Background The problem of inaccurate placement of gonad shields in children has been highlighted by several publications nationally and internationally.3
A written departmental protocol for the correct use of gonad protection, with regular audit, will:
Avoid confusion over when and where gonad protection is required
Help new staff and locum staff to adapt readily and easily to local policy
Reduce gonad dose without significant loss of radiographic information
The aim of the study is to make sure that children’s gonads are protected from the unnecessary harmful radiations caused by x-rays that can affect them in the long term
Gonad protection should be used according to the local policy in all cases.1 2 (The guidelines of the paediatric radiology department at BRI)
Initial Hip/Pelvic x-ray doesn’t require gonad shield to avoid obscuring the sacrum in females or symphysis pubis in males.
Gonad shield should be used and positioned accurately in all subsequent images.
PACS system was used to search for 2 views Hip/Pelvic X-ray in patients <16 years old at BRI hospital.
Retrospective study (Audit: September 2017 – April 2018)
(Re-audit April 2017 – August 2018)
- Each image was assessed to determine the presence or absence of gonad protection and whether the protection was placed correctly or not.
The results were discussed at the radiological clinical governance meeting.
The superintendent radiographer has sent a reminder e-mail to all the radiographers discussing the importance of not only using the gonad shield but also placing it correctly.
Reminder posters to use the gonad shield were put in every x-ray room.
A course has been conducted for the new radiographers by a senior radiographer about when and how to use the gonad shield.
The local guidelines have been reviewed and simplified to make it easier to follow.
Gonad shields have been used in the correct position in 60% of patients after implementing the changes compared to 33% only in the first cycle.
Conclusions It was noticed that the percentage of the well-positioned shields has improved dramatically from 33% to 60% after implementing the previous changes.
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