1.
Permissible Areas of Practice
A limited radiographer may practice only in the same one or
two categories in which the licensee trained pursuant to Chapter 6 of the
board's rules.
2.
Permissible Practice Settings
Limited radiographers may only practice in a setting
authorized by
32 MRSA
§9855(4).
3.
Permissible Practices
Limited radiographers may use ionizing radiation on human
beings for limited imaging purposes, excluding the administration of
radiopharmaceuticals or radionuclide devices, under the supervision of a
licensed practitioner. These limited activities include, but are not limited
to, adjusting equipment settings, positioning the patient, positioning the
equipment, positioning the image receptor, radiation protection, equipment
operation and maintenance, image production and evaluation, and patient
care/management/education.
4.
Impermissible Practices
Limited radiographers may not perform
cardiovascular-interventional radiography, cardiac-interventional radiography,
vascular interventional radiography, mammography, computed tomography, bone
densitometry, fluoroscopy or administration of radiographic contrast.
5.
Task Inventory
In interpreting and applying this section the board may
consult and be guided by the following task inventory:
A. Preparation and operation of the
radiographic unit and accessories;
B. Preparation and operation of digital
imaging devices such as computerized radiography, direct digital radiography,
and a picture archival and communication system;
C. Provision of radiation protection for
patients, workers and the public, including monitoring; shielding; and
knowledge and application of units of measurement and permissible levels;
biological effects of radiation; technical considerations in reducing radiation
exposure; and frequency of retakes. In performing these tasks, the limited
radiographer shall:
(1) Evaluate the need for
and document the use of protective shielding;
(2) Take appropriate precautions to minimize
radiation exposure to the patient, worker and member of the public;
(3) Question a female patient of
child-bearing age about possible pregnancy and take appropriate action (e.g.,
document the response, contact the physician);
(4) Restrict the beam to limit exposure area,
improve image quality and reduce radiation dose;
(5) Set kVp, mA and time or automatic
exposure system as appropriate for the procedure;
(6) Prevent all unnecessary persons from
remaining in the area during x-ray exposure;
(7) Monitor personal occupational exposure;
and
(8) Evaluate individual
occupational exposure reports to determine if values for the reporting period
are within established limits;
D. Provision of image acquisition, including
x-ray production using films/screens or digital detectors, holders and grids;
technique conversions; image processing; artifact evaluation; image quality
critique; and control of secondary radiation, for the specific category
requested. In performing these tasks, the limited radiographer shall:
(1) Remove all radiopaque materials from the
patient or table that could interfere with the radiographic image;
(2) Select the appropriate image receptor for
exposure;
(3) Select equipment and
accessories (e.g., grid, compensating filters, shielding) for the examination
requested;
(4) Use radiopaque
markers to indicate anatomical side, position or other relevant information
(e.g., time, upright, decubitus);
(5) Explain breathing instructions prior to
making the exposure;
(6) Position
the patient to demonstrate the desired anatomy using body landmarks;
(7) Determine appropriate exposure factors
using calipers, technique charts and automatic exposure control;
(8) Modify exposure factors for circumstances
such as involuntary motion, casts and splints, pathological conditions, or the
patient's inability to cooperate;
(9) Process the exposed image;
(10) Reload cassettes or magazines by
selecting film of the proper size and type, if applicable;
(11) Verify the accuracy of the patient
identification on the radiograph;
(12) Evaluate radiographs for diagnostic
quality;
(13) Determine corrective
measures if the radiograph is not of diagnostic quality and take appropriate
action; and
(14) Store and handle
film/cassettes in a manner that will reduce the possibility of artifact
production.
E. Provision
of patient care procedures, including aseptic technique, and emergency
procedures such as basic life support and first aid. In performing these tasks,
the limited radiographer shall:
(1) Clean,
disinfect or sterilize facilities and equipment, and dispose of contaminated
items in preparation for the next examination;
(2) Confirm the patient's identity;
(3) Evaluate the patient's ability to
understand and comply with requirements for the requested
examination;
(4) Examine the
radiographic order to verify accuracy and completeness of information (e.g.,
patient history, clinical diagnosis);
(5) Exercise responsibility for medical
equipment attached to patients (e.g., IVs, oxygen) during radiographic
procedures;
(6) Provide for patient
safety, comfort and modesty;
(7)
Communicate scheduling delays to waiting patients;
(8) Practice standard precautions;
(9) Select immobilization devices, when
indicated, to prevent patient movement and ensure patient safety;
(10) Use proper body mechanics and/or
mechanical transfer devices when assisting a patient;
(11) Recognize the need for prompt medical
attention and administer emergency care;
(12) Explain post-procedural instructions to
the patient or the patient's family;
(13) Maintain the confidentiality of patient
information; and
(14) Document
required information on the patient's medical record (e.g., shielding, exposure
factors, pregnancy status);
F. Proper positioning of anatomy for the
requested procedure;
G. Maintenance
of radiographic equipment, including x-ray tubes, grids, generators, electrical
circuitry and cabling, image processors, collimators, x-ray control consoles
and ancillary equipment. In performing these tasks, the limited radiographer
shall:
(1) Visually inspect the radiographic
unit and accessories and report and correct any malfunctions;
(2) For a film screen receptor system:
(a) Perform daily processor maintenance
(e.g., clean rollers, check transport system and solutions); and
(b) Perform daily sensitometry and check
darkroom conditions (e.g., safe light, light leak).
(3) For a digital receptor system, perform
routine reader/receptor quality control as determined by the
manufacturer.
