Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 465 - RADIOLOGIC TECHNOLOGY BOARD OF EXAMINERS › Chapter 8 - SCOPE OF PRACTICE › Section 465-8-5 - Limited Radiographers

Current through 2024-29, July 17, 2024
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.