Monitoring skin dose resulting from fluoroscopically guided interventions at Adam Malik Hospital Medan.

Medical exposure to fluoroscopically guided intervention (FGI) is a procedure with the highest risk of deterministic effects, so monitoring is necessary to determine the possibility of experiencing skin injury as a result of the dose given during the procedure. Skin dose estimation for PAC + PCI, PA, PCI and PAC procedures were carried out at the cardiac catheterization unit at Adam Malik Hospital in Medan using the C-Arm brand GE Medical System. Data were recorded for the period March to April 2023, with the provision that the total value of air kerma≥1Gy for adult patients regardless of sex. Dose metrics for each action procedure, both reference air kerma (Ka,r), DAP, fluoro time, kV and SID were recorded. Skin dose is estimated from the total available reference air kerma (Ka,r) (mGy). Then calculate the ESAK peak by applying the backscatter correction factor (BSF) and Ka,r. F-factor as a function of kVp (Jones et al., 2011) for fluoroscopy and digital acquisition modes. The F-factor converts air kerma to dose in a medium. "The skin dose is roughly estimated from ESAK and f-factor per exposure". The results show that the skin dose value is higher than the ESAK value for all measures. The estimated skin dose value for the PAC + PCI procedure was 3.2-6.7 Gy and PCI 1.5-8.5 Gy for each of 5 people. Also in the PA procedure, the estimated skin dose was 1.75-3.54 Gy in 3 people and PAC 1.5-8.6 Gy in 9 patients. The estimated values of skin dose at the highest PAC + PCI measure 6.7 Gy, PCI 8.5 Gy, PA 3.54 Gy and PAC 8.6 Gy. From the results obtained, it can be concluded that the skin dose value is the multiplication of ESAK with the f-factor and the skin dose value is higher than the total reference air kerma value. It is necessary to monitor the PAC + PCI, PA, PAC, and PCI measures, to evaluate the possibility that the patient will experience deterministic skin changes. The role of the medical physicist in estimating peak skin doses is very much needed so that actions in cardiac catheterization must be carried out with the aim that the dose achieved is as low as possible with maximum benefit. The calculation of skin dose and ESAK can be measured directly to the patient as material for further research so that more accurate skin dose results are obtained. [ABSTRACT FROM AUTHOR]