  DOI: http://dx.doi.org/10.1016/j.jvir.2013.12.279
  5. “Outcomes: What do your numbers look like?” Radiological Care Services. Nov 20, 2014. http://www.radcareservices.com/radiolgical-care-services-outcomes.html

When Is It Time For A New X-Ray Apron?

How Long Will My X-Ray Apron Last? 

The life of an x-ray apron will depend on the frequency of use, applications and how it is stored when not in use. Properly caring for your x-ray apron is the easiest way to extend the useful life of your apron. It is recommended to have the lead apron examined fluoroscopically at least once a year.

When Should I Replace My X-Ray Apron? 

“Any radiation protection garment displaying breaks in the lead lining should be replaced.” e.g. Rejecting an x-ray apron depends on the location, area size and number of flaws. It is best to keep the number of flaws to a minimum – Source: North Carolina Department of Health and Human Services, Division of Health Service Regulation, Radiology Compliance Branch, Radiation Protection Section¹

Lead Apron Integrity Inspection

X-ray aprons should never be folded. Cracks in the lead lining can develop at the fold reducing the useful life of the apron. The x-ray apron should be inspected annually or manufacturers recommendations.

Fluoroscopic Inspection

  1. Lay x-ray apron on the table
  2. Examine the entire x-ray apron using the fluoroscope
  3. Record results of the inspection following your facilities or state protocol

Fluoroscopic Inspection Alternative (When fluoroscopy unit is not available)

  1. Closely inspect the x-ray apron for kinks, creases, and irregularities
  2. Take a radiograph of the suspect areas (e.g. areas where the lead lining may be compromised)
  3. Process the film and inspect for breaks or flaws in the lead lining
  4. Record results of the inspection following your facilities or state protocol

Before Purchasing New X-Ray Aprons

Check with your Radiation Safety Officer to determine what lead equivalency is required to be compliant with your state’s radiation protection regulations. The American Registry of Radiologic Technologists has a helpful page that lists the contact information for each state.

 

Please Note: The information included in this post is intended for general reference only. The information provided is not a substitute for professional radiation protection advice and should not be relied upon in the absence of such professional advice.

How Do Lead Glasses Protect Your Eyes?

Protecting Your Eyes From Ionizing Radiation Exposure

Lead shielding is an important radiation safety principle. In fact, shielding is one of the three basic radiation safety principles. Time, distance and shielding are the primary means of eliminating or reducing ionizing radiation exposure.

Lead Shielding

Shielding should be used wherever it is necessary to reduce or eliminate radiation exposure. There are a variety of types of lead shielding options, the focus of this article will be on radiation eye protection and the use of lead glasses.

Radiation Attenuation 

Appropriate shielding placed between the source of radiation and the worker, radiation is attenuated and exposure may be completely eliminated or reduced to an acceptable level. Lead acts as a barrier to reduce x-ray’s effect by blocking or bouncing particles through a barrier material. Attenuation is the result of interactions between x-ray and matter that include absorption and scatter. Much like lead aprons which are commonly found in x-ray rooms in hospitals, lead glasses reduce radiation exposure and protect the lens of the eye.

Occupational Radiation Exposure Limits

Exposure limits have been established by the Nuclear Regulatory Committee (NRC) and set to a level where apparent injury due to ionizing radiation during a normal lifetime is unlikely. This limit is called the “maximum permissible exposure” and medical personnel should be aware of their occupational radiation dose. These occupational radiation exposure limits have been established to help minimize the amount of radiation a worker receives annually by monitoring their occupational radiation dose and keeping them under the established limits. “The exposure limit for the whole body (5,000 mrem) is lower than that for a single organ because all organs and tissues are exposed in whole body exposure, while only a single organ is involved in the single organ exposure limits¹.”

