*From the recently updated Cath Lab Guidelines from the SCAI 2021 Meeting: “SCAI Expert Consensus Update on Best Practices in the Cardiac Catheterization Laboratory”
1. Select low dose settings on fluoroscope, such as lower dose per frame, lower frame rate (4-7.5 fps for fluoroscopy, 7.5-15 fps for cine).
2. Use “Fluoro Save” instead of cine when possible.
3. Use collimation to lower radiation dose and scatter to patient and staff.
4. Avoid working in steep angles and change working angles to “spread the dose.”
5. Raise table height to decrease patient dose, and minimize distance between patient and detector to decrease patient dose and scatter to operator.
6. Use lower magnification (example 22 cm FOV instead of 19 cm).
7. Keep patient’s extremities out of the beam path and away from the x-ray tube.
8. Maintain furthest possible distance from x-ray tube by using long tubing, especially for radial cases, and “taking a step back”. Ensure proper use of moveable lead shields and under-table drapes.
9. Consider moveable lead screens to protect CCL staff.
10. Consider use of real-time radiation monitoring, radiation protection drapes and robotic PCI to lower operator radiation exposure.
11. Regular assessment and upgrading of equipment (hardware and/or software) to minimize radiation dose.
An additional step you can take is to incorporate The EggNest™ into your Cath Lab, allowing you to decrease Scatter Radiation by up to 97%, protecting everyone who works in the lab with minimal disruption to procedure flow.