Ionising Radiation (Medical Exposures) Regulations 2017 Flashcards
(39 cards)
What are the 3 key principles from the International Commission of Radiation Protection (ICRP)?
Optimisation
Justification
Limitation
State 5 medical exposures that could harm a patient
1) Unjustified exposures
2) Unauthorised exposures
3) Incorrect exposures
4) Exposures significantly greater than intended
5) Exposures significantly less than intended
What are the 4 types of duty holder under IRMER?
Employer
Referrer
Practitioner
Operator (+ Medical Physics Expert (MPE))
What are the 8 key duties of an employer under IRMER?
- Determine the entitlement of duty holders
- Establish referral criteria
- Establish a quality assurance system
- Establish dose constraints for research
- Ensure adequate training
- Investigate and report incidents
- Establish written protocols for standard practices
- Produce written procedures
Who are referrers?
Registered healthcare professionals who are entitles, in accordance with the employer’s procedures, to refer individuals to a practitioner for medical exposures.
What are the 3 key duties of a referrer under IRMER?
- Refer individuals to a practitioner for medical exposures
- Provide sufficient medical data for the practitioner to establish a net benefit in the exposure and facilitate justification
- Supply sufficient information to identify the patient
Who are practitioners?
Healthcare professionals who are entitled by the employer to take responsibility for an individual medical exposure in accordance with the employer’s procedures.
What are the 4 key duties of a practitioner under IRMER?
- Justifying and authorising exposures
- Allocating the practical aspects of an exposure
- Coorperating with other staff
- Ensuring that exposures of target volumes are individually planned so that doses to non-target tissues are ALARP, consistent with the therapeutic intention.
What does it mean to justify an exposure to ionising radiation?
To weight up the potential benefit against detriment. This includes considering the use of techniques that don’t require radiation. Justification can only be carried out by someone with knowledge of dose and its impacts.
Who are operators?
The healthcare professionals who carry out the practical aspects of exposures in accordance with the employer’s procedures. To do so they must be adequately trained, meaning that trainees cannot be operators.
What are the 5 key responsibilities of an operator?
- To carry out their aspect of a radiation exposure
- Correctly identify the individual undergoing the exposure
- Ensure pregnancy status is OK
- Optimise the exposure (with the pratitioner)
- Take responsibility for their own actions
Give 5 examples of tasks a physicist would complete as an operator
- Creating beam data
- Commissioning a linac
- Machine QC
- Creating a treatment plan
- Checking a treatment plan
- Giving advice to doctors
- Calibrator QA
- Measuring radionuclide activity
Compare the duties of an employer, referrer, practitioner, and operator
Give an example of an employer
A hospital
Give an example of a referrer
GP
A&E doctor
Oncologist
Give an example of a practitioner
Radiologist
Oncologist
Consultant radiographer
Give an example of a operator
Diagnostic radiographer
Therapeutic radiographer
Whagt is a medical physics expert (MPE)?
A special type of operator who is required to be involved in every standard medical exposure (other than standard nuclear medicine).
What are the key responsibilities of an MPE?
- Consultation on the optimisation of patient dosimetry
- Giving advice on radiation protection matters
- Procurement of equipment
- Commissioning of equipment
- Designing quality assurance programmes
- Developing treatment protocols with practitioners
- Giving advice on exposures
How does a clinical scientist become an MPE?
By producing an MPE portfolio and gaining an MPE certificate
Define dose optimisation
The process of keeping the magnitude of individual doses ALARP below the appropriate dose constraints, taking into account economic and social factors.
What are diagnostic/dose reference levels (DRLs)?
Local, national, and international levels used to assess patient dose and optimise exposures. If they are consistently exceeded then protocol review is necessary.
What is clinical evaluation?
The legal requirement under IRMER to assess a medical image and communicate it with the relevant parties so that it can benefit the care of the patient.
Give 5 examples of clinical evaluations
1) Radiologist reports
2) GP letters
3) Daily review by a radiographer
4) Treatment planning
5) Review by doctors