Lens of Eye (LDE) Radiation Exposure Limit

The occupational exposure limit for the lens of the eye (LDE) is 15,000 millirem or 0.15 Sieverts. The Lens of Eye Dose Equivalent (LDE) 10 CFR 20.1003 “applies to the external exposure of the lens of the eye and is taken as the dose equivalent at tissue depth of 0.3 centimeter (300 mg/cm²).”

Personal Monitoring 

The U.S. Nuclear Regulatory Commission has requirements regarding personal monitoring devices. Many medical personnel are required to wear an individual monitoring device to measure the dose to the whole body as well as one at an unshielded location closer to the eye to provide an accurate reading of the lens dose equivalent. Wearing lead glasses will help ensure the lenses of the eyes are properly protected from ionizing radiation thereby reducing your risk of developing cataracts.

“Radiation workers who operate x-ray machines, fluoroscopy units, certain unsealed and sealed radioisotopes or are exposed to other sources of gamma or high energy beta radiation are generally required to wear one or more dosimeters².”

Eye Protection: Reducing Tissue Reactions

Tissue reactions, previously referred to as deterministic effects or non-stochastic effects, describe a cause an effect relationship between radiation and some side-effects. There is a threshold dose, once exceeded, the severity of an effect increases with dose. Examples of tissue reactions include skin erythema, which can occur shortly after radiation exposure. Late tissue reactions, particularly those involving the lens of the eye, such as cataracts, can develop long after the initial radiation exposure, but still can be traced back to the original exposure.

Radiation-Associated Cataracts 

Two separate studies published in 2010 reported that interventional cardiology personnel have an increased risk of developing cataracts, a clouding or opacity of the eye that hinders vision. In a recent study, Radiation Cataract Risk In Interventional Cardiology Personnel (October of 2010), Vano et al tested 116 exposed interventional cardiologists, nurses, and technologists for radiation cataracts and compared them to 93 unexposed control personnel. Thirty-eight percent of the cardiologists, with a cumulative median lens dose of 6.0 Sieverts, developed cataracts, compared with 12 percent of the controls. Twenty-one percent of the other medical personnel, who were exposed to a cumulative median lens dose of 1.5 Sieverts, developed radiation-associated lens changes attributed to ionizing radiation exposure.

The second study, Risk For Radiation-Induced Cataract For Staff In Inventional Cardiology: Is there reason for concern? (November 2010)examines the prevalence of radiation-associated lens opacities among interventional cardiologists and nurses and to correlate with background radiation exposure. The results of the study demonstrated a dose dependent increased risk of posterior lens opacities for interventional cardiologists and nurses when radiation protection tools are not used. Although, a study of a larger cohort is needed to confirm these findings, the results suggest ocular radio-protection should be used.

Radiation Eye Protection 

Our eyes are one of our most valuable organs, without properly functioning eyes even the most routine tasks can become extremely difficult to complete. “Eyes are delicate and precious” says Dr. Andrew Lwach, spokesperson for the American Academy of Ophthalmology. When working near and around ionizing radiation it is important to protect your eyes from potential exposure by wearing lead glasses. Radiation safety glasses, commonly referred to as lead glasses, are designed to protect the lens of the eye by reducing the amount of radiation that is permitted to pass through the leaded glass lenses.

Conclusion 

According to a study, Comparing Strategies For Operator Eye Protection In The Interventional Radiography Suite, published in November of 2010, the “use of leaded glasses alone reduced the lens dose rate by a factor of five to 10.” The operator lens radiation dose rate was recorded with a solid-state dosimeter with nonleaded and leaded (0.75mm lead equivalent) eyeglasses. Lens dose measurements were obtained in right and left 15 degree anterior obliquities with the operator at the upper abdomen and during digital subtraction angiography (two images per second) with the operator at the patient’s groin.

Lead Glasses 

Today, lead glasses come in a wide-variety of styles and configurations including wraparound, goggles, fit over, economy, plastic, metal, and designer frames. For example, metal frames are available with frontal (lens) and lateral radiation(side shields) protection offering 0.75mm and 0.35mm lead (Pb) equivalency respectively.

