requesting radiographs

Question 1

what are the official personnel for diagnosis radiography

Answer 1

• employer
• referrer
• practitioner (IRMER)
• operator
• all of these act under the umbrella of the employer

Question 2

what are the principles of radiation protection

Answer 2

• justification
• optimisation (ALARP)
• dose limitation - for radiation workers, not public

Question 3

why is there no dose limitation for patients

Answer 3

• because if you can justify getting the exam then net benefit to patient outweighs risk

Question 4

what does ALARP stand for

Answer 4

• as low as reasonably practicable

Question 5

what is IRMER

Answer 5

• the Ionising Radiation (Medical Exposure) Regulations

Question 6

what is the ‘referrer’

Answer 6

• a registered health care professional who is entitled in accordance with the employer’s procedures to refer individuals for exposure to a practitioner
• refers to a practitioner

Question 7

what must the referrer supply the practitioner with

Answer 7

• unique ID of patient
• clinical information to justify exposure
• need to write as much detail as can

Question 8

what are the considerations for those who are pregnant

Answer 8

• in dentistry the abdominal and pelvic regions are not irradiated by the primary beam
• discuss with patient
• patient may not want it if they are pregnant
• strictly speaking, what we do has no effect on pregnancy

Question 9

what is the risk status based on

Answer 9

• high, low or moderate
• social history
• medical history
• dietary habits
• use of fluoride
• plaque control
• saliva
• clinical evidence

Question 10

how often should a high risk patient get a bitewing radiograph

Answer 10

• primary and permanent 6-monthly

Question 11

how often should a moderate risk patient get a bitewing

Answer 11

• annually unless risk status alters

Question 12

how often should a low risk patient get a bitewing

Answer 12

• primary dentition 12-18 monthly

- permanent 2-yearly (can be more if completely sound dentition)

Question 13

how to create a request on TrakCare

Answer 13

• completed by a logged-in clinician
• selects type of radiograph required
• clinical question and answers (type in relevant clinical findings and what you need to find out)
• use FDI notation when referring to teeth - must specify which teeth are to be radiographed
• codes for periapicals are non-specific

Question 14

use of laminated imaging slip

Answer 14

• complete slip using whiteboard pen with patients name and CHI number
• if they’re returning to you write it on slip
• if patient to go home write it on slip
• leave x-ray box blank

Question 15

what to tell patients

Answer 15

• go to level 3 reception with laminated slip and hand it in to desk
• there will be a wait till they are seen
• the radiographer will check their images as soon as they are taken
• if you are seeing them again that session patient will be given laminated slip to take back up to level 6

Question 16

what is the ‘practitioner’

Answer 16

• responsible for justification and authorisation
• authorises the request, confirming justification, in accordance with employer’s written procedures
• variety of permitted people
• ensure does are ALARP

Question 17

what is the operator

Answer 17

• responsible for each practical aspect which the operator carries out as well as for any authorisation given pursuant to regulation
• taking radiographs
• annotating the images
• sending to PACS
• recording findings (differs operator to one who took images)

Question 18

who takes the radiographs

Answer 18

• the operator

Question 19

where are X-ray images found

Answer 19

• on PACS

Question 20

what is the clinical evaluation report

Answer 20

• legal requirement
• clinical evaluation of the outcome of each exposure is (must be) recorded in accordance with the employer’s procedures
• responsibility normally the referrers
• complete in patient’s notes
• has to be done

Question 21

what is pericoronitis

Answer 21

• inflammation of tissues around crown of the tooth

Question 22

what is the best grade of radiograph

Answer 22

• grade 1 is ideal