Guess the Radiation Risk – Portable X-Rays in the Emergency Department

Written by Jonathan Brewer

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Despite a high number of portable radiographs obtained in the ED, exposure to this ionizing radiation does not appear to be a significant occupational hazard, and existing precautions appear to be adequate.

Why does this matter?
Emergency providers are commonly found in situations in which a portable radiograph is required. With the frequency of portable radiographs that are ordered within the emergency department, are we at higher risk for adverse events?

No need to leave the room
This was a prospective cohort study in a large, level one trauma center that was performed over the course of a 3-month period. During this time, 48 various staff members volunteered to wear dosimeter badges during their shifts. In addition, 12 stationary dosimeters were placed around the ED, mainly in resuscitation rooms where most portable radiographs were obtained.

During this study period, 1,464 portable radiographs were obtained, with a median exposure of 0.18 mSv in the main resuscitation room and 0 mSv for other critical care patient rooms. Of note, staff dosimeters showed no measurable radiation exposure (0.00 mSv) during this time, and no single individual exceeded normal background exposure. Even when extrapolated to a 1 year expected exposure in areas of highest scatter radiation, the individual would have an exposure of approximately 2.5 mSv (slightly more than two pelvic x-rays) which is far below the allowed occupational limits (50 mSv/year)

While there is limited long-term data on the effect of low-dose radiation, it appears that current occupational protections from radiation (distance of > 2 m away and lead aprons if within 2 m) seems to be adequate and no higher level of protection is recommended based on this study. I personally may just try to distance myself about 2 m and call it a day.

Source
Risk of Radiation Exposure to Emergency Department Personnel From Portable Radiographs. J Emerg Med. 2022 Oct 12;S0736-4679(22)00449-8. doi: 10.1016/j.jemermed.2022.08.002. Online ahead of print.