Intraoperative radiation exposure in a level 1 trauma centre orthopedic operating room
Bibliographic record
Abstract
Background: Although fluoroscopy is used routinely, surgeons and orthopedic residents are inadequately educated about the dangers associated with radiation exposure and protective measures in the operating room. We sought to report the average radiation exposure during common orthopedic trauma procedures for different team members and to determine if the fluoroscopy emitting report is correlated with the radiation measured in the room. Methods: We conducted a prospective observational study over 3 months in a level 1 trauma centre. We collected radiation levels from dosimeters in different standardized locations at 1 m, 2 m, and 3 m from the C-arm machine, labelled as dosimeters A, B, and C, corresponding to the locations of the surgeon, anesthesiologist, and nurse, respectively). We classified mean exposure (and standard deviations [SDs] according to the body part exposed and the dose delivered. Results: We included recordings from 100 patients who underwent surgery for fractures, of which 50 involved a distal extremity, 31 involved a proximal extremity and 19 involved the pelvic area. Dosimeter A (surgeon) recorded a significantly higher amount of radiation at a mean of 20.35 (SD 54.25) μSv than the other 2 dosimeters (B [anesthesiologist]: 0.87 [SD 1.55] μSv; C [nurse]: 0.49 [SD 0.92] μSv), regardless of the fracture location. Higher radiation levels were recorded for fixation of centrally located fractures, followed by lower-extremity fractures and upper-extremity fractures. Half-dose and quarter-dose fluoroscopy emitted statistically lower radiation than standard-dose fluoroscopy. The radiation report from the fluoroscopy machine was highly correlated with the measured radiation (ρ = 0.93; r2 = 0.909, p < 0.001). Conclusion: Radiation exposure is much higher closer to the fluoroscopy machine and decreases following an inverse-square law from the radiation source, becoming negligible at 2 m from the source. Using the low-dose radiation mode can significantly decrease radiation exposure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".