An accurate and comprehensive clinical history ensures patient safety and reduces unnecessary repeat examinations. Medical Radiation Technologists (MRTs) are encouraged to engage patients in conversation to fill in any gaps in the clinical information available. MRTs should speak with other members of the healthcare team to address any discrepancies with an imaging request.
Canadian Association of Medical Radiation Technologists. Appropriateness of requisition, order or prescription. Best Practice Guidelines, CAMRT. [Internet]. May 2016. [Accessed 17 Dec 2018].
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Gunderman RB, et al. Improving Clinical Histories on Radiology Requisitions. Academic Radiology. 2001;vol8(4):299-303. PMID: 11293777.
Gyftopoulos S, et al. Patient Recall Imaging in the Ambulatory Setting. Am J Roentgenol. 2016;vol206(4):787-791. PMID: 26866338.
Hawkins CM, et al. Improving the availability of clinical history accompanying radiographic examinations in a large pediatric radiology department. Am J Roentgenol. 2014;vol202(4):790-796. PMID: 24660708.
Munk PL. The Holy Grail — The Quest for Reliable Radiology Requisition Histories. CARJ. 2016 Feb;vol67(1):1. PMID: 26800619.
Troude P, et al. Improvement of radiology requisition. Diagnostic and Interventional Imaging. 2014 Jan;vol95(1):69-75. PMID: 23999241.
Zhou Y, et al. Errors in medical imaging and radiography practice: a systematic review. JMIRS. 2015;vol46(4):435-441.Share on Facebook Share on Twitter
Proper patient preparation reduces the need for repeat procedures and is an important quality and safety consideration for both medical imaging and radiation therapy. A multidisciplinary approach to pre-procedural care emphasizes the importance of advanced planning to achieve the desired outcomes for the procedure and ensures that the procedures do not need to be cancelled or repeated. This includes necessary laboratory results, adherence to dietary requirements and administration of pre-procedure medications. It is the Medical Radiation Technologist’s (MRT) responsibility to ensure patients have completed all necessary pre-procedural instructions.
Canadian Association of Medical Radiation Technologists. Patient education. Best Practice Guidelines. CAMRT. [Internet]. Nov 2015. [Accessed 17 Dec 2018].
Cramp V, et al. Use of a prospective cohort study in the development of a bladder scanning protocol to assist in bladder filling consistency for prostate cancer patients receiving radiation therapy. J Med Radiat Sci. 2016 Sep;vol63(3):179-185. PMID: 27648282.
Frush DP. Overview of CT technologies for children. Pediatr Radiol. 2014 Oct;vol44(S3):422-426. PMID: 25304699.
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Taslakian B, et al. Patient evaluation and preparation in vascular and interventional radiology: What every interventional radiologist should know (Part 2). Cardiovasc Intervent Radiol. 2016 Apr;vol39(4):489-499. PMID: 26606917.
Zaorsky NG, et al. ACR Appropriateness Criteria® external beam radiation therapy treatment planning for clinically localized prostate cancer, part I of II. Adv Radiat Oncol. 2017 Jan-Mar;vol2(1):62-84. PMID: 28740916.Share on Facebook Share on Twitter
Many patients have difficulty tolerating medical imaging and radiation therapy procedures that often cause repeat examinations and/or poor-quality outcomes. Medical Radiation Technologists (MRTs) must communicate with patients, their families and other healthcare providers to ensure patients are physically, mentally and emotionally able to perform the procedure requested.
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Canadian Association of Medical Radiation Technologists. Claustrophobia. Best Practice Guidelines. CAMRT. [Internet]. Feb 2016. [Accessed 17 Dec 2018].
Canadian Association of Medical Radiation Technologists. Patient and family-centered care in practice. Best Practice Guidelines. CAMRT. [Internet]. Nov 2015. [Accessed 17 Dec 2018].
Clover K, et al. Disruption to radiation therapy sessions due to anxiety among patients receiving radiation therapy to the head and neck area can be predicted using patient self-report measures. Psycho-Oncology. 2011 Dec;vol20(12):1334-1341. PMID: 20878722.
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Katz RC, et al. Anxiety and the determinants in patients undergoing magnetic resonance imaging. J Behav Ther Exp Psychiatry. 1994 June;vol25(2):131-134. PMID: 7983222.
Story MF, et al. Accessibility of Radiology Equipment for Patients with Mobility Disabilities. Human Factors. 2008 Oct;vol50(5):801-10. PMID: 19110840.
