Theatre 8 Debut

For those of us who have a had the privilege of rotating through the brand new catheterisation theatre will note just how small it is ! Nestled in the left hand corner of the theatre is a small pigeon nook for us to operate in. This of course brings some problems which shall be discussed. Apart from the ergonomics which are questionable and definitely the lack of a tea room with kettle makes this theatre far more formidable. However, it does boast probably the best cardiac images I have seen to date. Furthermore, the speed at which these diagnostic angiograms can be done is truly amazing. No more spinning the C-arm, less dye runs and far fewer screening attempts which bodes well for patient safety. This brings me to the all important question of that about our safety ?

Radiation safety is often overlooked in theatre, I have seen people not wearing lead aprons or just coming into theatre quickly for some item they require all the while being blasted by radiation. The danger of this cannot be underestimated. Here is a poster summarising some important information;

Source: http://www.concert-h2020.eu/en/Stakeholders/effects_health

So let’s get the question of radiation safety in theatre 8. The arc of radiation, which is highest from the patients head to about 2m in a semi circular arc around the patient. 

I’m sure many of you were worried about the cardiologists safety weren’t you ? No, actually they are quite safe. They have a moveable board that blocks lateral radiation, often have full protection from head gear to thyroid protection to even specialised googles to prevent eye injury. If the cardiologists are dressed to the nines then why do we only wear a lead apron? Tisk tisk guys. In theatre 9 there was a large area for us to run away from the radiation. But in theatre 8… IT WILL GET YOU! Distance is your friend with radiation. I’m sure many of us can recite the inverse square law formula:

Basically, the further you are from the source of radiation, there is an  exponential decrease in radiation exposure. In theatre 8, the distance from source to exposure is about 2 m or less. I’m sure you get the drift. What can we do to minimise risk? 

1. Increase the distance from you to the radiation 
2. Use theatre barrier methods such as physical screens
3. Use PPE such as goggles, hats, aprons, over shoes etc 
4. Limit time of expose
5. Angle of exposure to radiation 
6. Use of radiation exposure tags to prevent over exposure to personnel

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Take home message is this, please be aware of radiation. It is a danger that won’t affect you now but later… Dress up to prevent a mess up. 

For more information, our esteemed consultant Dr Latusek did her Mmed on radiation in theatre and would be happy to discuss in concerns or physics relating to the topic.

Here are some images of theatre 8 in all her glory! 

Some points for operating in this theatre from an anaesthetic point of view:

1. IV lines need to be secured and at least 3x 10cm extensions added and placed in a non-bendable site e.g. mid forearm.
2. Standard suction tubing is too short.
3. Use a long circuit
4. Ensure airway is secured as airway access is limited with the C-arms engaged.
5. Use the little screen on the Drager to monitor the patient while behind the lead apron screen.
6. Wear a jacket as it's cold in there!
7. Wear same PPE as the cardiologists !