The Radiographer’s Role in Radiation Protection in Diagnostic Radiography
Introduction:
Since its discovery, ionising radiation has played a major role in the healthcare service. The use of ionising radiation in the medical field has undergone massive growth in the past few decades (Brenner, 2012). For instance, Le Heron et al (2010) estimated that around four billion radiographic procedures are carried out every year, worldwide. However, the medical use of ionising radiation has a small but definitive risk of inducing cancer (Holmberg et al, 2010). Therefore, radiation protection is pivotal in order to prevent a deterministic effect and to minimise the stochastic effect of ionising radiation (Valentin, 2001). Although radiation protection involves more than one medical professional, the radiographer represents the role of the gatekeeper in radiation dose minimisation (Walker and Tuck, 2001). In this context, the radiographer has a responsibility to protect the patient from unnecessary and unintended ionising radiation (Holmberg et al, 2010). Therefore, this essay will explore the radiographer’s role in radiation protection in diagnostic radiography. This role will be divided into three areas; justification, optimisation and the managerial role of the radiographer.
Justification:
Justification of radiographic procedure represents the first step in radiation protection (Valentin, 2001). When the benefits of radiographic exams outweigh its potential risk, it can be expressed as justified. However, the historical view of ionising radiation has led to less effort being made regarding justification (Malone, 2008). Traditionally, ionising radiation has been regarded as the easiest way to investigate the patient regardless of the small risk associated with it (Amis et al, 2007). However, by the end of 1980s, a European directive stated that justification must be given for every radiographic procedure (Shannoun et al, 2008).
Despite the fact that the radiologist has the primary responsibility in radiographic procedure justification, the radiographer plays an important role in this process also (Amis et al, 2007). Indeed, Malone (2008) indicated that in some circumstances, the radiographer will take the responsibility of justification instead of the radiologist. For example, in the accident and emergency (A/E) x-ray room the radiobiologist usually covers all hospital departments and in such situations the radiographer will be expected to take a significant portion of responsibility in radiographic exams justification (Matthews and Brennan, 2008).
Moreover, Matthews and Brennan, (2008) pointed out that routine x-ray examinations requested by general practitioners or by clinicians in the outpatient go directly to the radiographer without radiologist justification. In such situations, the radiographer will play the practitioner’s role in justification as well as his/her role in optimisation. Therefore, the radiographer must ensure that the request form contains adequate demographic data in order to identify the patient (Walker and Tuck, 2001). Moreover, all relevant clinical information must be presented in the request to aid radiographers enhance the criteria of their justification (Koutalonis and Horrocks, 2012). This step will help avoid exposing the wrong patient or the wrong organ as it has been reported that busy clinicians may type inadequate information on the request (Koutalonis and Horrocks, 2012).