Wollman D, et al. Tolerance of MRI procedures by the oldest old. Magn Reson Imaging. 2004 Nov;vol22(9):1299-1304. PMID: 15607102.Share on Facebook Share on Twitter
Stopping patients from receiving unnecessary radiation dose is a primary consideration for Medical Radiation Technologists (MRTs). MRTs should use all available hardware, software, accessory devices, and patient instructions (pre and post procedure) to minimize dose to patients during medical imaging and radiation therapy planning and treatment alignment. All imaging should be performed using the As Low as Reasonably Achievable (ALARA) principle to optimize the appropriate dose for each clinical situation.
Akin EA, et al. Optimizing-Oncologic-FDG-PET-CT-Scans-to-Decrease-Radiation-Exposure. Image Wisely. [Internet]. Updated April 2017. [Accessed 7 Dec 2017].
Alessio AM, et al. Role of Reference Levels in Nuclear Medicine: A Report of the SNMMI Dose Optimization Task Force. J Nucl Med. 2015 Sep;vol56(12):1960-64. PMID: 26405164.
Canadian Association of Medical Radiation Technologists. Minimizing Patient Exposure. Best Practice Guidelines, CAMRT. [Internet]. May 2012. [Accessed 17 Dec 2018].
Canadian Nuclear Safety Commission. Regulatory Guide. Keeping Radiation Exposures and Doses As Low as Reasonably Achievable (ALARA). G-129, Revision 1. CNSC. [Internet]. Oct 2004. [Accessed 4 Dec 2017].
Canadian Nuclear Safety Commission. Regulatory Guide. Radiation Protection Regulations SOR/2000-203. CNSC. [Internet]. Amended Sept 2017. [Accessed 4 Dec 2017].
Image Wisely. Diagnostic Reference Levels, CT Diagnostic Reference Levels From the ACR CT Accreditation Program. Image Wisely. [Internet]. Nov 2010. [Accessed 14 Oct 2017].
Harkness B. Dose Reduction in Planar Nuclear Medicine Imaging. Image Wisely. [Internet]. Nov 2012. [Accessed 7 Dec 2017].
Health Canada. Safety Code 35: Safety Procedures for the Installation, Use and Control of X-ray Equipment in Large Medical Radiological Facilities. Government of Canada. [Internet]. Updated 14 Jan 2015. [Accessed 7 Dec 2017]. 2008.
Hedgire SS, et al. Recent advances in cardiac computed tomography dose reduction strategies: a review of scientific evidence and technical developments. J Med Imaging (Bellingham). 2017 Aug;vol4(3):031211. PMID: 28894760.
International Commission on Radiological Protection. ICRP Publication 105. ICRP. [Internet]. 2007. [Accessed 14 Oct 2017].
Moser JB, et al. Radiation dose-reduction strategies in thoracic CT. Clin Radiol. 2017 May;vol72(5):407-420. PMID: 28139204.
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Rawat U, et al. ACR White Paper-Based Comprehensive Dose Reduction Initiative Is Associated With a Reversal of the Upward Trend in Radiation Dose for Chest CT. J Am Coll Radiol. 2015 Dec;vol12(12 Pt A):1251-1256. PMID: 26482816.
Reiner BI. The Quality/Safety Medical Index: a Standardized Method for Concurrent Optimization of Radiation Dose and Image Quality in Medical Imaging. J Digit Imaging. 2014 Dec;vol27(6):687-691. PMID: 25193788.Share on Facebook Share on Twitter
All available central venous access lines should be assessed for compatibility with contrast injections before a new peripheral venous line is started. This prevents starting unnecessary lines which are uncomfortable for patients.
Bonciarelli G, et al. GAVeCeLT consensus statement on the correct use of totally implantable venous access devices for diagnostic radiology procedures. J Vasc Access. 2011 Oct-Dec;vol12(4):292-305. PMID: 21534233.
Bujis SB, et al. Systematic review of the safety and efficacy of contrast injection via venous catheters for contrast-enhanced computed tomography. Eur J Radiol Open. 2017 Sept;vol4:118-122. PMID: 29034281.
Herts BR, et al. Power injection of contrast media using central venous catheters: feasibility, safety, and efficacy. AJR Am J Roentgenol. 2001 Feb;vol176(2):447-453. PMID: 11159092.
Plumb AA, et al. The use of central venous catheters for intravenous contrast injection for CT examinations. Br J Radiol. 2011 Mar;vol84(999):197-203. PMID: 21325362.
Tee FY, et al. Patient Perceptions and Experience of Pain, Anxiety and Comfort during Peripheral Intravenous Cannulation in Medical Wards: Topical Anaesthesia, Effective Communication, and Empowerment. International Journal of Nursing Science. 2015;vol5(2):41-46.
Wienbeck S, et al. Prospective study of access site complications of automated contract injection with peripheral venous access in MDCT. Am J Roentgenol. 2010 Oct;vol195(4):825-829. PMID: 20858804.Share on Facebook Share on Twitter
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