Radiation Exposure and Fluoroscopy Factors which increase radiation exposure levels during use of fluoroscopy standing closer to the c-arm emitter imaging large body parts positioning extremity closer to the x-ray source use of large c-arm rather than mini c-arm radiation exposure is minimal during routine use of mini-c-arm fluoroscopy unless the surgical team is in the direct path of the radiation beam Factors to decrease radiation exposure to patient and surgeon maximizing the distance between the surgeon and the radiation beam minimizing exposure time manipulating the x-ray beam with collimation orienting the fluoroscopic beam in an inverted position relative to the patient strategic positioning of the surgeon within the operative field to avoid direct path of beam use of protective shielding during imaging Risk of Transmission Risk of HIV transmission needlestick seroconversion from a contaminated needlestick is ~ 0.3% exposure to large quantities of blood increases risk seroconversion from exposure to HIV contaminated mucous membranes is ~0.09% frozen bone allograft risk of transmission is <1 per million donor screening is the most important factor in prevention no reported cases of transmission from frozen bone allograft since 2001 blood transfusion risk of transmission from blood transfusion is 1/500,000 per unit transfused seronegative blood may still transmit virus due to delay between HIV infection and antibody development Risk of Hepatitis B transmission needlestick 37% to 62% eventually seroconvert following needlestick 22 to 31% develop clinical Hepatitis B infection following needlestick Risk of Hepatitis C transmission needlestick 0.5 to 1.8% risk of transmission Resident Surgeon Work Duty Hours ACGME has restricted work hours in order to address impaired performance by residents caused by long duty hours Duty hours include clinical time academic hours administrative work time on call no more than 1 day per every 3 days in house must include a 10-hour period of "off-time" between clinics on-call restricted to 80 or less per week (averaged over a 4 week period) 10% increase allowed if justified by educational value 1 day in 7 must be a day off (averaged over 4 week period) Results of new duty hours early evaluations have caused concern over issues of patient safety continuity of care communication and transfers in care have been cited as sources of decreased continuity of care as a sequelae of the 80-hour resident physician work week
QUESTIONS 1 of 6 1 2 3 4 5 6 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ10.179) Which of the following configurations creates the least radiation exposure for the operative surgeon during upper extremity surgery? QID: 3272 Type & Select Correct Answer 1 Imaging the thumb positioned against the x-ray source with the standard C-arm 1% (21/2582) 2 Imaging the wrist positioned against the x-ray source with the standard C-arm 3% (73/2582) 3 Imaging the thumb positioned against the image intensifier with the mini C-arm 60% (1543/2582) 4 Imaging the wrist positioned against the image intensifier with the mini C-arm 19% (500/2582) 5 Imaging the thumb positioned against the x-ray source with the mini C-arm 17% (433/2582) L 1 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ10.95) When using C-arm fluorocopy, patient radiation exposure will be increased with which of the following? QID: 3183 Type & Select Correct Answer 1 The extremity is positioned closer to the image intensifier 21% (378/1766) 2 A larger body part is imaged compared to a smaller body part 71% (1247/1766) 3 Use of radiation beam collimation 6% (111/1766) 4 Mini C-arm fluroscopy is used instead of large C-arm fluroscopy 1% (21/1766) 5 Decreased duration of imaging 0% (7/1766) L 3 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (OBQ09.88) All of the following are cited as a concern for decreased continuity of care when "signing out" patient care from one provider to another EXCEPT? QID: 2901 Type & Select Correct Answer 1 Omitting the patients' current clinical condition 3% (39/1538) 2 Omitting guidance for events likely to occur on the next shift 4% (66/1538) 3 Signing out to physician extenders instead of a resident physician 76% (1171/1538) 4 Rationale not given for plans provided to the covering physician 7% (115/1538) 5 Tasks not assigned to the covering physician for completion 9% (138/1538) L 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ06.3) An orthopaedic surgeon is closing a total knee replacement incision of a patient with HIV and accidently sustains a needlestick. What is the surgeon's approximate risk of contracting the virus? QID: 14 Type & Select Correct Answer 1 0.3% 92% (1219/1327) 2 3% 6% (76/1327) 3 10% 1% (14/1327) 4 20% 0% (6/1327) 5 30% 0% (3/1327) L 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic
All Videos (14) Podcasts (1) Login to View Community Videos Login to View Community Videos 7th Annual Frontiers in Upper Extremity Surgery Clinic & OR Efficiencies - Kristopher Avant, D.O. Kristopher Avant Basic Science - Occupational Health 11/3/2022 23 views 0.0 (0) 5th Annual Interdisciplinary Conference on Orthopedic Value-Based Care The Role of Nutrition in Orthopaedic Programs - Matthew S. Austin, MD Matthew Austin Basic Science - Occupational Health 10/26/2022 261 views 4.0 (1) Login to View Community Videos Login to View Community Videos 2022 California Orthopaedic Association Annual Meeting Fluoroscopy Radiation Safety - Isabel Newton, MD Basic Science - Occupational Health 8/11/2022 96 views 5.0 (1) Basic Science⎪Occupational Health Rachel Hoppner (OB) Basic Science - Occupational Health Listen Now 13:38 min 7/21/2020 59 plays 0.0 (0) See More See Less