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Registrants employ ionizing radiation, radiopharmaceuticals, electromagnetism and soundwaves to create images and data that are part of diagnostic imaging examinations or that are used for defining and recording treatment parameters. These images may be dynamic, on film, digital displays, three-dimensional models or templates. Registrants in the specialties of radiation therapy and nuclear medicine administer ionizing radiation to treat cancer and other diseases.
Registrants who apply ionizing radiation do so under the authority of and in accordance with the Healing Arts Radiation Protection Act and, where applicable, the Nuclear Safety and Control Act and their respective regulations. Registrants are permitted to apply electromagnetism for magnetic resonance imaging under an exemption set out in the Controlled Acts regulation made under the Regulated Health Professions Act. Registrants are also permitted to apply soundwaves for diagnostic ultrasound under an exemption set out in the Controlled Acts regulation made under the Regulated Health Professions Act.
Registrants perform five controlled acts, which they are authorized to perform under the Medical Radiation and Imaging Technology Act. These are:
1. administering substances by injection or inhalation;
2. tracheal suctioning of a tracheostomy;
3. administering contrast media or putting an instrument, hand or finger,
4. performing a procedure on tissue below the dermis; and
5. applying a prescribed form of energy.
Registrants must be able to create images and data that are sufficiently accurate and clear for the diagnostic or therapeutic procedures that are ordered by a physician or other authorized health professional. In the case of procedures that use ionizing radiation, registrant use only the minimum amount of radiation necessary during the course of the procedure. Registrants performing procedures using soundwaves for diagnostic ultrasound use the minimum acoustic power output and minimum exposure time. Registrants must be proficient in evaluating the images, data and tests relating to the procedures to ensure that the images, data and tests are satisfactory.
Registrants must be able to administer ionizing radiation, radiopharmaceuticals, electromagnetism for magnetic resonance imaging and soundwaves for diagnostic ultrasound accurately and in accordance with the order of the physician or other authorized health professional for the diagnostic or therapeutic procedure and the applicable legislation. Registrants must not apply or administer ionizing radiation or radiopharmaceuticals unless the conditions under the applicable legislation (including without limitation, the Healing Arts Radiation Protection Act and its regulations and the Nuclear Safety and Control Act, its regulations and licences issued thereunder) have been met.
Under the Medical Radiation and Imaging Technology Act, registrants are authorized to perform five authorized acts ("authorized acts") as required in the course of engaging in the practice of the profession. They must not perform the authorized acts or any exempted controlled act unless the conditions under the Regulated Health Professions Act, the Medical Radiation and Imaging Technology Act and their respective regulations, and the Standards of Practice have been met.
Registrants must:
a. perform procedures involving the application or administration of ionizing radiation only when the conditions under the applicable legislation have been met (This includes, without limitation, the Healing Arts Radiation Protection Act and its regulations and the Nuclear Safety and Control Act, its regulations and licences issued thereunder.)
b. perform only those controlled acts that have been authorized or exempted or excepted under the legislation or delegated in accordance with the legislation and the Standards of Practice(1)
c. perform authorized acts or delegated or exempted controlled acts only when the conditions under the legislation and the Standards of Practice have been met
d. ensure that the appropriate order authorizing the performance of the procedure is in place:
for application of ionizing radiation: the order must be from a physician or other authorized health professional listed in the Healing Arts Radiation Protection Act or regulations
for nuclear medicine procedures: the order must be from a person authorized under the regulations made under the Public Hospitals Act or in accordance with the generally accepted professional standards established under the Independent Health Facilities Act
for application of electromagnetism for magnetic resonance imaging procedures: the order must be from a physician or another authorized health professional listed in the Controlled Acts regulation made under the Regulated Health Professions Act, and in accordance with that regulation
for application of soundwaves for diagnostic ultrasound procedures: the order must be from a physician or another authorized health professional listed in the Controlled Acts regulation made under the Regulated Health Professions Act, and in accordance with that regulation
e. perform procedures, including authorized acts, only in the course of engaging in the practice of the profession
f. not perform procedures contrary to any terms, conditions or limitations placed upon the registrant’s certificate of registration
g. have and apply the necessary knowledge, skills and judgement to perform and manage the outcomes of performing the procedure safely, effectively and ethically
h. ensure that patient consent has been obtained
i. be responsible and accountable for performing the procedure and managing the outcomes having considered:
the known risks to the patient in performing the procedure
the predictability of the outcomes in performing the procedure
whether the management of the possible outcomes is within the registrant’s knowledge, skill and judgement given the situation
j. not perform any procedure or provide any advice which may result in serious bodily harm unless that procedure or advice is within the scope of practice of the profession or the registrant is authorized or permitted to do so by legislation
k. position the patient as required for the diagnostic or therapeutic procedure
l. ensure the area to be diagnosed or treated will be displayed on the resultant image or captured electronically
m. use radiation protection devices and other patient protection devices as required
n. instruct the patient on breathing and movement procedures
o. ensure that the orientation of the body and other pertinent parameters are marked correctly on the images and data
p. ensure the exposure provides optimum image quality while using minimal radiation
q. ensure examination results (images and data) provide all the information requested in the order
r. carry out the procedures ordered
s. assess the patient’s condition before, during and after the procedure or course of treatment
t. respond to any change in the patient’s condition during or after the procedure or course of treatment
u. complete the procedure, advise the patient of any post-procedural care, and transfer the care of, or release, the patient
In addition, registrants in the specialty of radiography, nuclear medicine, magnetic resonance and diagnostic medical sonography must:
v. determine if the images and/or data are of sufficient diagnostic quality or if additional or repeat images are necessary
In addition, registrants in the specialty of magnetic resonance must:
w. perform procedures involving the application of electromagnetism for magnetic resonance imaging only when the conditions under the Regulated Health Professions Act, the Medical Radiation and Imaging Technology Act and their respective regulations have been met
In addition, registrants in the specialty of diagnostic medical sonography must:
x. perform procedures involving the application of soundwaves for diagnostic ultrasound only when the conditions under the Regulated Health Professions Act, the Medical Radiation and Imaging Technology Act and their respective regulations have been met
y. use the minimum acoustic power output and minimum exposure time to obtain the optimum image quality and the necessary clinical information
In addition, registrants in the specialty of radiation therapy must:
z. develop and/or interpret a treatment plan for each patient
aa. calculate treatment doses and duration of administration
bb. ensure use of record and verification systems
cc. identify the treatment field and treatment volumes
dd. determine if the image verifies treatment parameters or if a repeat image is necessary
ee. assess and match the treatment verification image with the reference image and make required adjustments to patient position
ff. select and/or verify treatment parameters
gg. administer treatment
(2) Registrants may accept delegation of other procedures that are controlled acts under the Regulated Health Professions Act and not authorized to registrants under the Medical Radiation and Imaging Technology Act provided they comply with the Regulated Health Professions Act and the Standards of Practice as set out in Practice Standard 6, Professional Relationships.