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Theory Of Radiographic Practice > Ionising Radiation (medical Exposure) Regulations > Flashcards

Ionising Radiation (medical Exposure) Regulations Flashcards

1
Q

IR(ME)R 2017

A

Ionising radiation (medical exposure) regulations 2017

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2
Q

What 6 exposures does the IRMER 2017 cover?

A
  1. Non medical imaging carried out with medical equipment
  2. Immigration
  3. Insurance
  4. Radiological age
  5. Concealed objects imaged for legal reasons
  6. Employment checks
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3
Q

What should you do if an Incident occurs?

A

Make situation safe
Tell patient
Report the incident
Ensure the situation can’t reoccur
Patient,referrer and practitioner may need to be informed
Learn from mistakes
Share learning

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4
Q

What are the roles identified under IRMER?

A

-referrer
-practitioner
-operator
-employer
-medical physics expert

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5
Q

What is a referrer?

A

A registered medical practitioner who is entitled in accordance with the employer’s procedures to refer individuals for medical exposure to a practitioner

Main responsibility is to ensure that the practitioner has adequate evidence to help with the justification process

Request an imaging opinion

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6
Q

What does a referral look like?

A

-referrer must be identifiable on it
-paper or electronic
-must be completed

It includes…
1) patient details
2)practice info
3)clinical details and questions
4)modality
4)background medical info
5)referrer details

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7
Q

Who is an operator?

A

Any person who is entitled in accordance with the employers procedures to carry out practical aspects related to medical exposures to ionising radiation
E.g radiographer

Must have training consistently

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8
Q

Examples of operators

A

Radiographer

Radiologist

Medical physicist

Surgeon

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9
Q

Who is a practitioner

A

A registered medical practitioner, dental practitioner or other health professional who is entitled in accordance with the employers procedures to take responsibility for an individual medical exposure.

Main purpose is to provide adequate justification for an exposure

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10
Q

Justification

A

Carried out by practitioner

Weigh the benefits assist the risks

Use protocols and professional judgement

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11
Q

Authorisation

A

Carried out by operator

Checking that the patient meets the criteria set down by the practitioner

Follows protocol

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12
Q

Typical limitations

A

Unconscious patient

Pregnant patient

High dose exams

Where management is not clear

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13
Q

What does a medical physics expert advise on (MPE)

A

Optimisation

Dosimetry

Advice on legislation

Training of other staff

Technical specifications of equipment

Selection of equipment

Analysis of incidents

Quality assurance

Acceptance testing

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14
Q

IRMER employers procedures

A

Employers duties : establishment of general procedures, protocols and quality assurance programmes to minimise the patient exposure, the risk of errors and the severity should incidents occur.

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15
Q

Give 5 examples of employers procedures by IRMER?

A

Patient identification

Identification of IRMER duty

Pregnancy

Quality assurance of procedures and equipment

Assessment of patient dose

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16
Q

Who is responsible for patient ID procedures

A

It’s the operators responsibility to ensure that the right patient is exposed

-active confirmation using 3 points of ID
-ask patient their name, DOB, address

17
Q

PAUSED - clinical imaging examination IRMER operator checklist

A

Patient
Anatomy
Systems and settings
Exposure
Draw to a close

18
Q

Who is responsible for pregnancy checking ?

A

It’s the operator’s responsibility to check pregnancy/breastfeeding and to ensure right patient is exposed

(Breastfeeding only an issue in nuclear medicine)

Define which exams are in scope - diaphragm to knee

19
Q

Inclusive pregnancy status procedures
IPS

A

IPS forms have been produced and UHL procedures is to ask all patients to complete this form

20
Q

Pregnancy checking

A

Typically can’t authorise an exposure on a pregnant individual

21
Q

Low dose examination examples

A

Plain film x-rays of abdomen pelvis spine
Barium swallows
Interventional / fluoroscopy procedures where the fetal dose is below 10mGy

22
Q

Who is the 28 day rule applied to

A

For females of childbearing capacity ages 10-55

23
Q

Pregnancy checks on age 10-16 years

A

Have you started your periods?
YES/NO
If NO- patient must confirm they’re ‘not pregnant’ and must sign the declaration of pregnancy status form and proceed…

If YES- are you or might your be pregnant
If unsure- is your LMP over 28 days
If yes review requirements of radiological examination and discuss with radiologist to postpone cancel or override

24
Q

Pregnancy checks for age 17-45 years

A

Are you or might you be pregnant ?

If unsure- is your LMP over 28 days
If yes review requirements for the radiological examination and discuss with radiologist to postpone cancel or override

If no patient is to confirm they’re not pregnant and mayst sign the declaration of pregnancy status form and record date of LMP and proceed

25
Q

Pregnancy check for age 46-55 years

A

Do you still have periods?
If no patient is to confirm they’re not pregnant and must sign the declaration of pregnancy status form and record date of LMP and proceed

If yes ask are you or might be pregnant
If unsure ask if LMP is over 28 days
I’d yes review requirements for radiological examination and discuss with radiologist whether to delay postpone or override

Rebook according to 28 day rule

26
Q

What is the assessment of patient dose

A

To ensure individual patient does are known

27
Q

DLRs- diagnostic reference levels
Why should u use and review DRLs

A

To ensure dose are optimised

28
Q

Informing patient of the risks and benefits

A

Tell patient prior to exposure where possible
contingencies e.g deaf, translator unconscious

29
Q

What is an accidental exposure

A

Patients should not have been exposed

30
Q

What is an Unintended exposure

A

Patient is not correctly exposed

31
Q

What is a near miss

A

An accidental or unintended exposure that was prevented

32
Q

What should you do if you have a
-accidental exposure
-unintended exposure
-near miss

A

REPORT TO CQC
Care quality commission
And incident reporting system

Have procedure to inform patient or their representative, referrer and practitioner if a CSAU occurs

33
Q

How to stop things going wrong

A

Minimise probability and magnitude of accidental and unintended exposures by ensuring patient is not unnecessarily exposed

34
Q

Why does the Quality assurance programme do?

A

Ensuring that the quality of the service with radiation use is maintained

35
Q

Justification comforters and caterers

A

Ensure that the care and comforter is properly informed about dose constraints

Any likely health benefits to the patient being examined

Any possible benefits to the career or comforter

The detriment the exposure may cause

Theory Of Radiographic Practice (5 decks)

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