The industry standard 0.75mm lead equivalency SCHOTT SF6 radiation safety glass lenses provide protection from harmful radiation exposure. The lenses have been tested (CE Certified for Radiation Reducing Eyewear) at 100 kV and have a nominal lead equivalence of 0.75mm Pb and the side shields offer a nominal lead equivalence of 0.35mm Pb at 100 kV. Lead glasses are an essential piece of personal protective equipment that will help reduce the amount of radiation exposure to your eyes.

 

X-Ray Protective Apron Care: 9 Do’s And Don’ts

Proper X-Ray Protective Apron Care and Use

X-ray aprons serve a very specific purpose, to protect and shield you from the potentially harmful effects of ionizing radiation. Shielding, one of the three concepts of basic radiation safety, should always be used when the use of time and distance principles are not possible.

Protective x-ray aprons constructed of lead or a non-lead equivalent are designed to protect the radiosensitive areas of the body when it is necessary for the healthcare worker to be near the source of radiation. Typically, x-ray aprons will offer frontal protection of 0.5 mm lead equivalency. In some instances, wrap-around x-ray aprons are required when medical personnel will have their backs exposed to the radiation source.

By learning the proper way to maintain and care for your x-ray apron, you will ensure that you are properly protected and you will extend the life of the apron. Below are the four do’s and the five don’ts of proper x-ray apron care. After reading this post, you will know how to keep your x-ray apron looking good while also keeping yourself protected against the harmful effects of ionizing radiation.

X-Ray Protective Apron Do’s 

1. Inspect and Check Apron For Defects, Cracks, Creases, and Perforations 

Place the x-ray apron on a flat surface and visually check all the seams as well as the outer and inner covers of x-ray apron for any visible damage. Next, check the belts and fastening devices to confirm that they are in good condition. Lastly, inspect the surface of the apron with your hands to locate any potential lumps, cracks, sagging or separation from the apron seams. If the apron condition appears to be suspect, it should be inspected radiographically. “Rejecting an apron depends on the location, area size and number of flaws. It is best to keep the number of flaws to a minimum¹.”

Note: It is recommended that you follow the manufacturer’s recommendations and/or the state regulations regarding the proper care and use of lead protective equipment. 

2. Clean Regularly

X-ray Aprons should be cleaned daily and deodorized by scrubbing with a soft bristle brush, using cold water and a mild detergent. Completely remove cleaning residue by thoroughly rinsing with clean, cold water.

Apron Cleaning Tips

To ensure x-ray aprons are not damaged while cleaning, follow these helpful tips:

  • Never use products that contain bleach.
  • Do not soak or submerge x-ray apron in water.
  • Do not machine launder, autoclave or dry-clean.
  • Once cleaning is complete, if possible, hang the apron on the designated apron wall rack to air dry.

3. Properly Store X-Ray Aprons

The x-ray apron manufacturer’s recommendation regarding the proper handling and storage of the apron must be strictly observed. When not in use x-ray aprons must be stored on hangers to prevent cracks in the protective lead. If possible, do not store the x-ray apron on a flat surface. Aprons should be hung by the shoulder or on an approved apron hanger. Aprons should never be folded or creased, to avoid damaging the lead. “Cracks in the lead lining can develop at the fold, reducing the useful life of the apron¹.” Hook and loop fasteners must be secured properly to avoid snagging or tearing of fabric, always store apron with fasteners completely secured.

4.  Dispose Of Lead Aprons Properly

X-ray protective aprons that contain lead cannot be disposed of as municipal solid waste. Consequently, they must be disposed of as hazardous waste or recycled. The Environmental Protection Agency encourages recycling and reuse rather than disposal. According to the EPA, if the lead shield or apron can be reused by another business for its intended purpose then it remains a product, therefore it is not classified as waste or hazardous waste. Recycling the lead apron is the preferred method since it keeps the lead out of the landfill and extends the useful life of the lead apron. When recycling is not an option, you can contact a disposal service to properly dispose of the lead material.

