There has been very little talk about bill: H.R. 3652.  I think it’s very interesting because so many radiographers are currently unemployed in Michigan, while under educated and uncertified persons are performing x-rays in our own communities.  I also find it difficult to understand why our government has yet to see the importance of this bill.

Out of curiosity I did a google search for overexposure to x-rays (http://www.google.com/search?hl=en&source=hp&q=overexposure+to+x-rays&aq=9s&aqi=g-s10&aql=&oq=over+exposure&gs_rfai=CYMh27j0qTL-4IqX4MbrIia4KAAAAqgQFT9BtHVU)

This search resulted in 146,000 results.  The information is there for the viewing, but the general public is still sadly uninformed.

The first article titled: Over Exposure (http://www.hospitalmanagement.net/features/feature1765/) was very clear on their stance in regard to radiation.  The benefits must outweigh the risks. It went on further to state: “For example, one multi-detector body CT scan (750 chest X-rays) gives an extra risk over a lifetime of one cancer for every 750 patients. The average risk varies as a function of both gender and age. For women, the risks of developing cancer after exposure to radiation are 37.5% higher than they are for men.”

**The New York Times (http://www.nytimes.com/1987/11/13/opinion/l-unrecognized-risks-of-x-ray-radiation-954087.html”

also follows up with an article trying to express the need for licensed professionals to be operating radiographic equipment because radiation can be dangerous.

“Only 17 states require operators of X-ray equipment to be licensed, yet all 50 states require a license for a cosmetologist.

Doctors keep careful records of antibiotics prescribed, with prominent labeling of dose and contents on prescription bottles and in medical records. Yet no records of patient radiation exposure are maintained.

Patient radiation is a known carcinogen, and overexposure increases risk of cancer. Statistics are often used to demonstrate how few cancers are projected as caused by medical and dental X-rays, but any individual’s risk can be markedly increased by receiving a high dose of radiation during an X-ray examination.”

I could quote thousands of these same articles….It is our job as educated professionals in the field of radiography to help push this bill and protect the people in our communities.

Please follow this bill and share it on your facebook, twitter….wherever you can get others attention.

http://www.govtrack.us/congress/billtext.xpd?bill=h111-3652

Here’s a snippet!  Check it out!

‘(a) Qualified Personnel-

As an educator I spend a considerable amount of time researching the latest and greatest, and implementing things in the classroom to make my graduates more marketable upon graduation.  We have implemented an I.V. start certification, as well as Academic Service Learning credentials to help “beef” up our graduate’s resumes.  We also spend time writing resumes, having guest lecturers speak about interviewing including what a good resume looks like, and what it should consist of.

All these things we do are fantastic building blocks for success, but the one factor we cannot control is how our graduates conduct themselves during the interview.

I recently read a blog I found through a linked in group I belong to.  This blogger hit the nail on the head!  I was so impressed I continued to read the rest of the posts.  My favorite quote from the blog is :”Most interviewees do not understand that the interview is not about them, personally.  I realize that this is a hard concept to accept because you and the interviewer spend the whole time talking about you.  But, it is still not about who you are and certainly not about what you need.

It is a business meeting. The company has a position that they need filled.  This position has duties and responsibilities that are essential to the operations and profitability of the company.  In exchange for hiring someone capable, they will pay a salary and in most cases, benefits.

Your interview is about what you can do for the company and how well you will do it.”

There are excellent tips for interviewing, as well as the most common Interview Questions and how to answer them.

You can read the blog here: http://www.linkedin.com/news?viewArticle=&articleID=120397043&gid=37962&articleURL=http://www.infoployment.com/blog/&urlhash=MCp9&trk=news_discuss

As technologists we are always fielding the question “How much x-ray dose am I getting?” While doing some research I found a great site developed by the RSNA and the ACR. Here’s a fantastic chart from their website (http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray)
Check it out!

Tracking Radiology’s Risks By: Christina McGarvey

Studies have shown that as many as one-third of CT scans in the United States are unnecessary and that between 1% and 2% of cancer cases may be caused by CT radiation exposure. Radiology Resident Dr. Mark Otto Baerlocher designed an application in May available to iPhone and iTouch users for $2.99 called Radiation Passport. The purpose of Radiation Passport is to educate users about the radiation and cancer risks associated with medical imaging exams and procedures that physicians (and dentists) want you to undergo, to keep track of radiology and imaging-related exams and procedures, and to provide an estimate of risk of developing cancer because of this radiation. If you do not have an iPhone or an iTouch , you can also visit www.xrayrisk.com this website it is similar in principle.

97% of 127 patients recently said in a survey that they were not informed of the radiation risks associated with the tests they were scheduled to receive. Calculating the cumulative dose is a difficult task, because studies can become conflicting and have varying radiation doses and effects depending on age and gender, but Dr. Baerlocher thinks that this needs to change given the rapid growth in the use of CT exams. One abdominal CT scan is equal to around five-hundred chest x-rays “If you need the test, it should be done. But in patients who need continual monitoring, should you do repeat CT scans on a regular basis, or because of the high radiation dose, are there better tests to do instead? There may be some disagreements about the best way to approach the issue, but the end result is what’s most important- greater discussion and understanding of the effects of radiation.

