New Policy: No Foetal and Gonadal Shielding for Radiological Examinations

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Important Announcement

A practice that has been in place for over 70 years is changing!

Due to significant reduction in radiation doses from technological advances and an increase understanding of radiation risk, experts in the field are now recommending that gonadal and fetal shielding should no longer be used as routine practice. 

This recommendation is starting to be accepted around the world with the ACPSEM being the first professional body outside of North America to officially endorse this practice.

Chair – ACPSEM Radiology Specialty Group

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New Policy Release, April 2019

By American Association of Physicists in Medicine (AAPM)

The new AAPM position statement is:

Staff should no longer use gonadal or foetal shields on patients. 

The AAPM has outlined reasons for limiting routine use of foetal and gonadal shielding of patients during radiological examinations

This is a substantial shift in existing clinical practice.

Engaging Stakeholders

To ensure that all parties will be comfortable with this major change in policy, AAPM has convened a committee of stakeholders to discuss its implementation, called

Communicating Advances in Radiation Education for Shielding :

The CARES Committee

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The CARES ‘must read’ information:

CARES has prepared some frequently asked questions (FAQs) for circulation to healthcare staff, patients, parents and the public.

This is a first stage in implementing the new policy

Stop the use of foetal and gonadal shielding for radiological examinations.

Frequently Asked Question you Must Read

Information for Healthcare Staff:
Healthcare staff should read the complete CARES FAQs document by clicking on:  

CARES FAQ

Information for Patients, Parents and the Public
Patients, parents and the general public are welcome to read the CARES full document or you can read a summary of the CARES FAQ by clicking on:

                                    Summary of CARES FAQ for public

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Implementing the Policy Change

The CARES document has sections addressing:

1. Suggested wording of responses for Healthcare professionals (such as radiologic technologists, physicians, advanced practice providers, medical physicists, radiation safety officers, and nurses) when discussing ‘no need for shielding‘ with patients and parents or other caregivers of paediatric patients.
2. FAQs of common concerns amongst adult patients; and
3. FAQs for parents and other caregivers of paediatric patients. 

Important:

1. Facilities that choose to limit the routine use of patient foetal and gonadal shielding, should use this document, in part or in whole, to help establish a suitable  guide or policy for their practice.
2. Facilities should consistently adopt the new guidelines;
3. Facilities should maintain a consistent ‘no shield’ policy. Any inconsistency in the use or no use of shields can imply to patients a lapse of proper care. 

CARES Members

Representatives from many different societies and organizations who specialise in medical imaging and patient safety joined CARES. Members appointed are from:

American Association of Physicists in Medicine
American College of Radiology, represented by Darcy Wolfman, M.D.
American Society of Radiologic Technologists
Association of Educators in Imaging and Radiological Sciences, represented by Nina Kowalczyk, Ph.D. Canadian Organization of Medical Physicists
Conference of Radiation Control Program Directors
Health Physics Society
Image Gently
Image Wisely
Radiological Society of North America 

Endorsement by the Professions

The position statement has currently received endorsement from:

• The American College of Radiology (ACR)
• The Canadian Organization of Medical Physics (COMP)
• The Health Physics Society (HPS)
• The Canadian Association of Radiologists (CAR)
• The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM); and
• The Image Gently Alliance.

Amanda Perdomo, 31 January, 2020

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