X-Ray Protective Apron Don’ts 

5. Sit While Wearing Your Apron

Unless the x-ray apron has been designed specifically for seated procedures, you will want to avoid sitting while wearing your apron. Cracks in the lead lining can develop while wearing the apron if seated. Also, you will want to avoid sitting on the apron for the same reason.

6. Expose Apron To Extreme Temperatures 

To prevent damage to the apron, you will want to avoid exposing your x-ray apron to extreme hot or cold temperatures or to direct sunlight.

7. Lean Against Pointed Objects or Sharp Edges

Avoid storing sharp objects in the pockets. X-ray aprons can become damaged while leaning up against sharp or pointed objects, creating perforations in the lead lining and reducing the attenuating qualities of the lead.

8. Store Aprons Over Chair Backs or Equipment

Laying aprons over a chair back or piece of equipment can create creases in the lead lining and can reduce the useful life of the apron.

9. Fold Aprons

To prevent damage to the lead lining, avoid folding, wadding or creasing your x-ray apron.

Ensure Reliable Performance 

To ensure safe performance, as well as keeping your x-ray apron looking good for years to come, we strongly recommend that each x-ray protective apron is thoroughly inspected upon receipt and at regular intervals and properly stored when not in use.

X-ray aprons should be evaluated every 18-24 months to determine if replacement is needed, depending on the amount of usage and general wear and tear.  If you found this post helpful, please feel free to share this post or our SlideShare presentation with your colleagues.

 

 

 

 

 

How To Choose The Right X-Ray Apron Style (Part 3)

Which x-ray apron style is right for you?

X-ray aprons are available in a wide variety of styles to meet the specific needs of medical professionals. Determining which lead x-ray apron style is right for you may seem overwhelming. The selection process can be simplified into several easy steps and in this post we will walk you through the necessary steps to ensure that you find the right x-ray apron as well as the appropriate level of radiation protection. The x-ray selection process can be broken down into three steps: (1) choosing your core material, (2) selecting the type of protection required, and (3) determining the best x-ray apron style for your needs.

Core Materials

In our previous post, How-To Determine Which X-Ray Apron Material Is Right For You, we discussed the three different types of core x-ray apron material options including traditional lead, lead composite, and non-lead. Each core material offers a distinct benefit, traditional lead aprons are the most economical, lead composite aprons provide an average weight savings of 25% compared to traditional lead aprons, and non-lead aprons are the lightest weight option available. Once you have determined the core material you can then choose the type of protection needed.

X-Ray Apron Coverage Protection Options

When selecting the type of radiation protection required for your specific application, it is important to understand the unique benefits each style offers. The three common x-ray apron styles are front protection, front/back protection, and quick-drop. Front protection x-ray aprons are ideal for those who only require front-protection during procedures. X-ray aprons that offer front and back protection are designed for those who circulate and will have their back to the radiation source.  The quick- drop x-ray apron has been designed for those who need to remove the x-ray apron during surgery without breaking the sterile field.

Understanding The Various Style Options

Now that we understand the coverage and protection offered by the three main x-ray apron styles, we can take a closer look into the unique benefits available for each apron style.

Frontal Protection

X-ray aprons offering frontal protection are available with several important features including closure options, back type and frontal aprons designed for specialty applications. Front protection x-ray aprons are available with three different closure types including buckle closure, strap closure (tie style), and velcro closure.

There are several factors you will want to consider when choosing the right x-ray apron back type including apron weight, the length of procedure, and types of procedures performed. There are a variety of x-ray apron back types to choose from including the standard plain back apron, flex back apron, back relief/support apron, and fast wrap aprons. There are several speciality options available including pregnancy aprons (1.00mm Pb equivalency over fetal area) and lap guards, lead aprons with a sewn in thyroid collar, and the quick ship lightweight lead flex guard apron.

