Question

What do you feel is the responsibility of an imaging professional when imaging a patient who has special situations such as nasogastric and nasoenteric tubes, gastric tubes, gastrostomy tubes, tracheostomy, mechanical ventilators, chest tubes, and various tissue drains? (Remember, ultrasound technicians will be using machines with transducers, cords and cables).

Answer 1

A radiographer (or medical imaging technologist) is a university-trained health professional who works with cutting edge technology to produce X-rays, CT (computed tomography) scans, MRI (magnetic resonance imaging) scans and other medical images to assist clinical radiologists and other doctors diagnose, monitor or treat a patient’s injury or illness.Radiographers have a very thorough understanding of the body’s structure, how it is affected by injury, and the causes and effects of disease.

The radiographer performs the medical imaging on the instructions of the radiologist. The radiologist then interprets the images the radiographer has taken and communicates the results to the referring doctor. Interventional radiologists both diagnose and treat disease with imaging equipment. They use a range of medical images including MRI scans, CT (computed tomography) scans and ultrasound to precisely target and treat disease, and perform procedures such as biopsies.

Medical imaging is a broad discipline that encompasses a variety of techniques that create images of the human body for diagnostic purposes. The duties and responsibilities medical imaging technicians perform depend on the type of equipment they use. Imaging techs may work as radiologic technologists, medical sonographers or nuclear medicine technologists.

Radiologic technologists may specialize in X-rays, computed tomography or magnetic resonance imaging. For each specialization, the technologist must prepare the patient for the procedure. Preparing the patient includes answering questions, explaining the procedure, taking a medical history, positioning the patient and covering exposed areas that will not be imaged. Technologists operate and maintain the imaging equipment, evaluate the images and update patient records. Most states require a license to work as a radiologic technician, which requires the applicant to complete an approved training program and pass a certification examination.

Medical sonography uses sound waves to create visual images of organs and tissues in the body. Diagnostic medical sonographers may specialize in imaging different areas of the body, such as the abdomen, breasts or cardiovascular system. Professional sonographers prepare patients by taking a medical history, explaining the procedure and answering any questions. During the procedure, sonographers apply a gel to the area of the body they are imaging and operate the equipment. After producing the images, sonographers evaluate the quality of the images and update patient records. According to the Bureau of Labor Statistics, only a few states require a license to work as a diagnostic medical sonographer, but employers prefer applicants with a certification.

Nuclear medicine imaging uses radioactive drugs to detect abnormalities in the body, which the technologist images with specialized equipment. Technologists take patient histories, explain the procedure and answer questions. The procedure requires the technologist to prepare and administer the radioactive drugs, operate the imaging equipment and monitor the patient for an abnormal reaction to the drugs. After the imaging procedure, technologists maintain the equipment, evaluate the images and update patient records. The minimum education requirement for a nuclear medicine technologist is an associate degree. Bachelor's degree programs are also available. The BLS reports that some states require a license to work as a nuclear medicine technologist and national certification is available to enhance employment opportunities.

Responsibilities as a radiologist

• Ensure that each medical exposure is justified in consultation with the referring physician;
• Ensure that the exposure of patients is the minimum required to achieve the intended objective, taking into account the relevant diagnostic reference levels for medical exposure;
• Establish optimized protocols for diagnostic and image guided interventional procedures, in consultation with the medical physicist and technologist/radiographer;
• Provide criteria to manage the examination of pregnant women, paediatric patients, occupational health examinations and medical and biomedical research;
• Evaluate any radiation incident or accident from a medical point of view.

Responsibilities as a technologist/ radiographer

• Identify the patient;
• Inform the patient;
• Inform accompanying persons;
• Verify that the female patient is non-pregnant;
• Contribute to the preparation of specifications for new equipment;
• Participate in optimization of imaging protocols;
• Perform the radiological procedure following an optimized protocol and ensuring patient protection;
• Perform regular quality control of radiological equipment;
• take record of patient doses;
• inform the radiologist and radiation protection officer (RPO) in the case of an accident or incident.

Responsibilities as a medical physicist in radiology

• Plan, in conjunction with the radiologist and the radiation protection officer (RPO), the facilities for radiology practice;
• Prepare performance specifications for equipment with regard to radiation protection;
• Participate in the continuing review of the radiology practice's resources (including budget, equipment and staffing), operations, policies and procedures;
• Carry out acceptance testing and commissioning of equipment;
• Design, implement and supervise QA procedures;
• Supervise equipment maintenance;
• Carry responsibility for calibration of equipment and dosimeters;
• Perform patient dose assessment;
• Participate in optimization of imaging protocols;
• Participate in the investigation and evaluation of incidents and accidents;
• Contribute to the radiation protection training programme.