Why Lurie Children's is no longer using lead shields during X-ray exams

Lurie Children's is leading the way in best practice standards through the launch of So Long Shields, a campaign to no longer use lead shields over patients during X-ray exams.

If you or your child has ever had an X-ray, you are familiar with the heavy lead apron or shields. For many years, Lurie Children's has used patient shields to provide a protective effect from radiation used in X-rays exams.

While that may have been true in the early years of X-ray imaging, advancements in X-ray technology and over 40 years of research has now proven shields do not provide a reduction in radiation risk and can do more harm than good.

According to medical imaging experts, including the FDA and the American Association of Physicists in Medicine (AAPM), patient shields:

• Do not provide a reduction in risk to body parts either inside or outside the imaging area.

• Carry a substantial risk of increasing patient radiation exposure.

• May compromise the quality of the exam by hiding important body parts that the doctor needs to see.

For these reasons, experts on X-ray agree that for patient safety, patient shields should not be used.

"While the scientific rational for discontinuing the use of patient shielding is sound, the deeply ingrained fear of radiation in patients and health care workers proves to be a challenge in implementing this recommendation," said Cynthia Rigsby, MD, Department Chair of Medical Imaging at Lurie Children's.

"We recognized early on that this would be a substantial change in practice and would require a well thought out initiative focused on staff education and raising public awareness," Rigsby said.

To bring awareness to this new practice of care, Lurie Children's So Long Shields campaign is an educational campaign to support the discontinuation of all patient radiation shielding from medical imaging exams.

"When patients learn about this change in practice, many are surprised to hear that shields provide no benefit due to the low levels of radiation we use for our X-ray exams," Rigsby said. "These low levels which are very similar to the amount of background radiation, are safe and do not pose a health risk.

Families are also surprised to learn that shields placed outside of the imaging area do not do much to protect against scattered radiation."

Jan Pachon, medical physicist, and one of the key drivers of Lurie Children's So Long Shields campaign, said, "Changing practice is difficult, however, it should never be an excuse from inaction. As health care providers, we have a duty to make clinical decisions based on likely risks and benefits. That's exactly what we've done by discontinuing patient shielding, and through a well-planned campaign, we were able to convey this message in a compassionate way while putting our expertise on full display."

Pachon and Dr. Rigsby are now working with other health care organizations throughout the country to help make patient shielding discontinuation common practice.

Lurie Children's Department of Medical Imaging provides care that spans across all hospital divisions by providing services like medical imaging tests and interventional radiology.

The hospital's medical imaging team performs more than 115,000 procedures a year, helping our specialists care for their patients with the best imaging procedures possible. Most of Lurie Children's imaging programs are accredited by the American College of Radiology.

Our technologists are trained on low radiation imaging practices and our imaging team also includes medical physicists that routinely review patient radiation exposure to make sure that the radiation used for our X-ray exams is among the lowest in the country.

For more information and FAQs about our shielding practice, please visit: LurieChildrens.org/PatientShielding.

• Children's health is a continuing series. This week's article is courtesy of Ann & Robert H. Lurie Children's Hospital of Chicago. For more information, visit www.LurieChildrens.org.