Front and Back Protection

There are several options to choose from when looking for front and back protection including full wrap aprons and vest/skirt aprons.  Standard medical x-ray protection levels commonly available  for front/back protection aprons are offered in the following combinations:

Front Protection Pb Equivalent/Back Protection Pb Equivalent

  • 0.50mm/0.25mm
  • 0.35mm/0.25mm
  • 0.25mm/0.25mm

Full Wrap Aprons

Full wrap aprons are available in several styles including full overwrap, special procedure, and tabard styles while providing maximum protection. Full overwrap aprons provide lumbar support which reduces fatigue and upper back stress during long procedures. Vest/skirt aprons create maximum weight distribution between the shoulders and hips which eliminates stress on the upper and lower back.

Full Overwrap Protection 

The full overwrap aprons are secured via velcro straps and provides maximum radiation protection which reduces back fatigue during long procedures.

Special Procedure

Special procedure aprons have velcro seems that allow the sides of the apron to separate when bending or sitting while still maintaining front protection.

 

Tabard Style

The tabard style apron – a tabard was a short coat that men commonly wore during the middle ages – is a sleeveless, single piece apron that has a right shoulder and side velcro closure that allows for easy access.

Vest/Skirt Aprons

Vest/skirt aprons provide greater flexibility to the wearer with regard to sitting, bending, or stooping. The skirt is designed for complete overlap to provide maximum protection. Many of the vest/skirt sizes can be mixed to provide maximum comfort and fit.

Quick Drop X-Ray Apron

The quick-drop apron style is designed to be worn over the scrub suit and under the O.R. gown for quick removal without breaking the sterile field after x-ray procedures are completed. The quick-drop style aprons do not have arm holes and require assistance from a second party when putting it on or removing the apron. Quick-drop aprons are available with velcro criss-cross back flaps that assure easy removal. The Xenolite O.R. Quick-Drop Apron allows for freedom of movement, maximum flexibility, and optimal comfort.

Questions? 

Now that we have reviewed the various benefits of the core materials used in x-ray aprons, the different types of protection, and highlighted some of the main benefits of the different types of apron styles, you should be able to choose the right x-ray apron for your specific needs. If you have any additional questions, feel free to leave a comment below or contact us via live chat on our e-commerce site during normal business hours (M-F 9-5 EST).

Featured Product: 3B Scientific Clinical Breast Trainer

Today’s featured product is our 3B Scientific Clinical Breast Trainer! This medical anatomy trainer is an excellent tool to improve clinical skills in diagnosis and palpation.

Features:

  • Five identifiable anatomical anomalies
  • Fluid filled cyst for aspiration and palpation
  • 2 palpable lumps (approx. 1 cm and 1.5cm diameter) on the lateral side of the breast
  • Infection in Armpit in axilla region
  • Lump in tissue above the clavicle
  • Modular design for simple replacement of skin, cyst, lump axilliary gland
  • Skin detaches for replacing cysts
  • Realistic tactile feel
  • Easy to keep clean
  • Weight: 1.11 kg (2.45 lb)
  • Dimensions: 33 x 25 x 15 cm (13.0 x 9.8 x 5.9 in)

This clinical breast trainer is a great medical tool to use for hands on learning. Have a question or comment about our clinical breast trainer? Leave a message in the box below!

Lead Markers For Clinical Education

Lead Markers

Lead markers for radiography are also known by a number of different names including Pb markers, X-ray markers, anatomical side markers, and radiographic film identification markers. Lead markers are used to mark X-ray films in hospitals, clinics, and other healthcare facilities. Most lead markers come color-coded to denote right and left on X-ray or radiographic images to assist the radiographer or radiologic technologist on identifying the right and left side of the body. The lead markers will generally have a letter R for the right and the letter L for the left as well as the radiologic technologist (R.T.s) initials.

Radiologic Technology Program

When students are admitted into a radiologic technology program it can be overwhelming at first. There are a number of important things that you have to take care of before your first day of class. You will have to schedule a physical and get your immunizations before you can start your clinical. After you have taken care of your immunizations you can look forward to picking out your clinical attire usually including white shoes, division scrubs, name tag, lead markers, and radiation monitor.

