2.5 - Requesting Radiographs

Question 1

What are the relevant regulations for requesting radiographs?

Answer 1

IRMER17

Question 2

What are the roles in IRMER17?

Answer 2

referrer

practitioner

operator

employer

Question 3

What are the principles of radiation protection? (3)

Answer 3

Justification

Optimisation

Dose limitation

Question 4

How can we allow for radiation exposure?

Answer 4

we must justify first (practitioner) that the radiograph has a sufficient net benefit

we must consider why we want this exposure - what will be the diagnostic benefits? what will be the detriments? is there alternative techniques we can use?

Question 5

What are some exams we must do prior to x-ray?

Answer 5

look with good light source

listen to pts complaints

take history and clinical exam

Question 6

What is optimisation?

Answer 6

ALARP

Question 7

What is dose limitation?

Answer 7

This is for radiation workers and members of gen public (there is no dose limitation for pts because if we justify the need for radiographs then we must optimise radiation dose so that the pt receives dose that will benefit them)

Question 8

Who is the referrer?

Answer 8

Registered HCP who can refer pts to practitioner - they will take med history and do exam and must justify why they need this exposure

Question 9

What info is required by the referrer?

Answer 9

Pt name, dob and CHI number

Clinical info justifying exposure (what have we found)

pregnant?

if pt has any hearing problems

Question 10

What must we consider in radiographs in women?

Answer 10

pregnancy - must consider the pt and unborn child

Question 11

If our pt is pregnant and needs an x-ray what should we consider?

Answer 11

The urgency of exposure - in dentistry there is no abdomen or pelvic exposure therefore no risk to unborn child

but we must consider emotions - pt may not want the x-ray so we can delay until baby is here (take note in notes of this - pt apprehensive)

include in notes if pt is pregnant

Question 12

What categories do we look at to assess pt risk status?

Answer 12

SH 
MH 
Diet 
F use 
plaque control 
saliva 
clinical evidence

Question 13

What is a caries risk assessment?

Answer 13

Clinical evidence

Fluoride use

Medications

OH

Saliva

Diet

SH

Question 14

If pt is high risk how frequently should they havee radiographs?

Answer 14

6 monthly until no new caries then moved to moderate

Question 15

If pt is moderate risk how freq should they have radiographs?

Answer 15

annually unless risk status alters

Question 16

If pt is low risk how freq should they have radiographs?

Answer 16

2 years in adults

12-18mths in kids

Question 17

After completing a trakcare radiograph request what must we do?

Answer 17

provide pt with laminated imaging slip telling them where to go and their name and CHI number

Question 18

What info do we give to pt going to get x-ray?

Answer 18

go to level 3 reception and hand them the slip

there will be a wait until you are seen

ur images will be checked by radiographer and they will let you know when you can leave unless ur coming back to us then you will get laminated slip back to level 6

Question 19

What is the IRMER practitioner responsible for?

Answer 19

justification and authorisation

Question 20

What do we do before we request radiographs?

Answer 20

we check for existing radiographs

Question 21

What is the IRMER operator?

Answer 21

The person who is responsible for practical aspect (taking x-ray, annotation, sending to PACS and recording findings)

Question 22

What do we do if pt needs endo radiograph?

Answer 22

We dont fill out trakcare as this sends to Lebel 3 instead we have to use a radiology request form found on level 6 where we write out clinical info and justification

Question 23

What is a clinical evaluation report?

Answer 23

Legal requirement after any x-ray where we evaluate the outcome of exposure

must include:

Type of x-ray
Teeth present 
Apical pathology 
Bone levels
Coronal pathology