Operating Room Personnel Research Articles

The child's behavior during inhalational induction and its impact on the anesthesiologist's sevoflurane exposure.

Sevoflurane is commonly used for inhalational inductions in children, but the personnel's exposure to it is potentially harmful. Guidance to reduce gas pollution refers mainly to technical aspects, but the impact of the child's behavior has not yet been studied. The purpose of this study was to determine how child behavior, according to the Frankl Behavioral Scale, affects the amount of waste sevoflurane in anesthesiologists' breathing zones. Sixty-eight children aged 36-96 months undergoing elective ENT surgery were recruited for this prospective, observational investigation. After oral midazolam premedication (0.5 mg/kg body weight), patients obtained sevoflurane using a facemask with an inspiratory concentration of 8 Vol.% in 100% oxygen (flow 10 L/min). Ventilation was manually supported and a venous catheter was placed. The inspiratory sevoflurane concentration was reduced, and remifentanil and propofol were administered before the facemask was removed and a cuffed tracheal tube inserted. The child's behavior toward the operating room personnel during induction was evaluated by the anesthesiologist (Frankl Behavioral Scale: 1-2 = negative behavior, 3-4 = positive behavior). During induction mean (c¯mean) and maximum (c¯max), sevoflurane concentrations were determined in the anesthesiologist's breathing zone by continuous photoacoustic gas monitoring. Mean and maximum sevoflurane concentrations were c¯mean = 4.38 ± 4.02 p.p.m and c¯max = 70.06 ± 61.08 p.p.m in patients with positive behaviors and sufficient premedications and c¯mean = 12.63 ± 8.66 p.p.m and c¯max = 242.86 ± 139.91 p.p.m in children with negative behaviors and insufficient premedications (c¯mean: P < .001; c¯max: P < .001). Negative behavior was accompanied by significantly higher mean and maximum sevoflurane concentrations in the anesthesiologist's breathing zone compared with children with positive attitudes. Consequently, the status of premedication influences the amount of sevoflurane pollution in the air of operating rooms.

Ultrasound guided ureteroscopy in children: Safety and success

Ureteroscopy has been shown to be a highly efficacious and safe modality for the treatment of pediatric urolithiasis. However, conventional ureteroscopy relies on fluoroscopy for intraoperative guidance, exposing both patient and operating room personnel to ionizing radiation. Pediatric urolithiasis patients are at a particularly increased risk from this radiation exposure. The use of ultrasound in place of fluoroscopy for intraoperative guidance has emerged as one modification that can reduce radiation exposure during ureteroscopy. Although ultrasound-guided ureteroscopy has been shown to be a safe, and effective approach to stone management in adults, there have been no studies to date utilizing this approach in children. The aim was to describe our initial experience with ultrasound-guided ureteroscopy in children as a safe and feasible modality to manage pediatric urolithiasis. A retrospective review of consecutive patients that underwent ultrasound-guided ureteroscopy by one pediatric urologist (A.K.S.) from 2014 to 2016 for symptomatic urolithiasis was performed. Patient data were extracted from our center's IRB-approved prospectively maintained database of all children with urolithiasis. Real-time ultrasonic guidance was provided by a pediatric uroradiology attending, with fluoroscopy available on standby. With the probe positioned on the patient's flank, ultrasound was used to visualize advancement of guidewire, dual-lumen catheter, and ureteroscope through the ureteral orifice and up to the renal pelvis (Figure). Stones were identified and removed via basket retrieval. At the conclusion of each case, ultrasonography was then used to confirm stent placement of indwelling double pigtail ureteral catheters. Eleven patients were identified that underwent 12 ultrasound-guided ureteroscopic procedures in an outpatient setting. Stones were accessed in various locations and were removed by basket retrieval. Laser calycostomy into calyceal diverticulum and balloon dilations of ureterovesical junction and calyceal infundibulum were also performed. There were Clavien grade I and II complications in four patients; all of which were related to pain control. To our knowledge, this is the first study reporting the successful use of ultrasound-guided ureteroscopy in children. The main limitation of this feasibility study is its small sample size. A larger series is needed to corroborate these findings and make them generalizable to a wider population. This feasibility study accomplished its aim of demonstrating for the first time that ultrasound-guided ureteroscopy can be safely used in children to manage urolithiasis.

Prediction of Preventive Behaviors of the Needlestick Injuries during Surgery among Operating Room Personnel: Application of the Health Belief Model.

