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Estimating Fluoroscopic Peak Skin Dose Using Manual Calculations

Berry, Kendall, Elizabeth*

doi: 10.1097/HP.0000000000000865
Operational Topic

Not all healthcare providers can afford to purchase commercially available programs that can quickly and easily provide peak skin dose estimations for patients undergoing diagnostic and international fluoroscopic procedures. The air kerma reference point exposure, Ka,r, available on all equipment manufactured after 2006, may over or under estimate the patient's peak skin dose. The total air kerma reference point exposure provided at the end of a case might be on the order of 20 Gy for a patient, indicating that a Joint Commission "sentinel event" may have occurred. An investigation to determine whether a sentinel event has occurred becomes necessary. This article will introduce information available to the investigating health physicist for data mining, how to process that information, and then how best to interpret the results. I have used this system of data mining and analysis to effectively influence how physicians performing diagnostic and interventional fluoroscopic procedures use fluoroscopic equipment. Arriving at an answer is not simple; it is time consuming, and the methodologies are imperfect. Your effort can result in improved utilization of fluoroscopic equipment at your institution which in turn will lower patient and staff doses.

*Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111.

The author declares no conflicts of interest.

Kendall Berry earned her dual degree MSPH in health physics and industrial hygiene in 1997 from University of North Carolina–Chapel Hill. She immediately began working in an academic and medical Radiation Safety Office and now has 20+ years of experience in academic/medical facilities. She has worked as a Radiation Safety Officer for the past 10 years and is currently the RSO at Fox Chase Cancer Center in Philadelphia. She is interested in helping patients, families, and staff overcome their fears of radiation and routinely works to replace fear with understanding and a healthy respect for sources of radiation. Her email is

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