Selective Shielding Use

Apply patient shielding selectively based on exam type and diagnostic necessity and avoid routine use that may obscure anatomy or trigger automatic exposure increases. Use gonadal shielding for appropriate radiographic exams when it does not interfere with the diagnostic region. For CT and fluoroscopy consider bismuth or equivalent shields only after protocol optimization and vendor guidance.

Positioning and Collimation

Accurate patient positioning and tight collimation reduce irradiated volume and improve image quality by limiting scatter. Use immobilization and support devices to minimize motion and avoid repeat exposures. Train technologists in positioning techniques for diverse patient body habitus and clinical indications.

Pediatric Considerations

Children require size adapted shielding and technique selection to minimize dose while preserving diagnostic information. Use weight or diameter based protocols and prefer non ionizing modalities when feasible. Communicate with caregivers and use child friendly immobilization to reduce motion and need for repeat scans.

Documentation and Consent

Document shielding decisions and positioning rationale in the imaging record when deviations from standard practice occur. Provide clear patient information about benefits and risks and obtain informed consent for procedures with significant exposure. Use standardized checklists to ensure consistent application of protective measures.