Required Equipment

All radiologic labs require students to have their radiation monitoring badge (radiation dosimeter), lead markers, and name tags before entering the X-ray laboratory. Many programs will consider the student out of acceptable uniform if they show up to their clinical assignment without his or her personalized lead makers. Lead markers are very important when performing procedure evaluations and must be used on all images of the exam. Generally an explanation of the use of any other markers must be noted on the procedure evaluation form by the technologist. Most programs require the student to keep a record of all the examinations he or she assists in a performs in a daily clinical log book. The total number of procedures participated in by the student must be recorded on a tally sheet or “tallies”  that is submitted at the end of each semester. School policies usually require the student’s personalized lead marker to be present on the film to be marked “performed”, please check with your school for specific course information.

Program Specific Requirements for Lead Markers

Many programs will have explicit rules in place regarding the use of lead markers. It is common practice to require the student to purchase their own set of markers before starting the program although some schools provide lead markers for their students. Lead markers are usually customized with the students initials and thereby used to identify which procedure was performed by the student. Schools will usually hold the student responsible for all radiographs bearing their markers so it is important to notify the clinical coordinator immediately if markers are lost.

Questions? 

Check with your school or program to determine what policies are applicable to you. Upon acceptance, most programs will send you a welcome packet or handbook with detailed information regrading program information. Congratulations and good luck on your journey!

What Are The Parts Of A Lead Eyeglass Frame?

Why are lead eyeglasses important? The risk for radiation induced eye injuries are particularly high for health professionals such as interventional cardiologists, interventional radiologists, doctors using fluoroscopy in operating theaters and paramedical personnel who remain close to the patient during the procedure.  These individuals may be within the high-scatter X-ray radiation field for several hours a day during procedures.

It is important to protect your eyes from potential radiation exposure and reduce the risk of eye injuries. When selecting a pair of lead eyeglasses it is important to understand the various parts of the lead glasses. Once you have purchased your lead eyeglasses you may be wearing them for the majority of your workday so you will want to ensure that you find the most comfortable style frame possible. Below are common terms used to describe the different parts and sections of the lead eyeglasses.

Frame Front: The frame front is the section of the lead eyeglass that holds the lenses in place and bridges the top of the nose.

Eye Wire/Rim: The eye wire or eye rim is the part of the frame front where the lead lenses are inserted.

Bridge: The section between the lenses that sit above the nose is referred to as the bridge. There are several types of bridges listed below in more detail.

  • Keyhole bridge: Shaped like an old-fashioned keyhole and rests on the upper sides of the nose, this style is perfect for individuals with small or flat nose bridges.
  • Saddle bridge: Shaped like a saddle and evenly distributes the weight of the lead eyeglasses across the sides and top of the nose, works well for heavy lead glasses and those who are sensitive to pressure.
  • Adjustable bridge: Nose pads are designed to be adjusted for fit and comfort.
  • Double bridge: The double bridge has a second reinforcing bar that goes over the top of the bridge.

Hinges: The part of the frame that connects the frame front to the temples and allows the temples to swing.

Lead Side Shields: Shields offer additional protection and are made from removable lead equivalent plastic.

Lead Lenses: Lenses are made from 0.75mm lead equivalent (medical industry standard) that provide radiation protection for the eyes. Available in prescription and non-prescription lenses.

Temples

  • Skull temples: The most popular for plastic frames, they are bent down slightly over the ear and follow the contour of the skull.
  • Spring-hinged temples: Some frames come with a spring-hinge for added comfort and increased protection from breaking.
  • Library or paddle temples: This particular temple style is straight and is designed so that they can be slipped on an off easily.

 End Pieces: The extensions of the frame front where the temples are attached.

Nose Pads: The nose pads are made from a soft material like rubber or plastic to help keep the frame in the proper place. They can be attached directly to the glasses or to the pad arms.

