Educate patient about the potential for skin injury and document this in chart. Schedule an office visit in 2 to 4 wk. Gray If calculated PSD is indeed 15 Gray, the physician and/or radiation safety officer/medical physicist should contact hospital risk management within 24 h. Report the event to the Joint Commission and as needed to the appropriate State Department of Health. *Ka,r is total air kerma at reference point; PKA is air kerma-area product; FT is total fluoroscopy time, does not include cine; PSD is peak skin dose, which requires calculations made by a qualified physicist. FOV indicates field of view; and FT, fluoroscopy time. Adapted with permission from Chambers et al.317 Appendix 4B. The SCAI Lesion Classification System Type I lesions (highest success expected, lowest risk) 1. Does not meet criteria for C lesion Type II lesions 1. Meets any of these criteria for ACC/AHA C lesion Diffuse ( 2 cm length) Excessive tortuosity of proximal segment Extremely angulated segments, 90 Inability to protect major side branches Degenerated vein grafts with friable lesions Type III lesions 1. Does not meet criteria for C lesion Type IV lesions 1. Meets any of these criteria for ACC/AHA C lesion Diffuse ( 2 cm length) Excessive tortuosity of proximal segment Extremely angulated segments, 90 Inability to protect major side branches Degenerated vein grafts with friable lesions Occluded for 3 mo ACC indicates American College of Cardiology; AHA, American Heart Association; and SCAI, Society for Cardiovascular Angiography and Interven- tions. Reprinted with permission from Krone et al.879 Appendix 4E. 