This section provides a list of tasks promoting radiation-safety items during fluoroscopy. The checklist is divided into pre-procedure, intra-procedure and post-procedure items.

Radiation injury during fluoroscopic procedures is influenced by many factors. Adequate pre-planning and attention to techniques to minimize radiation dose are integral components of mitigating the risk of radiation injury.

Following these guidelines should reduce the incidence of adverse reactions to the patient due to excess radiation and improper technique.

Careful planning and execution of fluoroscopically guided interventional procedures can reduce procedure risk as well as radiation exposure to the patient and hospital staff.

Establishing a radiation safety-conscious environment in the cardiac catheterization laboratory for all procedures, diagnostic and therapeutic/interventional, should be a collaborative effort involving physicians, staff, medical physicists, quality assurance personnel and hospital administration.

Physicians and ancillary professionals should be familiar with current recommendations on protocols and radiation management from professional organizations.

As image quality improves, it begins providing more and more information that leads to increases in the probability of success. However, these increases eventually reach a point where further increases in image quality have little or no impact on the result.

The general relationship between the number of incident photons entering the patient’s skin and exiting photons reaching the detector is described by the Beer-Lambert Law.

The factors governing system performance are often divided into broad categories that can be used to begin cataloguing the numerous factors that govern radiation use during fluoroscopic procedures.

Patient injuries from fluoroscopic procedures should be reported in the same manner as other harmful events.

Improving radiation safety during fluoroscopic procedures requires a systematic approach where radiation metrics are routinely captured and analyzed and the results are used to determine if prior changes have led to improvement.

Minimizing the likelihood and severity of skin injuries requires attention before, during and after a procedure is performed.

Several guidelines for training in radiation protection and management have been developed by professional societies and should be fully implemented.

Control charts are designed to signal individual procedures or sequences of procedures where the observed results should be attributed to causal factors rather than random variation.

MRI has found success in replacing at least some fluoroscopic diagnostic studies, as discussed here.

The examples discussed here illustrate specific indications in which ultrasound is preferred over fluoroscopy for interventional procedures.

Training of physicians and ancillary personnel who use fluoroscopic equipment is essential in preventing or minimizing both deterministic effects and stochastic risks.

Radiation safety during fluoroscopic procedures depends on an extensive network of people working together as a team. High-performing teams greatly exceed the capabilities of individuals, no matter their skill, intelligence or dedication.

With each incremental advancement in fluoroscopy technology, smaller vessels and more subtle contrast differences can be visualized in real time, often with low radiation dose.