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M4: Radiology > Radiology 13 > Flashcards

Radiology 13 Flashcards

1
Q

If your were unsure of terminology within the radiation legislation who could you seek for advice?

A

Radiation protection adviser OR medical physics expert

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2
Q

IRR99

A

Ionising Radiation Regulations 1999 (replaced on January 1st 2018 - now known as IRR17)

Deals with equipment and the protection of staff and general public

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3
Q

IR(ME)R 2000

A

Ionising Radiation (Medical Exposure) Regulations 2000 (replaced on 6th February 2018 - now known as IR(ME)R 17

Aimed primarily at the protection of patients

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4
Q

How was IRR17 introduced?

A

In a three tier approach:
1. Notification
2. Registration
3. Licensing

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5
Q

Legislation vs guidlines?

A

Legislation: a “MUST”

Guidelines: good practice based off expert opinions, contain the word “should”

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6
Q

Radiation protection advisor (RPA)

A
  • Need to appoint one - medical physicist or specialist company.
  • When to consult RPA - planning new surgery etc. radiation over dose.
  • Establishing the controlled area
  • Name and contact details in Radiation Protection File
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7
Q

How do the RPA and the Medical Physics Expert differ?

A

RPA has a role in the IRR2017 regulations.
MPE is part of IRMER2017 - though could be the same person.

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8
Q

Controlled area

A
  • Only the patient can be in the controlled area during exposure
  • Size depends on kV of machine
    (1.5m for under 70kV)
  • BUT size depends on Local Rules
    DDH stand 2m away for all machines
    Or behind appropriate shielding
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9
Q

Radiation Protection Supervisor (RPS)

A
  • Every practice must have one
  • Usually dentist or senior member of staff
  • Must be adequately trained
  • To ensure compliance with IRR 2017 and Local Rules.
  • Closely involved in radiography
  • Have authority to carry out their duties
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10
Q

Local rules

A
  • All practices must have written local rules
  • Apply to all employees
  • Relate to radiation protection
  • Name of RPS & MPE
  • Name of person with legal responsibility for compliance – usually employer
  • Identification & description of controlled area
  • Contingency arrangements if malfunction – these need to be rehearsed
  • Details & results of dose investigation levels
  • Name & contact details of RPA
  • Personal dosimetry arrangements
  • Arrangements for pregnant staff
  • Reminder of IRR2017 obligations
  • “Displayed” where x-ray equipment
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11
Q

4 key roles in radiography

A
  1. Employer
  2. Referrer
  3. Practitioner
  4. Operator
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12
Q

Key duties of the employer

A
  1. Entitlement of duty holders
  2. Training
  3. Quality assurance
  4. Clinical audit
  5. Protocols
  6. Establish recommendations for selection criteria and for radiation dose levels
  7. Ensuring a clinical evaluation of every image is carried out.
  8. Ensuring staff have all read local rules.
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13
Q

Selection criteria 1

A

Radiograph must be able to be JUSTIFIED.

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14
Q

Selection criteria 2

A

Deciding which is the most appropriate radiograph to take depending on the clinical situation

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15
Q

Clinical evaluation

A
  • All radiographs must be clinically evaluated and the findings recorded in the patient’s record
  • Findings may include the quality of the radiograph – is it diagnostic or not – and any unusual factors relating to the exposure or dose to the patient
  • Note must be made of any abnormal findings
  • Even if everything is normal, this should be recorded
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16
Q

The referrer

A

A registered medical practitioner, dental practitioner or other health professional who is entitled in accordance with the employer’s procedures to refer individuals for medical exposure to a practitioner

17
Q

Duties of the referrer

A
  • Supply practitioner with sufficient information to allow the exposure to be justified
  • State that there is a net benefit to the patient
  • Signed a request form*
  • Given details to allow correct identification of the patient*
18
Q

Questions needed to be considered when justifying a radiograph

A
  1. Will exposure lead to a change in patient’s prognosis or management?
  2. Are other radiographs or reports available?
  3. Does the radiograph requested relate to the history & examination of patient?
  4. Have the risks & benefits been assessed?
  5. Could other techniques with lower or no radiation dose be utilised?
19
Q

What is the dental nurse legally able to do?

A
  • Can act as an “operator”
  • Process dental radiographs – either conventionally or digital scanning
  • Additional qualification allows entitlement to take dental radiographs on “prescription” of a another dental registrant.
20
Q

What is the dental hygienist and therapist able to do?

A
  • According to the GDC they can prescribe radiographs and take, process and interpret various film views used in general dental practice.
  • Suggests qualified for limited entitlement as referrer, operator and practitioner.
  • The employer would need to make it clear what these limitations are.
21
Q

What is the clinical dental technician legally allowed to do?

A
  • GDC Scope of Practice says they can “take and process radiographs and other images related to providing removable dental appliances”
    This assumes entitlement as operators.
  • Patients with natural teeth or implants need to be seen by a dentist before the CDT can start treatment
  • However SoP also states that CTD could develop additional skills including “prescribing radiographs”
22
Q

What can the dentist legally do?

A
  • Does everything all the other DCP can do
  • Prescribe and interpret radiographs.
  • Eligible to be entitled as referrers, operators and practitioners for all dental related radiography.
23
Q

Who can physically take radiographs in GDP?

A

a dentist
a dental hygienist or therapist
a suitably qualified dental nurse
a clinical dental technician

24
Q

The operator duties

A
  • Taking radiographs

Other duties include:
- Medical physicists
- Technicians from medical physics
- Those who process films etc. possibly.
- The clinical evaluation is also an operator duty but this can only be undertake by those qualified to do so.

25
Q

only member of team who can “report” on all aspects of a radiograph

A

Dentist

M4: Radiology (16 decks)

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