EQUIPMENT AND INSTRUMENTS

Angiography system - includes fluoroscopy and digital imaging system to visualize blood vessels and heart chambers
Sheaths - are tubular devices inserted into blood vessels to facilitate the introduction and exchange of catheters during the procedure
Catheters - used to access and cannulate blood vessels which include diagnostic, guiding and balloon catheters
Guidewires - are also used to access and cannulate blood vessels, guide placement of catheters and other devices
Balloons - inflatable devices used to widen narrowed or blocked blood vessels
Stents - small mesh tubes used to support narrowed blood vessels
Hemodynamic monitoring system - measures and displays parameters such as vital signs of the patient during the procedure
Radiation protection gear - include lead gown/apron, thyroid shield and other protective equipment used to minimize radiation exposure during the procedure

Photo grabbed from: https://www.researchgate.net/publication/351593847_Ergonomics_in_Interventional_Radiology_Awareness_Is_Mandatory/figures?lo=1

WEARING OF LEAD GOWN

It is recommended to have the lead apron examined fluoroscopically at least once a year. The x-ray apron should be inspected annually or per manufacturer recommendations. The process is straightforward and often done in conjunction with the hospital’s radiation safety officer. The fluoroscopic inspection starts with placing the apron on the x-ray table. Then scan and examine the entire x-ray apron using the fluoroscope. The results of the inspection should follow your facility’s or state’s radiation safety protocols. Lead aprons are required protection for anyone working in or around areas with ionizing radiation (cath and electrophysiology labs, fluoroscopic areas in the operating room, pulmonary or intensive care unit, or emergency department).

Any individual risking exposure to radiation must wear protective garments. Lead aprons or skirt/vest combination garments should have sufficient shielding. Lead aprons absorb 90-95% of scattered radiation that reaches them. Lead aprons generally have shielding equivalence equal to an 0.25-0.5 mm lead and thus do not completely block, but only attenuate, the radiation. A lead apron with an 0.35 mm lead thickness equivalence should be sufficient for most fluoroscopic procedures. For high workloads, a wrap-around lead apron with an 0.25 mm lead equivalence that overlaps on the front, and provides 0.25+0.25=0.5 mm lead equivalence on the front and 0.25 mm on the back would be ideal. For a low workload, an 0.25 mm lead equivalence apron should do well.

Lead aprons protect sensitive body organs and also reduce the total body effective exposure dose by up to 85%. Wrap-around lead aprons are useful when medical personnel face away from the tube and away from the patient. Logically, then, when using aprons which are not 360-degree coverage, operators and staff should not turn away from the tube during beam activation.

Office Address: Sixth Floor, Cardiovascular Section, Philippine General Hospital, Taft Avenue, Ermita, ManilaEmail Address: uppghcardiaccathlab@gmail.comTelephone Number: (02) 8554-8400 (Loc. 3676)

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