The Ionising Radiation (Medical Exposure) Regulations IR(ME)R were published in the year 2000.
It is a legal requirement that these regulations are adhered to. The main points of the regulations are set out below, however a familiarity with the full document is recommended (follow link at bottom of page) The National Osteoporosis Society have published guidelines that cover all aspects of the 2000 regulations.
Under IR(ME)R, all DXA operators using X-ray equipment must, by law, have formal Radiation training BEFORE scanning patients unsupervised. (It is however possible for someone to participate; 'in practical aspects of the procedure as part of practical training if this is done under the supervision of a person who himself is adequately trained').
'The IR(ME)R regulations state that 'no practitioner or operator shall carry out a medical exposure without having been adequately trained.' This means that 'practitioners and operators shall have successfully completed training, including theoretical knowledge and practical experience in radiation production, radiation protection and statutory obligations relating to ionising radiation.'
Radiographers and Medical Physicists will have already had adequate training to work unsupervised. All other operators need to ascertain whether they need further training. The NOS run an IR(ME)R course to provide this training, if need be. Details of the NOS IR(ME)R training course
Justification of Medical Exposure
The regulations state that all medical exposures must be justified and authorised by a trained practitioner:
'No person should carry out a medical exposure unless':
'The referrer shall supply the practitioner with sufficient medical data relevant to the medical exposure requested by the referrer to enable the practitioner to decide on whether there is a sufficient net benefit.
- 'There is 'a sufficient net benefit' to the patient'.
- 'it has been authorised by the practitioner or the operator'
- 'In deciding whether to justify an exposure the practitioner shall take account of any data supplied by the referrer and shall consider such data in order to avoid unnecessary exposure'
- 'Where it is not practicable for the practitioner to authorise an exposure the operator shall do so in accordance with guidelines issued by the practitioner.'
'The employer shall ensure that written procedures for medical exposures are in place' and complied with.
'The employer shall establish recommendations concerning referral criteria for medical exposures, including radiation doses, and shall ensure that these are made available to the referrer'
Each scanning centre must have prepared full written protocols covering every technical and scientific aspect of its service and these must be read by all staff, regularly updated and be available for inspection at all times.
Medical Physicist support
'A medical physics expert shall be involved as appropriate for consultation on optimisation, including patient dosimetry and quality assurance, and to give advice on matters relating to radiation protection concerning medical exposure, as required'.
Radiation dose reduction, Quality Assurance, and Radiation protection should also be understood by all operators. Follow the links below for more information.
Read the IR(ME)R regulations HERE (do a search for 'Radiation Regulations')
Read the NOS Guidelines for the Provision of a Clinical Bone Densitometry Service HERE
Institute of Physics and Engineering in Medicine: Diagnostic Radiology Special Interest Group
The DLG was founded by Jessica Wilkinson, a DXA Radiographer at the Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH.
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