Background:Operating room personnel are at high risk of needlestick injuries (NSIs) and exposure to blood and body fluids. Objective: To investigate the predictors of NSIs preventive behaviors during surgery among operating room personnel based on a health belief model (HBM).Methods: This cross-sectional study was conducted on 128 operating room personnel in Hamadan, western Iran. Participants were selected, by census sampling, from teaching hospitals, completed a self-reported questionnaire including demographic characteristics, knowledge and HBM constructs.Results:The levels of knowledge and perceived self-efficacy for the NSIs preventive behaviors among operating room personnel were not satisfactory. However, the levels of perceived benefits, susceptibility and severity were reported to be relatively good. The results showed that the perceived susceptibility (β ‑0.627) and cues to action (β 0.695) were the most important predictors of the NSIs preventive behaviors.Conclusion:The framework of the HBM is useful to predict the NSIs preventive behaviors among operating room personnel.

Perception of Safety of Surgical Practice Among Operating Room Personnel From Survey Data Is Associated With All-cause 30-day Postoperative Death Rate in South Carolina

To evaluate whether the perception of safety of surgical practice among operating room (OR) personnel is associated with hospital-level 30-day postoperative death. The relationship between improvements in the safety of surgical practice and benefits to postoperative outcomes has not been demonstrated empirically. As part of the Safe Surgery 2015: South Carolina initiative, a baseline survey measuring the perception of safety of surgical practice among OR personnel was completed. We evaluated the relationship between hospital-level mean item survey scores and rates of all-cause 30-day postoperative death using binomial regression. Models were controlled for multiple patient, hospital, and procedure covariates using supervised principal components regression. The overall survey response rate was 38.1% (1793/4707) among 31 hospitals. For every 1 point increase in the hospital-level mean score for respect [adjusted relative risk (aRR) 0.78, 95% CI 0.65-0.93, P = 0.0059], clinical leadership (aRR 0.86, 95% CI 0.74-0.9932, P = 0.0401), and assertiveness (aRR 0.71, 95% CI 0.54-0.93, P = 0.01) among all survey respondents, there were associated decreases in the hospital-level 30-day postoperative death rate after inpatient surgery ranging from 14% to 29%. Higher hospital-level mean scores for the statement, "I would feel safe being treated here as a patient," were associated with significantly lower hospital-level 30-day postoperative death rates (aRR 0.83, 95% CI 0.70-0.97, P = 0.02). Although most findings seen among all OR personnel were seen among nurses, they were often absent among surgeons. Perception of OR safety of surgical practice was associated with hospital-level 30-day postoperative death rates.

Disruptions in Surgical Workflow: Perceptions and Implications

Surgical flow disruptions (SFD) are defined as deviations from the natural progression of a procedure which are potentially compromising to the safety of the operation. Investigators have demonstrated that SFDs can increase the mental workload and likelihood of surgical errors. This study investigated the frequency, cause, and significance of flow disruptions from the perspective of operating room team members. A questionnaire consisting of 16 questions was used. Operating room (OR) personnel at 3 academic medical centers were emailed a link. The questionnaire was designed to validate the definition of disruptions and explore potential consequences of SFDs. There were 111 responses (64% response rate). Forty percent of respondents were between the ages of 25-34 and 56% were male. Nurse anesthetists made up the largest group of respondent (32%). Sixty-five percent reported that surgical flow disruptions happen either “several times a day” or “every procedure.” Forty percent ranked “poor communication” as the most frequent cause of SFDs. Respondents who identified as attending surgeons felt impacts in patient safety and staff burnout were the most likely consequence of SFDs. Scrub technicians and nurses, felt that economic consequences were the most likely result. The data demonstrates that OR team members recognize that surgical flow disruptions are an issue and believe poor communication is a significant factor. Responses confirm the belief that SFD compromise patient safety and lead to personnel burnout. By understanding surgical flow disruptions from this perspective, researchers will be better equipped to design interventions for optimizing OR outcomes.

