GI Unit Leadership: Optimizing Endoscopy Operations through Leadership (On-demand)

ASGE radiation safety

Pdf Summary

The American Society for Gastrointestinal Endoscopy's (ASGE) document emphasizes the importance of radiation and fluoroscopy safety during gastrointestinal (GI) endoscopic procedures. It highlights the widespread use of X-rays in medical settings, particularly in interventional endoscopy, and the potential risks due to radiation exposure for both patients and healthcare professionals. The document stresses the limited formal education in radiation safety for endoscopists despite its critical need, outlining key procedures for safe usage.<br /><br />Fluoroscopy, a form of X-ray imaging, is essential in endoscopic procedures like ERCP (Endoscopic Retrograde Cholangiopancreatography). Proper understanding of how fluoroscopy works, including controlling radiation doses while maintaining image quality, is vital for safety. Techniques such as utilizing the ALARA (As Low As Reasonably Achievable) principle, which focuses on minimizing radiation exposure, are essential in endoscopic practice.<br /><br />Key safety practices include using pulse fluoroscopy, reducing fluoroscopy time, maintaining proper distance from radiation sources, and effective use of shielding. Lead aprons and thyroid shields are crucial in protecting endoscopy team members from radiation scatter. The document also discusses varying safety practices by states in the U.S., with some states requiring specific licensing for fluoroscopy use, underscoring the uneven regulatory landscape.<br /><br />Specific challenges, such as the increased radiation risk in obese patients, pediatric, and pregnant patients, require special considerations to minimize exposure. Despite the risks, with appropriate protective measures, procedures can be conducted safely even on pregnant patients or by pregnant endoscopists.<br /><br />The document calls for improved education and standardized training protocols in radiation safety for endoscopists, likening the need for regulatory reform to advancements in other specialties using fluoroscopy. Future advancements like artificial intelligence could further reduce radiation exposure, highlighting the evolving nature of radiation safety technology in medical procedures.

Keywords

radiation safety

fluoroscopy

endoscopic procedures

X-ray imaging

ALARA principle

protective measures

educational reform

regulatory landscape

artificial intelligence

radiation exposure