MANIPULATION UNDER ANESTHETIC OF CHILDRENS FRACTURES - USE OF THE IMAGE INTENSIFIER REDUCES RADIATION EXPOSURE TO PATIENTS AND THEATER PERSONNEL

During simulated manipulation of children's forearm fractures, levels of scattered radiation from both plain radiographs and an image intens ifier in different modes were measured at various sites on the surgeon , anaesthetist, radiographer, and patient both with and without recomm ended shielding. By using fluoroscopy in the pulsed screening mode but allowing only single pulses to occur, radiation levels could be subst antially reduced to the eye, thyroid, and gonads of all those exposed. The radiographer and the anaesthetist were so far from the source and guarded by various pieces of equipment that levels were almost unreco rdable. Effective dose equivalent for the surgeon using pulsed mode, b ased on circa six pulses per manipulation, during 100 manipulations pe r year, would equate to 1 mu Sv even in the unshielded state (<0.1 mu Sv shielded), which is similar to 1/1,000 of background radiation at s ea level. Because the current dose limit is 50 mSv (50,000 mu SV) per year for employees, we are many orders of magnitude in the safety zone .