Projectional X-ray of the chest

2. Radiation Protection

Appropriate radiation protection for mobile radiography should always be employed.  When examining COVID-19 patients PPE for radiation protection (i.e lead rubber apron) will also need to be combined with PPE for infection control.  Lead rubber aprons should be worn under COVID-19 PPE (Figure 7) and should be correctly cleaned and stored following use.  Radiation protection PPE and practices should comply with relevant legislation and the local rules. Radiographer / RTs and relevant personnel should understand that the ‘Controlled Area’ around a mobile unit exists when the unit is exposing and will extend in the direction of the primary beam until the beam is sufficient attenuated and for 2 metres from the patient and X-ray tube in all other directions.    Access to this Controlled Area should be restricted by the radiographer / RT who will give a verbal indication of the intention to conduct a radiation exposure and ensure that all non-essential persons leave the area.  In some instances, it may be necessary for a non-radiographic staff member or relative to physically support the patient during the examination.  If a staff member then this person should not be used on a regular basis.  Females, of childbearing age, should be asked if they are pregnancy and if they answer anything other than ‘no’ they should not be permitted to support the patient.  Any person supporting a patient during a mobile X-ray examination must wear a protective apron and must be instructed to avoid the primary X-ray beam.  Additional lead rubber aprons should be available on mobile X-ray equipment.  The radiographer / RT should take special care to minimise the exposure of patients in adjoining beds.  Any operating key should be removed when the mobile X-ray unit is not in use or if password protected the system must be adequately ‘logged off’.      

Mobile X-ray unit and radiographer

Figure 7.  Radiographer preparing to undertake a mobile chest X-ray on a suspected COVID-19 patient. Note that the radiographer is wearing a lead rubber apron under a disposable apron.  Image courtesy of the Countess of Chester Hospital NHS Foundation Trust.