Optimizing Radiation Safety Without Compromising Quality of Care

Abstract

Background: Cumulative radiation exposure in the cardiac catheterization laboratory poses substantial long-term health risks to operators and staff. Although lead aprons mitigate exposure, they contribute to occupational injury. Recent innovations such as the Rampart M1128 enhanced protection system promise improved shielding without the occupational risk, but their impact on urgent performance metrics remains uncertain, prompting a quality improvement (QI) initiative to evaluate safety and timeliness in patients with ST-segment elevation myocardial infarction (STEMI).

Project rationale: This initiative investigated whether introducing the Rampart M1128 maintained timely perfusion while improving staff safety.

Project summary: In a single-center retrospective QI analysis, 174 patients with STEMI underwent percutaneous coronary intervention-87 with standard lead aprons and 87 after Rampart M1128 adoption. Adjusted analyses showed a mean difference in door-to-balloon time of 1.51 minutes (95% CI: -0.86 to 3.87 minutes; P = 0.21), well within our predefined 5-minute noninferiority threshold. No delays were seen in high-acuity subgroups.

Take-home message: Adopting enhanced radiation shielding with Rampart M1128 preserved STEMI treatment timelines while improving staff safety, supporting its integration into catheterization laboratory QI strategies.

Keywords: ST-elevation myocardial infarction (STEMI); door-to-balloon time (D2B); enhanced radiation protection system; occupational hazard; radiation safety.