Evaluation of Knowledge, Attitude and Practice of Personnel in Operating Room, ERCP, and ESWL Towards Radiation Hazards and Protection

Background: Recently, X-rays radiation hazards rise with the exposure of patients and personnel. Exposure of people to radiation in the operating rooms is an important problem to study the safety of personnel and patients. To date, few studies are accomplished to evaluate knowledge, attitude, and practice (KAP) among personnel in hospitals. The current study aimed at evaluating KAP level of radiation hazards and protection amongst personnel in the operating room. Methods: A questionnaire-based, cross sectional study was conducted in 11 provinces of Iran from 2014 to 2015. Respondents in the current study were 332 personnel of operating room, endoscopic retrograde cholangiopancreatography, and extracorporeal shock-wave lithotripsy. Demographic characteristics, as well as knowledge, attitude, and practice levels of operating room personnel were collected. The selected hospitals were 3 types (educational, non-educational, and private clinics) located in 5 different regions of Iran (Tehran, Center, East, North, and West). Data were analyzed using SPSS version 16.0 and statistical analyses were accomplished with the one-way ANOVA. Results: The current study results showed no statistically significant difference in the KAP level of operating room personnel towards radiation protection for both genders (P = 0.1), time since graduation (P = 0.4), and work experience (P = 0.1). According to the analyses, the highest level of KAP concerning radiation protection was observed in the personnel of private clinics (mean score = 53.60) and the lowest value was observed in non-educational hospitals (mean score = 45.61). Besides, the KAP level was significantly higher in the Northern region (P < 0.0001) and the lowest was observed in the hospital personnel of the Central region (mean score = 34.27). Conclusions: The current study findings showed that the level of KAP regarding radiation protection among operating room personnel was inadequate and it is necessary to pay attention to the principles of radiation protection in the operating room. In this regard, holding courses on radiation protection and an elaborate educational program might be useful.

Is there an association between surgeon hat type and 30-day wound events following ventral hernia repair?

While several patient and operative variables have been shown to be associated with an increased risk of postoperative wound events, the association between surgical hat type worn by surgeons and postoperative wound events remains controversial. The purpose of this study is to investigate the association between type of surgical hat worn by surgeons and the incidence of postoperative wound events following ventral hernia repair using the Americas Hernia Society Quality Collaborative database. All surgeons who input at least ten patients with 30-day follow-up into the AHSQC were identified. These surgeons were sent a survey asking them to identify the type of surgical hat they wear in the operating room. The association of the type of surgical hat worn, patient variables, and operative factors with 30-day wound events was investigated using multivariate logistic regression. A total of 68 surgeons responded to the survey, resulting in 6210 cases available for analysis. The type of surgical hat worn by surgeons was not found to be associated with an increased risk of 30-day surgical site infections or surgical site occurrences requiring procedural intervention. Our study is the first study to directly compare the association of surgical hat type with postoperative wound events. There is no association between the type of surgical hat worn and the incidence of postoperative wound events following ventral hernia repair. Our findings suggest that surgical hate type may be chosen at the discretion of operating room personnel without fear of detriment to their patients.

C-arm Positioning Is a Significant Source of Radiation in Spine Surgery.

Prospective chart review. It is well-known that radiation exposure during minimally invasive spine procedures can be substantial. Less interest has focused on setup radiation exposure before incision, including preoperative images used for surgical approach. The present study seeks to better quantify the significance of setup radiation in the total radiation exposure of minimally invasive spine surgery. Radiographic localization is necessary in minimally invasive spine procedures to visualize anatomy, but increased radiation exposure is associated with health risks. Preoperative imaging for anatomical localization has not been previously analyzed as an appreciable source of radiation. From an institutional review board-approved database of more than 1100 procedures, the minimally invasive spine cases with recorded set-up radiation were extracted. The total radiation, set-up radiation, and procedure type data were evaluated. Statistics were generated using a chi-squared analysis. Set-up and total radiation data were collected for 270 spine surgeries performed by four surgeons at two locations. There were 30 thoracic and 240 thoracolumbar/lumbar cases; 78 anterior and 192 posterior cases. Average total radiation (set-up and intraoperative) was 8.04 rad, and average setup radiation was 1.90 rad (28%, std 2.97 rad) across all cases. On average for the thoracolumbar/lumbar cases, set-up radiation accounted for almost 25% of total radiation with 1.76 rad from setup out of 8.16 rad total. Thoracic-only cases often necessitated even more images for localization, generating an average set-up/total percentage of 52%. Across all procedures, set-up radiation significantly increased the total radiation exposure because it accounted for more than 25% of the total procedure. Radiation exposure during preoperative localization can be substantial. Operating room personnel should recognize the high percentage of radiation that occurs during set-up, and merit should be given to techniques and technologies that can limit unnecessary radiation exposure during this portion of the procedure. 2.

Introductions During Time-outs: Do Surgical Team Members Know One Another's Names?