Pad Arms: The pad arms are attachments that hold the nose pad in place and allow for adjustment to the bridge.

Top Bar: Frequently found in aviator style glasses, this reinforcement bar crosses the top of the lead eyeglasses on some metal frames.

Temple Tips/Ear Piece: Generally a plastic coating used to cover the ends of the temples behind or over the ears.

Rimless Frames: Rimless frames or mountings attach the temples and bridge directly to the lenses without the use of eye-wires or rims.

Selecting the right pair of lead eyeglasses is important and we are here to help you along the way. We recommend consulting with your radiation safety officer for more local standards and  information for your facility. Remember, whether your staff is working around radiation every day or once a month, it is crucial to keep their eyes protected from harmful radiation exposure! If you have any questions please feel free to contact us directly via email or live chat. We are always looking to assist our customers by providing them more knowledge to ensure they make the right choice, if you have a particular question that you feel would make a good addition to our blog, please leave a comment below.

What Is Breast Cancer?

October is National Breast Cancer Awareness Month which gives us a chance to help raise awareness about the importance of screening and the early detection of breast cancer. If you or loved one has been diagnosed with breast cancer, it is important to understand what breast cancer is and how it develops.

To gain a better understanding of breast cancer it is important to understand how any cancer can develop. When genes responsible for regulating the growth of cells and keeping them healthy, mutate or experience abnormal changes, cancer can develop. Genes are found in each cell’s nucleus and when operating normally the cells in our bodies follow an orderly process where the new healthy cells replace the old ones as they die out.  Over time, abnormal changes or mutations can turn on certain genes and turn off others in a cell. When cells experience these mutations, the orderly process of normal cell growth is disrupted and the cells can continue to keep dividing without following the control of order, they produce more of the same cells and ultimately form a tumor.

There are two forms of tumors; benign and malignant tumors. Benign tumors are not dangerous to health or considered cancerous because their cells are close to normal in appearance, slow growing, are not invasive to nearby tissues, and they don’t spread to other parts of the body. Malignant tumors on the other hand are cancerous and left unchecked the cancerous cells can spread beyond the original tumor to other parts of the body.

Breast cancer is a malignant tumor that has developed from cells in the breast. The normal breast is comprised of lobes and lobules (milk-producing glands), milk ducts (tiny tubes that carry the milk from the lobules to the nipple), and the stroma (fatty tissue and connective tissues surrounding the ducts and lobules, blood vessels, and lymphatic vessels). Breast cancer usually begins in the lobules (lobular cancers) or the ducts (ductal cancers), although it can begin in the stromal tissues of the breast.

Breast cancers can spread through the lymph system, this occurs when cancerous cells invade healthy breast tissue and make their way into the underarm lymph nodes (small organs that filter out foreign substances in the body). Once a cancer cell has made it into the lymph nodes, the cancerous cells have a pathway to spread beyond the original tumor and onto other parts of the body. Breast cancer stages (expressed as a number on a scale of 0 through IV) refer to how far the cancerous cells have spread beyond the original tumor.

Genetic abnormalities or a mistake in the genetic material is the cause of breast cancer. Inherited genetic abnormalities are only responsible for 5-10% of cancers, while genetic abnormalities resulting from the aging process and everyday life are responsible for 85-90% of breast cancers.

These are some examples of steps everyone can take for staying as healthy as possible which may have some impact on your risk of getting breast cancer.

  • Eat a balanced diet
  • Maintain a healthy weight
  • Limit alcohol consumption
  • Avoid tobacco products
  • Exercise regularly

While taking these steps to live a healthier lifestyle they may have some impact on your risk of getting breast cancer but they cannot eliminate the risk. Learn more about how you can manage breast cancer risk factors and the importance of monthly breast self-exams (BSE) as well as annual screening tests (mammograms). Johns Hopkins Medical center states “Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.” Mammograms are important in helping detect cancer before you can feel a lump, breast self-exams help you become familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes.