Ch 1-2 Flashcards
This started becoming organized in 1922 by establishing a national registry
Radiologic technology
Radiologic technology started becoming organized in 1922 by establishing a national registry
Initially it was called the American Registry of Radiologic Technicians but the name changed due to formal training that started 1962
American Registry of Radiologic Technologists
Establishment of the registry comes from this society of medical professionals
Radiologic Society of North America (RSNA)
A lot of times you have to be accredited by this society in order to bill patients that have certain insurances, like Medicare, otherwise you may not get paid.
Equipment has to be certified by this society for insurance
Nonprofit professional society with more than 36,000 member radiologists, medical physicists and radiation oncologists. The Core Purpose is to serve patients and society by empowering members to advance the practice, science and professions of radiological care. Members are actively engaged in socioeconomic health policy, providing advanced leadership and clinical education, and advocating for positive healthcare reform at state and federal levels. Driven by its core values of leadership, integrity, quality and innovation, this society has established an array of well-respected medical imaging practice parameters, technical standards, advanced education and accreditation programs that are the cornerstone of its commitment to quality patient care
Define principles for the delivery of high-quality imaging and therapeutic care. The accreditation programs offer radiologists and other providers the opportunity for peer review of their facility’s staff qualifications, imaging equipment, quality control and the resultant image quality
American College of Radiology (ACR)
A professional membership association for medical imaging technologists, radiation therapists, and radiologic science students
Used to be called American Society of Radiologic Technicians
By being a member, you can get your continuing education points that you need every two years to stay an “active” RT
American Society of Radiologic Technologists
Sets standard for accreditation of educational programs within radiography, radiation Therapy and MRI
Joint Review Committee on Education in Radiologic Technology (JRCERT)
Mission Statement: Prepare, protectand assist the citizens of the State of Illinois through planning, prevention, training, mitigation, response, and recovery to all hazards, natural or manmade
Gives you permission to push the button and give radiation
Illinois Emergency Management Agency (IEMA)
What has been added to the radiologic technologists’ scope of practice under the ASRT?
Injections used to be the responsibility of the radiologist, but now technologists are asked to perform venipuncture and the injection of radiopharmaceuticals and pharmaceuticals (contrast and medications) as long as they are prescribed
Due to these changes, venipuncture and injection of radiopharmaceuticals have been added to the scope of practice to establish a professional standard under the ASRT
A series of guidelines set forth to determine what these health care specialists should and should not do under certain circumstances
A basic principle in the law that justifies and encourages the expanded role of radiographers in the areas of venipuncture and administration of pharmaceuticals
Encourages the expanded role of the radiographer in the areas of venipuncture and administration of pharamceuticals
Scope of practice
Failure to do something that a reasonable person of ordinary prudence would do in certain situations, doesn’t necessarily have to result in injury
Ex: using unsanitary tools to clean a wound
Medical negligence
A breach of duty to adhere to a standard of care, has to result in injury
Ex: the wrong kidney is removed from a patient
Medical malpractice
Applied to measure the competence of the professional
The medical professional practice his/her profession with an average degree of skill, care, and diligence exercised by members of the same profession
Standard of care
These issues increase when technologists cross specialization lines and practice in fields in which they have limited education and experience
Liability
Have been developed that define what an accredited program must do to educate students.
Should be met by all personnel practicing in the field of medical imaging
Should maintain certification/registration in their areas of expertise (JRCERT)
Educational Standards
These are the results of efforts by the Clinton Administration and congressional proponents to reform healthcare
Health Insurance Portability and Accountability Act (HIPAA)
4 primary objectives of HIPAA
Ensure health insurance portability by eliminating “job-lock” caused by a preexisting medical condition
Reduce health care fraud and abuse
Enforce standards for health information/care
Guarantee security and privacy of health information
The inability of an employee to freely leave a job because doing so will result in the loss of employee benefits (usually health or retirement related).