Introductions are the first item of the time-out in the World Health Organization Surgical Safety Checklist (SSC). It has yet to be established that surgical teams use colleagues' names or consider the use of names important. A study was conducted to determine if using the SSC has a measurable impact on name retention and to assess if operating room (OR) personnel believe it is important to know the names of their colleagues or for their colleagues to know theirs. All OR personnel were individually interviewed at the end of 25 surgical cases in which the SSC was used. They were asked (1) to name each OR participant, and (2) if they believed it is important to know the names of their team members and (3) for their team members to know their name. Of the 150 OR personnel interviewed, 147 (98%) named the surgery attending correctly. The surgery attending named only 44% of other OR staff (p <0.001). Only 62% of the OR staff correctly named the anesthesiology attending. The anesthesiology resident was the least well known but was able to name 82% of the others. The anesthesiology attending named his or her resident 100% of the time; the surgery attending correctly named his or her resident only 68% of the time (p = 0.002). This study suggests that OR personnel may consider introductions to be another bureaucratic hurdle instead of the safety check they were designed to be. It appears that this first step of the time-out is often being performed perfunctorily.

The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review.

A 2007 study in the United Kingdom showed that three of 98 surgeons surveyed admitted using dedicated smoke extractors; 72% of respondents believed inadequate precautions were in place to protect staff from the potential dangers of electrosurgical smoke. Surgical smoke contains harmful chemicals (e.g., hydrogen cyanide, acetylene, and butadiene) that can circumvent standard masks used in the operating room (OR). In addition, bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers, but also because they, like other health care providers, may be exposed to smoke routinely. The authors of this review recommend the regular use of smoke evacuation in ORs and avoidance of electrosurgery whenever possible to protect OR personnel from the potential long-term harmful effects of electrosurgical smoke.

Needlestick Injuries in Healthcare Workers in the North East of Iran

Introduction: Needle-stick injuries are the second most commonly reported adverse incident and constitute a major hazard for the transmission of blood transmitted diseases. The incidence of Needle stick is higher than the reported cases in different countries. Reporting of these exposures is often a challenge for HCWs (health care workers). This article describes the prevalence of occupational injuries caused by contacting patients with needle and sharp objects and fluids of the patients’ body fluids in HCWs. Materials and Methods: This cross-sectional study has been conducted in 4 hospitals affiliated to Mashhad University of medical sciences, Iran during 2008-2015. We assessed self-reported occupational exposures in HCWs includes nurse, physician, medical student and other. Results:Among the HCWs with NSIs, other personnel includes paramedics, assistants, crew, midwife, operation room personnel, and laboratory, radiology and physiotherapy personnel had the highest percentage of needle stick contact , followed by nurses. Self-reporting of needle-stick has been growing in this period. In this study, the hepatitis B immunity in sharps injury recipients was 90-95% in 2015. Conclusion: The prevalence of needle stick in HCWs is high. Preventive strategies had to be devised. Use of safety engineering devices, to encourage recording and reporting of incidents, hepatitis B immunity, serological tests, follow-up post exposure, training in precaution standard is necessary for HCWs and medical students.

Effects of Intervention and Team Culture on Operating Room Traffic.

How changes in the surgical team's culture can potentially reduce operating room (OR) traffic. Excessive OR traffic during surgical procedures can present a risk to the patient's safety and recovery. Data suggest that limiting the number of OR personnel during the intraoperative period can reduce excessive OR traffic. However, it is unclear whether the surgeon's verbal intervention can also successfully reduce intraoperative OR traffic. This study compares traffic rates in hip and knee arthroplasty cases against traffic rates during nonarthroplasty cases to examine the effects of verbal interventions implemented by the surgeon to reduce intraoperative traffic. The study consisted of 16 orthopedic surgeons in a noninterventional group and 1 orthopedic surgeon in the interventional group. The surgeon in the interventional group implemented verbal protocols to OR staff to limit excessive intraoperative traffic. Operating room traffic was monitored for 3 consecutive months (January-March 2015) with the use of infrared automated door counters that tracked door openings when someone entered or left the OR. A total of 50 hip and knee arthroplasties cases and 157 nonarthroplasty cases were tracked during the study period. A total of 134 hours and 4482 movements were collected for the hip and knee arthroplasty cases. A total of 498 hours and 22 902 movements were collected for the nonarthroplasty cases. Comparing the 2 groups, the interventional group averaged 33 movements per hour while the noninterventional group averaged 46 movements per hour (P < .001). These results suggest that operative room traffic can be reduced through simple verbal protocols established by the surgical team.

