Medical Imaging - Essay Example

Literature Review – Medical Imaging Introduction The delivery of healthcare does not operate in a vacuum, but under the laws and regulations of thecountry that targets high quality and safety standards in the delivery of healthcare in an atmosphere that ensures the rights of the healthcare service provider and the healthcare service. This is particularly relevant in those areas of healthcare service, where there is the potential risk on the quality or safety standards in providing healthcare service (Forrester and Griffiths 2005). Medical imaging has and continues to remain an area of concern, because of the risk that improper use of medical imaging poses to the safety of the patient. The use of medical imaging is on the rise and with that the potential risk for safety of the patient (Fazel et al, 2009). The relevance of these concerns can be gauged from reports of patient exposure to excessive radiation doses in medical imaging tests, like computed tomography (CT) scans. In essence the blame for the exposure to excessive radiations, posing the risk for radiation cancer, stems from too frequent use of medical imaging on the same patient and improper handling of the medical imaging machines (Louis, 2009). It is against this background that it becomes important for the Medical Imaging Technologists (MIT) to be fully aware of the legislations and laws of the land that govern the use of medical imaging, to ensure that they do not transgress these legislations and laws and find themselves facing legal action. Literature Review Radiation Safety Act 1999 The Radiation Safety Act 1999 was put in place with the main objective of protecting individuals and the environment from the hazards associated with certain sources of radiation and harmful non-ionization radiation. This focus of the Act is the reason for choosing it. The Act makes it mandatory for people to be protected from exposure to ionizing radiation unless it is deemed essential, through the three processes of justification, limitation and optimisation. The process of justification calls for the evaluation of the benefits to risk involved in the radiation practice, so that exposure is used only when the benefits outweigh the risks. The process of limitation has implications for minimising radiation dose exposure or employing techniques to achieve exposure to radiation that is below the acceptable levels and thereby minimize the health risks posed to the patient. The process of optimisation requires minimizing the health risks to individuals through the lesser degree of exposure to radiation, by ensuring the optimal use of medical imaging (Government of Queensland, 1999). The Act makes it mandatory for the individual employing a radiation source as a part of a diagnostic or therapeutic procedure to have a use licence that allows the use of the source to carry out the procedure. Exemption to this rule is granted in the case where the person may not be licensed to use the source, but is under the supervision of a use licensee. A radiation protection and safety plan is expected to be put in place, where radiation sources are used and the person operating the radiation source can do so only when the person has a copy of the said plan in possession and ready for inspection and the person has undergone the required training program as mentioned in the plan. The Act makes it mandatory that prior to the use of the radiation source for a diagnostic or therapeutic procedure, ascertaining that the same has been requested by authorised person is undertaken. While carrying out the diagnostic or therapeutic procedure the individual using the radiation source must make sure that the person is not exposed to radiation doses in excess of the radiation dose that is allowed through the relevant regulations. It is also necessary to ensure that the devices used for imaging and environment in which the imaging is done comply with relevant radiation safety standards. Furthermore, the Act makes it necessary for the person operating the radiation source or imaging device to ensure that the manner in which the handling of the imaging device does not affect the health and safety of the person undergoing an imaging procedure. There are several ways in which dangerous events can occur, like malfunctioning of the imaging device or the controls for radiation emission from the imaging device. In the case of any such event occurring, it is mandatory that these events are reported to the chief executive. Finally, it is necessary to ensure that no sources of radiation that are banned are employed for medical imaging (Government of Queensland, 1999). Implications for Medical Imaging Technologists (MIT) Nearly 15% of exposure to ionizing radiation in the case of the