Job lock
Code RED
Fire
Code BLUE
Cardiac / Respiratory Arrest
Code PINK
Infant / Child Abduction
Code BLACK
Bomb
Code ORANGE
Hazmat / Bioterrorism (release of toxic chemicals)
Include such substances as toxic chemicals, fuels, nuclear waste products, and biological, chemical, and radiological agents
Hazmats (hazardous materials)
Code GREY
Violence/Security Alert
Code WHITE
Hostage
Code YELLOW
Lockdown
Code GREEN
Mass Casualty / Disaster
Code BROWN
Severe Weather
The study of drugs in living systems
Medications can be very helpful but can also cause serious harm to patients
The technologist should understand thoroughly any medication before giving it to a patient
Pharmacology
Nine things a technologist must know before giving a drug
Dose Route of administration Indications Significant side effects Adverse Reactions Major drug interactions Contraindication Implementation Evaluation techniques
2 examples of cardiac medications
Lidocaine
Epinephrine
4 examples of analgesics
Hydrocodone
Morphine
Acetaminophen
Oxycodone
Pain medication
Analgesics
4 examples of antihistimines
Benadryl
Allegra
Zyrtec
Claritin
Allergy medicine
Antihistamines
2 antidiabetics
Metformin
Glucophage
3 anticonvulsants
Diazepam
Lorazepam
Phenobarbital
Seizure medicine
Anticonvulsants
2 antipsychotics
Haloperidol
Loxapine
2 antidepressants
Amitriptyline
Buproprion
2 antianxiety medications
Diazepam
Midazolam
2 antibiotics
Penicillin
Tetracyclin
4 drug names
Chemical Name: N- (4-hydroxphenyl)
Generic Name: Acetaminophen
Trade/Brand/Proprietary Name: Tylenol
They can also have code names: those used for secrecy
The federal agency responsible for protecting the public against fraudulent claims by manufacturers or merchants of food or drugs, allows the name to be shortened for ease of memory, which is the generic name
Drug testing in animal and human studies
Food and Drug Administration (FDA)
4 main drug sources
Plants
Animals and humans
Minerals
Chemical substances: refined or produced in the lab
Substances that are produced entirely from chemical reactions in a laboratory; x-ray drugs
Synthetic drugs
Order for a medication, legal document admissible in a court of law; usually valid for six months
Prescription
This order does not necessarily constitute a valid prescription
If the prescriber does not sign this order, the prescription is neither legal nor valid
It is in the best interests of all involved either not to take these orders or to have in place a written protocol that has been accepted as proper and standard medical care for all patients admitted to the radiology department This can safeguard a technologists legal rights
Verbal order
Medications that require a prescription
Must have this caption or legend
Ex: “CAUTION: Federal Law prohibits dispensing without a prescription.”
Legend drugs
7 components a valid prescription must include
Patient name, room number or address, and identification number
Drug Name (generic or brand)
Dosage (in proper units)
Dosage form (tablet, injection)
Route of administration (oral, parenteral (other than digestive system, IV/IM), rectal)
Date order is written
Prescriber’s signature
5 rights of drug administration
The right medication: one that is prescribed and NOT contraindicated
The right client/patient: not someone else’s medication
The right dose: prescribed and appropriate
The right form, route, and technique: as prescribed
The right time: usually within a half hour of the indicated time
Medications that have a high potential for abuse are placed into one of the five substance abuse schedules (C-I, C-II, C-III, C-IV, C-V)
Have a stamp placed on the outside of the container that will designate which schedule they fall into
The “C” designates a controlled substance and the Roman Numeral designates the potential for abuse; the lower the numeral, the greater the potential for abuse
Controlled substances
3 drugs controlled substances include
Narcotics
Sedative
Stimulant medications
Pain relievers
Narcotics
3 examples of narcotics
Morphine
Codeine
Hydrocodone (Vicodin)
Depress the CNS, lower doses are used as sedatives and higher doses are used as hypnotics and sleep aids; hypnotic and anti-anxiety drugs
Sedative
2 examples of sedatives
Diazepam (Valium)
Midazolam (Versed)
2 examples of stimulants
Cocaine
Amphetamines
Highest abuse potential for illegal abuse