Mental workload and its association with fatigue in operating room personnel of Hamadan hospitals, Iran, 2016

Mental workload and its association with fatigue in operating room personnel of Hamadan hospitals, Iran, 2016

Wearing ID Badges in the Operating Room Environment: Is Reconsideration Warranted?

BackgroundSurgical site infection and nosocomial infections in general have appropriately undergone increased scrutiny over the last decade. Numerous studies have documented pathogenic bacterial contamination of personal items such as cell phones, pagers, ties, and pens in the hospital setting. It is our understanding that Joint Commission on Accreditation of Healthcare Organizations requires all personnel to wear an identification badge at all times, which includes the operating room environment. MethodsBadges, lanyards, and pagers from operating room personnel were swabbed and cultured using the same protocol used for surgical specimens in the operating rooms. Personnel included orthopedic attendings (14), orthopedic residents (20), nurses (19), and anesthesia personnel (11). ResultsA total of 64 badges were sampled, with no methicillin-sensitive Staphylococcus aureus (MSSA) or methicillin-resistant S. aureus (MRSA) cultured on any of the badges. Two of 64 had enterococcus (3%), and 1 of those was vancomycin resistant. Pagers had similar results, with only 1/42 growing MSSA or enterococcus (2.4%), and no MRSA. Lanyards showed higher rates of contamination. There were 11% with MSSA or MRSA out of 27 sampled. Highest contamination rates were with orthopedic staff and resident lanyards, with 3/22 (13.6%) growing MSSA or MRSA. No lanyards grew enterococcus. When comparing rates of MSSA and/or MRSA between groups, lanyards had a statistically significant higher rate (P < .05). ConclusionAt a minimum, operating room personnel should probably not use lanyards to display their ID badges.

13: AN IMPROVEMENT ON THE SURGICAL SAFETY CHECKLIST ACCORDING TO PRACTICE-BASED EVIDENCE

Background and aims:One of the primary duties that circulating and scrub nurses fulfill is to record instruments used and procedures adopted during a surgical operation. An appropriate checklist based on...

An Update on the Innovative Surgical Double-Glove Hole Puncture Indication Systems: Reliability and Performance.

During operative procedures, operating room personnel wear sterile surgical gloves designed to protect them and their patients against transmissible infections. The Food and Drug Administration (FDA) has set compliance policy guides for manufacturers of gloves. The FDA allows surgeons' gloves whose leakage defect rates do not exceed 1.5 acceptable quality level (AQL) to be used in operating rooms. The implications of this policy are potentially enormous to operating room personnel and patients. This unacceptable risk to the personnel and patient could be significantly reduced by the use of sterile double surgical gloves. Because double-gloves are also susceptible to needle puncture, a double-glove hole indication system is urgently needed to immediately detect surgical needle glove punctures. This warning would allow surgeons to remove the double-gloves, wash their hands, and then don a sterile set of double-gloves with an indication system. During the last decade, Regent Medical has devised non-latex and latex double-glove hole puncture indication systems. The purpose of this comprehensive study is to detect the accuracy of the non-latex and latex double-glove hole puncture indication systems using five commonly used sterile surgical needles: the taper point surgical needle, tapercut surgical needle, reverse cutting edge surgical needle, taper cardio point surgical needle, and spatula surgical needle. After subjecting both the non-latex and latex double-glove hole puncture indication systems to surgical needle puncture in each glove fingertip, these double-glove systems were immersed in a sterile basin of saline, after which the double-gloved hands manipulated surgical instruments. Within two minutes, both the non-latex and latex hole puncture indication systems accurately detected needle punctures in all of the surgical gloves, regardless of the dimensions of the surgical needles. In addition, the size of the color change visualized through the translucent outer glove did not correlate with needle diameter. On the basis of this extensive experimental evaluation, both the non-latex and latex double-glove hole puncture indication systems should be used in all operative procedures by all operating room personnel.

