Lecture 7: introduction to Legislation & IRR17 Flashcards
What are the 2 sets of regulations that govern the use of radiation in the UK?
1- The Ionising Radiation Regulations 17
2- Ionising Radiation (Medical Exposures) Regulations 17
Who does Ionising Radiation (Medical Exposures) Regulations 17 protect?
only patients and carers assisting in radiological examinations
What are the 2 cornerstones to the regulations?
1- justification of the exposure
2-optimisation of the dose
What are the 4 key roles defined with the regulations?
1- practitioner
2-employer
3- referrer (prescriber)
4- operator
What are the general duties of the employer?
to provide a framework for radiation protection of the patient through provision of standard operating procedures
What are the general duties of the operator?
to carry out practical aspects except when training, where they do so under the direct supervision of a person who is adequately trained
What is the definition of an employer?
any person who is entitled to carry out practical aspects, except when training where they do so under the direct supervision of a person who is adequately trained
What procedures must employers put in place?
protocols/guidelines for:
- patient ID
- referral criteria
- individuals of childbearing age
- competencies of practitioners and operators
- setting dose reference levels
- regular monitoring of patient doses
- medico-legal exposuez
- reduce accidental exposure to ALARP
- protocol for the protection of carers
When and how is a patient identified?
- If the radiographic exam is not part of an examination or treatment, there must be a positive identification check
- a defined method of ID must be documented (name, date of birth, address)
What are the 3 selection criteria for carrying out a radiograph?
1- selective: symptomatic to confirm or refute
2- routine: circumstantial evidence
3-screening: no evidence
How should a person of child bearing age be managed?
There is no need to alter normal referral criteria, so there is no requirement to ask the question but it is up to the practice
What is the diagnostic dose reference level (DRL)?
the level of dose that 75% of patients will fall below
What are the arrangements for carers?
- should not be a member of staff
- should not be pregnant or under the age of 18
- risks must be explained to them
- dose constraints must be set
- justification for dose to the carer must be documented
Who is the referrer?
a registered medical or dental practitioner or other HCP who is entitled in accordance with the employer’s procedures to REFER individuals for a medical exposure
What are the general justifications that can explain x-ray exposure?
- part of patient’s diagnosis
- occupational health screening
- general screening
- voluntary participation in research
- none medical exposures
What 3 things justify a medical exposure?
1- there must have been a clinical examination
2-the reason for the radiograph must be recorded
3- there must be a timely clinical assessment of the radiograph
What quality control checks must be carried out on x-ray equipment?
- electrical: sockets, plugs, insulation
- mechanical: mountings, support, brakes, stability
- radiation: output checks, tube heads, mains isolation switch
What does the quality assurance for automatic processors involve?
- transport
- electrical
- light proof
- image quality
what does ALARP mean?
as low as reasonably practicable
Who does the Ionising Radiation Regulations 17 protect?
workers
members of the public
protection of outside workers there for specific purposes
Who is the IR(ME)R practitioner?
a registered medical or dental practitioner or other HCP who is entitled in accordance with the employer’s procedures to TAKE RESPONSIBILITY for an individual medical exposure
Who is the operator?
any person who is entitled to carry out practical aspects, except when training, where they do so under the direct supervision of a person who is adequately trained
What are the specific dose limits for all radiation employees?
- over 18 / carrying out xrays?
- under 18 / not carrying out xrays?
- pregnant employees
- over 18 year old / staff carrying out xrays: 1mSv per year
- under 18 year old / staff not carrying out x rays: 0.3mSv per year
- pregnant person: unborn baby/foetal dose: <1mSv for term of pregnancy
What can employers do to keep doses to staff ALARP?
- reduce the number of people
- safe barriers (lead-lined walls)
- safe place to stand
- test equipment
- monitor doses
