Reduction in operator radiation exposure during transradial coronary procedures using a simple lead rectangle

Objectives: Transradial access for percutaneous coronary intervention (PCI) reduces procedural complications however, there are concerns regarding the potential for increased exposure to ionizing radiation to the primary operator. We evaluated the efficacy of a lead-attenuator in reducing radiation exposure during transradial PCI. Methods and results: This was a non-randomized, prospective, observational study in which 52 consecutive patients were assigned to either standard operator protection (n = 26) or the addition of the lead attenuator across their abdomen/pelvis (n = 26). In the attenuator group patients were relatively older with a higher prevalence of peripheral vascular disease (67.9 vs 58.7 p = 0.0292 and 12% vs 7.6% p < 0.001 respectively). Despite similar average fluoroscopy times (12.3 ± 9.8 min vs. 9.3 ± 5.4 min, p = 0.175) and average examination doses (111866 ± 80790 vs. 91,268 ± 47916 Gycm2, p = 0.2688), the total radiation exposure to the operator, at the thyroid level, was significantly lower when the lead-attenuator was utilized (20.2% p < 0.0001) as compared to the control group. Amongst the 26 patients assigned to the lead-attenuator, there was a significant reduction in measured radiation of 94.5% (p < 0.0001), above as compared to underneath the lead attenuator. Conclusions: Additional protection with the use of a lead rectangle-attenuator significantly lowered radiation exposure to the primary operator, which may confer long-term benefits in reducing radiation-induced injury. Advances in knowledge: This is the first paper to show that a simple lead attenuator almost completely reduced the scattered radiation at very close proximity to the patient and should be considered as part of the standard equipment within catheterization laboratories

Tangling With Spaghetti: Pedagogical Lessons From Games

International audienceGovernments are seeking to develop entrepreneurial competencies among today’s technology, science, and engineering graduates. However, the creation of “bilingual” graduates who have dual technical and managerial competencies is thwarted by students’ inferior teamwork and interpersonal skills. In education, what is taught is inextricably bound to how it is taught (Dewey, 1916). Current pedagogies in engineering education are insufficiently adapted to student learning style needs (Felder & Silverman, 1988), and the management component of engineering education remains underdeveloped. This problem is keenly felt in one French engineering school where students struggle with a team-based innovation project. We detail efforts made to equip students with teamwork skills by using games as a pedagogical device. Student teams compete to build weight resistant structures using only spaghetti sticks and sewing thread. Their written feedback forms the primary qualitative data for this study. Individual student interviews were subsequently carried out to further uncover potential learning outcomes. We found that students’ responses to the spaghetti game were overwhelmingly positive. Their commentary also illustrates concrete learning of many crucial teamwork processes. Finally, we discuss what makes this pedagogical innovation work and how it should be further studied.<br/