I believe that tracking radiology’s risks by using the application is a greater way for patients to be more involved and will make physicians want to learn more about what these procedures involve once patients start asking them more questions which I believe would come up after using the application.  These doctors should know this stuff to begin with and inform the patients before sending them out the door with a prescription for pain meds with side effects attached, that the X-Ray or CT they just sent them for could have risks as well. We as students and workers have to wear film badges to track how much radiation we are around, why not have something available to patients as well?

I can see where this could be a bad thing as well, like making people look at just the risks and not the benefits of these exams. A patient could refuse a scan because they downloaded a program on their iPhone that tells them the risk is high, and they say “forget it” when they’ve made the decision based only on the risks and not the benefits.  I know if I had to go in regularly and get x-rays or scans I would definitely do the research, plus it does help that I have some knowledge already. I can’t say I would have been that adamant about knowing about them before because I didn’t know much about radiation.  When it comes to pregnant woman as far as treating them with care and making sure they don’t receive radiation unless they really have to, the radiology staff takes them and their health very seriously. But on the other hand an adult receiving multiple CT scans might not even know there is a risk involved. It just does not seem to be treated as seriously as someone who is pregnant. I think that even radiology workers could benefit from a refresher once in a while on radiation and how it affects patients and themselves, they tend to over expose when not needed, but if only they were the ones being imaged they might feel different about the excess radiation they are giving to their patients.

images from:http://itunes.apple.com/us/app/radiation-passport/id311250677?mt=8

Written by: Jessica Richards

1/25/10

Merton’s Ten Commandments of Sonography

Inspired by Pope Benedict XVI’s new rendition of the Ten Commandments as it applies to driver’s safety, Daniel A. Merton conjured one of his own.  His spin on the Ten Commandments centers around sonography guidelines.  Although his article is directed specifically towards sonography, I find that these principles can be applied to the practice of radiography as well.

Merton’s Ten Commandments, without further involvement with the SDMS or AIUM organizations, presents guidelines to become a successful sonographer.  His topics involve qualifications and becoming certified, taking a proper medical history and applying it to the exam, using standard scanning protocols, taking a good image, ethics, respect and safety for patients, educating others, and maintaining a professional demeanor.  He further defines these topics with specific suggestions to becoming a good sonographer and breaks down his “Ten Commandments.”  These same applications can be related to radiography.

The first guideline is, “Thou shall perform sonographic examinations only if qualified to do so.” I relate this to a radiographer performing an exam to the optimal level of their ability, and not outside their level of education.  This involves not trying to diagnose a patient even though it may be evident on film, or attempting to insert an IV if not properly trained to do so.  This principle could be discarded by an overzealous radiographer.

The second Commandment says, “Thou shall obtain personal certifications and maintain continuing medical education requirements.” This involves becoming certified and encourages furthering one’s education.  I think this is especially important with the technological advances in the field.  For example, the transition from CR to DR.  Any additional training in other modalities would be beneficial to a technologist.

The next states, “Thou shall use all the available information during the performance of sonography examinations.” It’s important for a radiographer, as well, to take a proper medical history.  A patient’s condition or certain pathologies will require a radiographer to alter their technique.  This is vital to obtaining an accurate image for the radiologist to make a proper diagnosis.

“Thou shall utilize standard scanning protocols.” Each radiographer has their own techniques they select to get a passable image.  Though these techniques may be slightly different, it should fall within an acceptable range while following the ALARA principle.

The next Commandment, “Thou shall properly annotate thy image.” I relate this to positioning the patient correctly, and efficiently manipulating the equipment.  This will decrease the likelihood of having to repeat an exam.

“Thou shall perform thy responsibilities in an ethical manner.” As a radiographer, it is crucial to perform an exam without discrimination.  This involves eliminating any preconceived notions one could have about a patient.  I also feel patient confidentiality and anonymity could fall under this category.  A patient’s circumstances should not be discussed outside of assessing the patient.

“Thou shall educate patients and other healthcare professionals.” Patients should have a full understanding of their situation in order to make the proper decision about their medical care.  This could involve answering questions about why a radiograph is being taken.  It’s also important to be informative to surrounding healthcare workers.  If a nurse wants to stand in the room while an exam is performed, it would be the responsibility of the radiographer to explain the harm the radiation could have.

“Thou shall respect thy patients.” All patients should be treated in a respectable manner.  This involves not speaking down to them or a family member of theirs. Treating their situation with sensitivity and being considerate of their needs and feelings.  It is also important to take into consideration how a patient may feel about their body, and to be delicate with possible insecurities.

“Thou shall promote patient safety.” Accessing a patient’s physical capabilities can determine how an exam will be performed.  An example of this is whether or not a patient can stand for a radiograph to be taken.  Proper shielding and technique should be practiced, as well as always following the ALARA principle.  This should always be a top priority for a radiographer.

The last Commandment discussed is, “Thou shall demonstrate professionalism.” A radiographer is considered an expert in their field, and should take pride in their abilities by demonstrating a professional demeanor.  This means having proper décor, taking on responsibilities, representing their establishment, and treating patients and coworkers with respect.

Merton’s creative portrayal of the Ten Commandments outlines important guidelines to become a successful sonographer.  These concepts, I have found, are also pertinent to a radiographer’s responsibilities.  The culmination of these ideas should be remembered and practiced on a daily basis to ensure the patient is getting optimal quality care.

Advance , “Merton’s Ten Commandments of Sonography.”  By Daniel A. Merton.  Pg 7