ASN Report 2018

departments, 32 vascular and osetoarticular interventional radiology departments and 12 neuroradiology departments): ∙ ∙ of the 202 operating theatre departments, 187 had at least one mobile C-arm, 12 had fixed C-arms and 4 had mobile CT scanners; ∙ ∙ of the 140 interventional imaging departments, 110 had at least on fixed C-arm, 28 had mobile C-arms and 10 had fixed CT scanners. To summarise, in more than 90% of the inspected interventional imaging departments, the procedures are carried out using fixed C-arms, whereas in the operating theatres the physicians mainly use mobile C-arms (90%) to guide their surgical procedures. It is also observed that ever-more efficient medical devices are installed in the operating theatres. These are mobile CT scanners or fixed C-arms in the «hybrid» rooms, which combine the characteristics of a conventional surgical room with those of an interventional imaging room; the combination enables the surgeon to perform «mini-invasive» surgery with 2D and 3D imaging. Graph 13 shows the distribution of the medical devices according to the interventional procedures performed. 5.3.1  –  Radiation protection of medical professionals • In interventional imaging departments and in operating theatres… Occupational radiation protection seems to be taken into account effectively, with the appointment of an RPE-O (in about 90% of the departments inspected), display of access instructions in controlled areas (about 70% of the departments inspected) and radiological zoning of the facilities (more than 80% of the departments inspected). However, the lack of training of the medical professionals in occupational radiation protection (refresher training for all the personnel provided in only about 20% of the departments inspected), especially practitioners working in operating theatres, is a recurrent inspection finding. The training of medical and paramedical professionals who use machines with Number of medical devices according to the nature of the fluoroscopy-guided interventional practices 0 20 40 60 80 100 120 140 160 180 200 FGIP in neuroradiology FGIP in cardiology/rhythmology FGIP in coronary angiography/cardiology FGIP in radiology FGIP in operating theatre FGIP: fluoroscopy-guided interventional practices. Mobile CT scanner Fixed CT scanner Mobile C-arm unit Fixed C-arm unit Diagram 13 Percentage of conformity of the facilities inspected with regard to radiation protection of patients 0% 20% 40% 60% 80% The POPM sets out an organisation appropriate for the risks Patient doses recorded, analysed and optimised 100% of medical personnel trained Patient monitoring organised if an HAS threshold is exceeded FGIP: fluoroscopy-guided interventional practices. POPM: Medical Physics Organisation Plan. HAS: French National Authority for Health. FGIP in operating theatre FGIP in interventional imaging Diagram 14 222  ASN report on the state of nuclear safety and radiation protection in France in 2018 07 – MEDICAL USES OF IONISING RADIATION