• Timothy McAleese, Alexander Price, Anthony G Ryan, and Fiachra E Rowan.
• Department of Trauma and Orthopaedic Surgery, University Hospital Waterford, Waterford, X91ER8E, Ireland. timmcaleese@rcsi.ie.
• Ir J Med Sci. 2024 Feb 1; 193 (1): 257263257-263.

BackgroundThe widespread use of intraoperative fluoroscopy in orthopaedic procedures has revolutionised surgical practice. However, there are risks associated with using ionising radiation. Efforts to reduce radiation exposure include low-dose imaging protocols and lead protective equipment. Current communication during fluoroscopic procedures can be inefficient and lead to excessive radiation exposure for patients and staff.AimsThis study aims to implement a communication tool with standardised commands to reduce radiation exposure in an Irish orthopaedic department.MethodsRadiation exposure was evaluated using dose-area product (DAP) measured in uGy/m2. A control group was recorded before implementing the communication tool. Training sessions were conducted and posters of the standardised commands were displayed. Feedback was collected from surgeons and radiographers via surveys. Statistical analysis was performed to compare pre- and post-intervention groups.ResultsA total of 673 surgical cases were included over 6 months. The post-intervention group showed a mean reduction in radiation exposure from 59.8 to 36.4 uGy/m2 (p < 0.011). Subset analyses revealed reduced radiation exposure for ORIF of the distal radius, ankle, humerus, and phalanges. Surgeons and radiographers recognised the need for improved communication and expressed willingness to learn the new tool.ConclusionsImplementation of a standardised communication tool effectively reduced patient and staff radiation exposure. It was also believed to have a positive effect on theatre staff morale. Incorporating a universal language tool into training programmes could be beneficial. Surgeons and radiographers provided several suggestions to improve the effectiveness and implementation of this tool into other units.© 2023. The Author(s).

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