Shielding patients during diagnostic imaging has been common practice for more than 40 years. As of July 1, however, UVA Health joins other medical centers worldwide that have decided to discontinue the use of lead aprons for patients undergoing imaging exams.
“Given the information we currently have and the outcomes we’ve seen from current imaging practices, it’s clear that shielding is no longer necessary and, in fact, can cause more harm,” says UVA’s Chief Diagnostic Medical Physicist Allen Goode, MS, DABR.
Why Stop Shielding?
According to the American Association of Physicists in Medicine and the American College of Radiology, advances in technology and new evidence outlining the minimal risks of limited radiation exposure justify this shift in practice. In a position statement, the AAPM notes that:
- The levels of radiation used in diagnostic imaging are negligible and have not been shown in any human studies to cause measurable harm to the gonads or fetus, and does not increase the risk of hereditary disease.
- The minimal amount of radiation exposure a patient receives during diagnostic imaging is primarily the result of internal scatter and, therefore, is not lessened by external shielding.
- Shielding can do more harm than good because it can impact the quality of the image, resulting in the need for repeat scans.
Goode suggests that there are additional benefits to this change in practice in light of current events. “Placing a shield from one patient to the next increases the risk of transferring coronavirus, so this is an opportunity to remove that risk from the imaging setting,” he says. “It’s one less thing to clean and we can move forward with scans more quickly.”
A Shift In Thinking
Altering what has become standard practice for staff and patients for many decades requires a thoughtful approach to education and communication. To ensure a smooth transition, UVA Health is currently providing training to imaging staff, which includes:
- Information to alleviate their own concerns about eliminating shielding
- Tips on how to inform patients and families about the change in practice
- Steps to take should a patient or family member resist imaging without a shield and guidance on when to make an exception to the rule.
UVA patients will receive a handout explaining the new process for diagnostic imaging and will have an opportunity to discuss their concerns with UVA staff prior to their exam. “This is a small change in practice and it’s extremely safe,” says Goode. “If patients or referring providers have questions, they can contact us. We’re happy to answer any questions they may have.”
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