Requesting radiographs Flashcards
What are the 4 official personnel names, relevant to diagnostic radiography?
- Employer
- Referrer
- Practitioner (According to the regulations)
- Operator
What are the 3 principles of radiation protection?
- Justification
- Optimisation - ALARP
- Dose limitation - for radiation workers and members of the public, NOT patients
Why does dose limitation not refer to patients?
- No dose limitation for patients as if you justify the examination correctly then optimise it the net benefit to the patient outweighs the potential risk of damage to them
What are the general principles of justification of an individual exposure to radiation?
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Who is the referrer?
- ‘Referrer’ means a registered health care professional who is entitled in accordance with the employer’s procedures to refer individuals for exposure to a practitioner
Who is the ‘referrer’ at the dental hospital?
- Dentist supervising on the clinic
What must the referrer do prior to placing a referral?
Must take a history and conduct a clinical examination of the patient
Who does the referrer make the referral to?
- Refers to the ‘practitioner’ (IRMER practitioner)
- Must provide certain information to the IRMER practitioner
Who takes the responsibility for justifying and authorising the examination (x-ray)?
- The practitioner
What is the required information of the referrer in TrakCare? (4)
- Unique ID of patient (name, DOB, address, unique CHI number)
- Clinical info to justify exposure
- Info on pregnancy etc is relevant (if there is info that you think would be useful for someone to know put it in e.g. if you patient is hard of hearing etc)
- Unique identifying signature - TrakCare captures dentist logged
What are the considerations when possible taking an x-ray on a pregnant patient? (5)
- The urgency of the exposure, where appropriate, in cases involving - an individual where pregnancy cannot be excluded, in particular if abdominal and pelvic regions are involved, taking into account the exposure of both the person concerned and any unborn child:
- In dentistry the abdominal and pelvic regions are not irradiated by the primary beam
- BUT emotions are important - can delay if considered prudent
- Discuss with clinician and patient (make a note that the patient is apprehensive)
- Inform radiology if requesting radiographs - note it within your TrakCare request
Read these
- patient info leaflet (moodle)
- Selection criteria for dental radiography
In order to determine the caries risk status of a patient what should we consider? (7)
- Social history
- Medical history
- Dietary habits
- Use of fluoride
- Plaque control
- Saliva
- Clinical experience
How frequently should bitewings be taken for high caries risk individuals?
- Primary and permanent - six-monthly
- Recommends 6 monthly until there is no new caries and hopefully patient has moved into the moderate level
How frequently should bitewings be taken for moderate caries risk individuals?
- Annually unless risk status alters
How frequently should bitewings be taken for low caries risk individuals?
- Primary - 12-18 months
- Permanent - two yearly
What must dentate patients have undergone prior to requesting radiographs?
- Must have undergone a caries risk assessment
What should you include in TracCare when creating a request? (4)
- Completed by logged in clinician
- Selects type of radiographs required
- Clinical questions & answers - type in relevant clinical findings and what you need to find out; if your patient is to go home after attending radiology put that information in here
- Use FDI notation when referring to teeth - you must specify which teeth are to be x-rayed if you choose any of the periapical codes, as the codes are non-specific
What should you tell your patient when you are sending them down to radiology in the dental school? (4)
- Go to level 3 reception with laminated slip, and hand it in to the radiology/x-ray receptionist
- There will be a wait until they are seen
- The radiographer will check their images as soon as they are taken, and tell them when they can leave radiology
- If you are seeing them again that session, the patient will be given the laminated slip to take back with them to Level 6 to show that they have had their radiographs taken
What is the IRMER practitioner responsible for?
- Responsible for justification and authorisation
- Authorises the request, confirming justification in accordance with employer’s written procedures
- Ensures doses are ALARP
Who is permitted to be the IRMER practitioner?
- Variety of permitted people - for dental radiographs it will be one of the radiographers
What is the operator responsible for? (5)
- The operator is responsible for each practical aspect which the operator carries carries out as well as for any authorisation given pursuant to regulation 11
- Taking radiographs
- Annotating the images
- Sending to PACS
- Recording findings (different operator to the one taking the images)
Once the patient has had their x-ray what should be done?
- On the radiology request envelope/form write in the clinical indication box the details of your clinical findings, in order to justify the radiograph
- After doing the radiograph write the exposure details in the Radiographers use only section
- Fill in the details of the examination in the radiograph/exposure log in the x-ray room
- Do not complete TrakCare
- These images are not sent to PACS
IS the clinical evaluation repost a legal requirement?
- Yes
What is the clinical evaluation report?
- Clinical evaluation of the outcome of each exposure is (must be) recorded in accordance with the employers procedures
Who’s responsibility is it to fill out the clinical evaluation report?
- Responsibility of the referrer to record the outcome of the examination
- If your patients - your responsibility
Where should the clinical evaluation report be completed?
- Complete in the patient’s written notes only
Example of what you might write in your findings at bottom of the lecture
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