To acquire this drugs, an institution must be registered with the federal DEA as either a manufacturer or a researcher of narcotic and dangerous drugs only
C-I
A United States federal law enforcement agency under the U.S. Department of Justice, tasked with combating drug smuggling and use within the United States
The Drug Enforcement Administration (DEA)
4 examples of C-I drugs
Heroin
Opium
Marijuana (although legal in some states)
Crack Cocaine
Accepted medical use under medical supervision only
Have the highest potential for legal abuse
May lead to severe psychological or physical dependence
These are strictly regulated and every dose must be signed and accounted for
Usually will need a co-signer and are locked up; usually kept by a house/charge nurse
Prescriptions may not be refilled
C-II
Any missing dose of C-II drugs require that a report be filled out and filed with this Federal Agency
Bureau of Narcotics and Dangerous Drugs (BNDD)
2 examples of C-II drugs
Morphine
Fentanyl
Have a high abuse potential but less that C-I or C-II
Moderate to low psych or physical dependence
Accepted medical use under supervision
Maximum five refills, prescription expires in six months
C-III
2 examples of C-III drugs
Tylenol with codeine
Aspirin with codeine
Abuse potential lower than the C-I - C-III
Limited or low psych or physical dependence
Accepted medical use under supervision
Maximum five refills, prescription expires in six months
C-IV
2 examples of C-IV drugs
Diazepam (Valium)
Lorazepam (Ativan)
Abuse potential is the lowest of them all
Accepted medical use
Can be bought over the counter (OTC) in some states
Limited or no physical or psychological dependence
C-V
2 examples of C-V drugs
Acetaminophen with codeine cough syrup
Diphenoxylate with atropine sulfate tablets
From weight loss to depression, their scope can be somewhat broad and can be dangerous
Should ask if patients are taking any of the OTC drugs
Herbal products
2 examples of herbal products
A weight loss product containing Ma Huang (ephedra) which can lead to serious hypertension, cardiac dysrhythmias, and death
Ginkgo biloba: for memory
The ratio of the median lethal dose to the median effective dose
When it becomes toxic and when is it effective
Therapeutic index
A legal medical record belonging to the hospital
This should tell an accurate, chronologic history of events as they occur under the supervision of medical professionals
Patient chart
Most hospitals use a this system of charting which is an easily accessible way to preserve data and assessment of patient
Problem Oriented Medical Record (POMR)
2 things radiologic technologists are responsible for placing various documents into the medical record
Informed consents for procedures
A patient history regarding the imaging procedure, like patient assessment and any drug administration
Compilation of various package inserts put out by pharmaceutical manufacturers
Physicians Desk Reference (PDR)
Quick reference of drugs, usually in a three ring binder or on CD-ROM
Facts and Comparisons
A comprehensive reference book with regard to drug information
American Hospital Formulary Service Drug Information (AHFS)
Discusses physical and chemical stability of injectable drugs when combined with one another in the same IV tubing
Handbook on Injectable Drugs
Determines whether a drug-to-drug interaction may occur when combined
Drug Interaction Facts and Hansten’s Drug Interactions
Recommended in any practice that deals with pregnant patients or women who are breast-feeding
Drugs in Pregnancy and Lactation
The most complete computer drug reference information for intense and rapid information gathering (but costly)
MicroMedex
3 other drug references
Pharmacist
Poison control centers
Other computer drug information sources
Professional association that seeks to promote quality healthcare provisions by the hospitals through public policy and is a source of info on healthcare issues
American Hospital Association (AHA)
What would be considered an adverse reaction to contrast?
Hives, shortness of breath, an undesirable reaction not predicted by the doctor, etc.
5 steps if a patient has had a previous contrast reaction and the test you are to perform requires contrast
Talk to Radiologist
See if the patient has been pre-medicated
Talk to patient to find out what type of reaction they had
Talk to the referring physician
Don’t do the test with contrast