general public is the result of artificial source, with diagnostic medical imaging being the responsible for a very large proportion. Estimate figures from the year 2000 of ionizing exposure to the general public show that diagnostic medical imaging is responsible for 0.4 mSv from the 3mSv per caput effective dose (Ron, 2003). Experiences from the consequences of the use of the atom bombs on Japan and current estimates show that even with a single brief whole body dose of 0.1 Gy or 10 Rad of gamma radiation in a population of 100,000, the extra deaths from cancer as a result of this exposure is 800 (Beir, 1996). Thus the Radiation Safety Act has been founded on definite evidence of the potential health risks posed by medical. Imaging technologies involve different levels of exposure to ionizing radiation and technicians operating the imaging devices have to be aware of those imaging technologies that cause higher ionizing radiation exposure risks to patients during imaging, like CT scans. In addition imaging of tissues deep within the body enhances the risk for higher ionization radiation exposure for enhancing the clarity of the images. The imaging technicians thus need to maintain a fine balance between lowering the exposure to ionization radiation and image clarity requirements for diagnostic needs (Tien et al, 2007). The focus should however remain on reducing the exposure of patients to ionizing radiation and keeping it to a minimum. In case this is not possible, alternative imaging technologies need to be concerned and even it means higher costs, providing the patient with adequate information to make an informed decision on changing the imaging modality or be willing to the take the risks with the higher ionizing exposure risk imaging modality (Lockwood, Einstein & Davros, 2007). The thumb rule for MIT to keep within the prescribed regulations of the 1999 Act have to ensure that the patients are protected to the maximum possible extent from exposure to ionizing radiation and exposed only when it is deemed necessary and that too within the levels allowed by regulations. Ensuring the proper functioning of the imaging device prior to its use falls with the responsibility of the MIT. The healthcare service provider would have a radiation protection and safety plan in place and the MIT has to ensure that the use of ionizing radiation imaging modalities is well within the norms of this radiation protection plan. In spite of all these precautions, there is the possibility of the occurrence of a dangerous and the MIT must report this occurrence in writing to the designated authority (Government of Queensland, 1999). Conclusion Legitimate concerns of the risk of cancer associated with high exposure to ionizing radiations during medical imaging resulted in the enacting the Radiation Safety Act 1999 to protect individuals and the environment from the hazards associated with certain sources of radiation and harmful non-ionization radiation. The regulations within the Act have implications in the practice of medical imaging by MIT. In essence these implications in their practice focus on reduced exposure of patients to ionizing radiation and exposure only when deemed necessary, within the stipulated exposure norms; following the radiation protection and safety plan of the health care institution and reporting any occurrence of dangerous events in the appropriate format to the designated authority. Literary References Beir, V. 1996. Health Effects of Exposure to Low Levels of Ionizing Radiation. Washington: National Academy Press. Fazel, R. Krumholz, H. M., Wang, Y. Ross, J. S., Chen, J., Ting, H. H., Shah, N. D., Nasir, K., Einstein, A. J. & Nallamuthu, B. K. 2009. Exposure to Low-Dose Ionizing Radiation from Medical Imaging Procedures. The New England Journal of Medicine, 361(9):849-857. Forrester, K. & D. Griffiths. 2005. Essential of Law for health Professionals. Sydney: Elsevier Mosby. Government of Queensland.1999. Radiation Safety Act 1999. http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/R/RadiatSafA99.pdf (accessed March 22, 2010). Lockwood, D., Einstein, D. & Davros, W. 2007. Diagnostic Imaging: Radiation Dose and Patients Concerns. Journal of Radiology Nursing, 26(4): 121-124. Louis, P. 2009. Excessive radiation from medical imaging tests raises concerns. Natural News.com http://www.naturalnews.com/027541_radiation_medical_imaging.html (accessed March 22, 2010). Ron, E. 2003. Cancer risks from medical radiation. Health Physics, 85(1): 47-59. Tien, H. C., Tremblay, L. N., Sandro, B., Gelberg, J., Spencer, F., Caldwell, C. & Frederick, B. 2007. Radiation Exposure From Diagnostic Imaging in Severely Injured Trauma Patients. The Journal of Trauma: Injury, Infection, and Critical Care, 62(1): 151-156. Read More