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Registrants operate equipment, apply ionizing radiation, electromagnetism for magnetic resonance imaging and soundwaves for diagnostic ultrasound, and administer radiopharmaceuticals. All of these could be dangerous if used incorrectly. Registrants endeavour, at all times and in every aspect of their practice, to reduce the risk of harm to their patients, to themselves, to their colleagues and to any other individuals who may be present in the practice environment.
Registrants must have and maintain the knowledge, skills and judgement to practise safely by adhering to all relevant provincial and federal legislation and guidelines, departmental protocols and policies and manufacturers’ directions pertaining to health and safety. In the event of any unexpected problems or emergencies, registrants must be competent and prepared to handle or to assist in the management of the situation.
Registrants must:
a. observe all departmental and facility policies and relevant provincial and federal legislation and guidelines pertaining to health and safety, such as:
Regulated Health Professions Act and its regulations
Medical Radiation and Imaging Technology Act and its regulations
Public Hospitals Act and its regulations
Independent Health Facilities Act and its regulations
Healing Arts Radiation Protection Act and its regulations
Occupational Health and Safety Act and its regulations
Nuclear Safety and Control Act and its regulations and licences issued thereunder
Radiation Emitting Devices Act and its regulations
Transportation of Dangerous Goods Act and its regulations
Health Protection and Promotion Act and its regulations
Health Canada’s Technical Reports and Publications, including:
Safety Code 20A - X-Ray Equipment in Medical Diagnosis Part A: Recommend Safety Procedures for Installation and Use, 1980
Safety Code 26 - Guidelines on Exposure to Electromagnetic Fields from Magnetic Resonance Clinical Systems, 1987
Safety Code 30 - Radiation Protection in Dentistry, 1999
Safety Code 35 - Safety Procedures for the Installation, Use and Control of X-Ray Equipment in Large Medical Radiological Facilities, 2008
Safety Code 36 - Radiation Protection and Quality Standards in Mammography - Safety Procedures for the Installation, Use and Control of Mammographic X-ray Equipment, 2013
As Low As Reasonably Achievable (ALARA) principle
b. conduct the appropriate quality control tests, or ensure that the appropriate quality control tests have been conducted, for all equipment and substances to be used in the diagnostic or therapeutic procedure
c. take corrective action if quality control tests are not within acceptable limits
d. use substances only before their expiry time or date
e. verify the patient’s identity for all diagnostic or therapeutic procedures
f. prior to performing the procedure, ascertain whether there are any contraindications to the procedure, including pregnancy for procedures involving ionizing radiation, and notify the patient’s physician, authorized health professional, radiologist, nuclear medicine physician, cardiologist or radiation oncologist of any contraindications and obtain direction to proceed, modify or halt the procedure
g. prior to administering a substance orally, by injection or inhalation, or into the body through an orifice, ascertain whether there are any contraindications to administering the substance to the patient and make necessary explanations, or referrals or implement necessary restrictions
h. assess the patient’s physical and emotional limitations and ensure that the patient will not be expected to perform any task or movement that would cause physical harm
i. take all reasonable precautions to ensure that no equipment can injure a patient
j. use the ALARA principle to minimize patient exposure to radiation and soundwaves for the procedure
k. use shielding/protective devices where indicated
l. initiate emergency response procedures, notify a physician (if possible) and assist in, or carry out, emergency treatment as required if a patient suffers any adverse reaction to treatment or to administered substances
m. use appropriate aseptic techniques and infection control procedures in the course of the diagnostic or therapeutic procedure
n. protect themselves, their colleagues, other members of the health care team, any other individuals who may be present as well as any patient from any unnecessary exposure to radiation
o. ensure all positioning aids and immobilization devices maintain the patient’s position appropriate to the diagnostic or therapeutic procedure according to departmental or facility policy
p. assess the patient’s condition before, during and after the course of treatment or procedure
q. where appropriate, remove markers and accessory equipment/devices before the patient is released
In addition, registrants in the specialty of magnetic resonance must:
r. ensure that there are no contraindications present that could harm the patient or would exclude the patient from having the examination
s. ensure that all equipment and devices, both patient-specific and accessory, are MR compatible before being brought into the MR area
t. administer and follow the necessary safety precautions for entry to the magnet room to protect themselves, the patient, their colleagues, other members of the health care team and any other individuals who may be present
In addition, registrants in the specialty of nuclear medicine must:
u. conduct personal and area contamination monitoring
v. decontaminate where necessary in accordance with any licence(s) issued under the Nuclear Safety and Control Act
w. use appropriate personal protection equipment when handling radioactive materials in accordance with any licence(s) issued under the Nuclear Safety and Control Act
In addition, registrants in the specialty of radiation therapy must:
x. label and orient all patient-specific ancillary equipment