Concern over clinical radiation dose is on the rise, but biomeds play an important function in minimizing risk for patients. At the AAMI 2014 session “The Role of Biomeds in Reducing Clinical Dose,” Joseph Kaminski, Vincent Maier, and Paul Mashack of ISS Solutions outlined how HTM professionals can influence safety through scheduled maintenance, equipment repair, and purchase decisions.

Excessive exposure in fluoroscopy can lead to conditions such as erythemia (a reddening of the skin) or epilation (removal of hair). Features such as a dose area product (DAP) meter won’t reduce exposures, but they can alert operators to appropriate or inappropriate exposure levels. Fluoroscopic timers will go off after 5 minutes and must be reset before equipment operation can continue. The last frame hold feature on some machines allows the radiologist to shut off the beam while viewing the last image on the screen, ensuring that the patient doesn’t receive a continuous dose during visualization. Adjusting imaging technique to use a low pulse frequency and short pulse length will also reduce the patient’s exposure.

In performing scheduled preventive maintenance (PM), the updated CMS directive continues to require hospitals to follow OEM guidelines. Biomeds should periodically check for any updates to PM procedures. Maintenance should focus on proper adjustments to kV and mA levels, pulsed kV and verification grid control, timer verification, automatic exposure control (AEC) and phototiming calibration, and DAP meter verification.

Repairs for general diagnostic x-ray machines should center on replacement of tubes, collimators, and the generator as well as filtration and beam quality. When evaluating new equipment for purchase, biomeds should compare dose levels of comparable systems and consider newer digital technology. Many digital systems offer lower dose via higher filtration and harder beam quality, which reduces soft radiation. New computed tomography (CT) systems have also made use of revised front end detector designs and updated algorithms that produce sharper images at a reduced dose.

Jenny Lower is associate editor of 24×7. She can be reached at