A hybrid tracking system for image-guided spine surgery using a tracked mobile C-arm: a phantom study

In recent years, an increasing number of various surgeries are observed utilizing fluoroscopy. The radiation exposure received by patients and medical staff and the surgical guidance in multiple planes frequently necessitate the positioning of a mobile C-arm. Operative navigation enables a mobile C-arm to provide multiplanar surgical guidance and decreases the radiation dose to the patient and operating room personnel. In this study, we propose a video-based tracked mobile C-arm (referred to as a "tracked C-arm system") to position the system. This system defines a reference framework to maintain the video-optical tracker data and computed tomography (CT) or cone-beam CT images' alignment as fine as possible despite patient or tracker movement. By employing our uniquely designed "six-facet" reference marker attached to the spine phantom, registration between the video-optical tracker and the spine phantom is maintained at arbitrary angles of the mobile C-arm. The tracked C-arm system provides a statistically significant improvement (P < 0.001) in target registration error in comparison with the conventional system: 0.80 $\pm $ 0.34 mm versus 1.60 $\pm $ 0.43 mm, respectively. The tracked C-arm system is designed to generate digitally reconstructed radiograph images from the mobile C-arm perspective, with projection error on the order of 0.74 $\pm $ 0.13 mm. Integration of the hybrid tracking system with mobile C-arm guidance has the capability to provide registration, reduce radiation exposure, and improve target registration accuracy.

An in vitro evaluation of bacterial penetration through different kinds of surgical drapes

PURPOSE: Surgical site infection is a major cause of increased post-operative morbidity. The surgical drape functions as a barrier between the surgical field and the potential sources of microorganisms in the environment and operating room personnel. The extent to which the materials act as barrier depends on the closeness of the weave and water-resistant properties of the fabric. This is an in vitro study to evaluate the ability of different types of surgical drapes to prevent bacterial strike through. MATERIALS AND METHODS: Four types of fabrics used as surgical drapes were tested for their ability to prevent strike through when exposed to different bacteria for varying spans of time. We tested the drapes with Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. RESULTS: Drapes made of cotton (CC) or polyester-cotton (PC) textile exhibited least resistance to bacterial penetration. Disposable woven continuous filament polyester fabrics showed better resisting powers. The disposable non-woven polythene fabrics were found to resist bacterial penetration most effectively. The penetration through the woven fabrics was found to be dose- and time-dependent. CONCLUSION: The practice of using reusable textile clothes as surgical drapes should be discontinued and be replaced by non-woven seamless disposable fabric. Surgical drapes should be tested for their penetrability before introducing in operation theatre.

An Update on the Global Epidemic of Human T-Cell Lymphotrophic Virus Type-I (HTLV-I)

Infection with human T-cell lymphotrophic virus-I (HTLV-I) is now a global epidemic, affecting 10 to 20 million people. This virus has been linked to life-threatening, incurable diseases, adult T-cell leukemia/lymphoma (ATLL), and HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP), as well as several chronic illnesses, such as uveitis and dermatitis. The cumulative lifetime risk of developing these incurable diseases is approximately 5% in asymptomatic patients. For operating room personnel performing surgery among patients from high-risk groups, HTLV-I and its associated diseases are presenting an increasing challenge. This report describes its transmission, seroprevalence, treatment, and public health initiatives that must be instituted to prevent the spread of this retrovirus. Coinfection with HTLV-I and human immunodeficiency virus (HIV) has been shown to accelerate the progression of acquired immune deficiency syndrome (AIDS).

Orthopedic surgeons' knowledge regarding risk of radiation exposition: a survey analysis.

Introduction: The purpose of this study is to evaluate the knowledge levels of orthopedic surgeons working in Turkey about the uses and possible risks of fluoroscopy and assess methods for preventing radiation damage. Methods: A questionnaire with a total of 12 questions was sent to 1121 orthopedic surgeons working in Turkey. The questionnaire evaluated participants’ knowledge about the uses and risks of fluoroscopy and methods for preventing damage. One thousand and twenty-four orthopedic surgeons were found to be suitable for inclusion in the study. The effects of fluoroscopy on patients were not assessed in our study. Results: The data obtained were statistically evaluated. Of the surveyed surgeons, 313 (30%) had used fluoroscopy in over 50% of their operations. The average number of fluoroscopy shots per case was 54.5. A lead apron was the most commonly used (88%) protection from the harmful effects of radiation. Fluoroscopy shots were performed with the help of operating room personnel (86%). A dosimeter was used 5% of the time. Conclusion: According to the survey results, the need for fluoroscopy was very high in orthopedic surgery. However, orthopedic surgeons have inadequate knowledge about the uses and risks of fluoroscopy and methods for preventing damage. Therefore, we believe that training on this topic should be provided to all orthopedic surgeons.