Current through Register Vol. 51, No. 19, September 20, 2024
A. The scope of practice of a radiologist
assistant includes the following activities to obtain the clinical history and
physical examination of the patient:
(1)
Review the patient's medical record to verify the appropriateness of a specific
exam or procedure;
(2) Interview
the patient to obtain, verify, or update medical history;
(3) Explain procedure to the patient or
significant others, including a description of risks, benefits, alternatives,
and follow-up;
(4) Obtain informed
consent;
(5) Determine if the
patient has followed instructions in preparation for the exam such as diet and
premedications;
(6) Assess risk
factors that may be contraindications to the procedure such as health history,
medications, pregnancy, psychological indicators, and alternative
medicines;
(7) Obtain and evaluate
vital signs;
(8) Perform physical
examination and analysis of data such as signs and symptoms, laboratory values,
and significant abnormalities, as required by the imaging procedure to be
conducted; and
(9) Report findings
related to Regulation .10A(1)-(5) of this chapter to the supervising
radiologist.
B. The
scope of practice of a radiologist assistant includes the following general
procedures:
(1) Apply ECG leads and recognize
life threatening ECG abnormalities;
(2) Perform urinary
catheterization;
(3) Perform
venipuncture;
(4) Monitor IV for
flow rate and complications;
(5)
Position patient to perform required procedure, using immobilization devices
and modifying technique as necessary;
(6) Assess patient's vital signs and levels
of anxiety and pain and inform radiologist when appropriate;
(7) Recognize and respond to medical
emergencies, such as drug reactions, cardiac arrest, and hypoglycemia, and
activate emergency response systems, including notification of the
radiologist;
(8) Administer oxygen
as prescribed;
(9) Operate a
fixed/mobile fluoroscopic unit;
(10) Assure documentation of fluoroscopy
time;
(11) Explain effects and
potential side effects to the patient of the pharmaceutical required for the
examination;
(12) Administer
contrast agents as prescribed by the radiologist;
(13) Administer general medications,
excluding radiopharmaceuticals and narcotic or sedating medications, as
prescribed by the radiologist; and
(14) Monitor patient for side effects or
complications of the pharmaceuticals.
C. The scope of practice of the radiologist
assistant includes performing the following examinations and procedures,
including contrast media administration, placement of needle or catheter, and
operation of imaging equipment, under the immediate available direction of a
radiologist:
(1) Upper GI;
(2) Esophagus;
(3) Small bowel studies;
(4) Barium enema; and
(5) Evaluation of percutaneous gastric and
enteric tubes.
D. The
scope of practice of the radiologist assistant includes performing the
following examinations and procedures, including contrast media administration,
placement of needle or catheter, and operation of imaging equipment, under the
on-site supervision of a radiologist:
(1)
Cystogram and voiding cystourethrogram;
(2) Nasoenteric and oroenteric feeding tube
placement;
(3) Joint injection and
aspiration;
(4) Arthrogram,
including conventional, CT, and MR;
(5) PICC placement;
(6) Paracentesis with appropriate image
guidance;
(7) Thoracentesis with
appropriate image guidance; and
(8)
Lumbar puncture under fluoroscopic guidance.
E. On a case-by-case basis as specified in
Regulation .12 of this chapter, the Board or its designee may approve a
radiologist assistant to perform one or more of the following procedures under
the level of supervision by a radiologist as specified in the request letter
submitted by the radiologist and radiologist assistant:
(1) Lower extremity venography;
(2) Lumbar, thoracic, or cervical
myelography;
(3) Non-tunneled
venous central line placement;
(4)
Venous catheter placement for dialysis;
(5) Breast needle localization;
(6) Ductogram (galactogram);
(7) T-tube cholangiogram;
(8) Retrograde urethrogram;
(9) Port injection;
(10) Fistulogram,
(11) Sinogram;
(12) Loopogram;
(13) Swallowing study;
(14) Hysterosalpingogram; and
(15) Other specific procedures approved by
the Board.
F. The scope
of practice of a radiologist assistant includes the following post-imaging
activities:
(1) Review of imaging procedures,
making initial observations, and communicating observations only to the
radiologist;
(2) Communication of
radiologist's report to referring physician;
(3) Provision of radiologist-prescribed
post-care instructions to patients;
(4) Performance of follow-up patient
evaluation, and communication of findings to the radiologist;
(5) Documenting procedure in appropriate
record, and documenting exceptions from established protocol or
procedure;
(6) Writing patient
discharge summary for review and co-signature by radiologist;
(7) Participating in quality improvement
activities within radiology practice; and
(8) Assisting with data collection and review
for clinical trials or other research.
