[ RadSafe ] RE: Medical Radiological Technician Oversight

Sat Jun 25 06:57:56 CEST 2005

"The tech refused to
allow me (or anyone else) to be in the room with the child while the
x-ray was taken. The kid was hurt, scared, and in a place (and alone)
that he had never been before."

Comment:

I think about 6 years ago I wrote to Radsafers on conforters and visitors to
support patients. Anyhow taking into account your above topic, the Basic
Safety Standards, IAEA Safety Series 115, recommends, page 93:

DOSE LIMITATION FOR COMFORTERS AND VISITORS OF PATIENTS*
Dose limitation for comforters and visitors of patients
II-9. The dose limits set out in this part shall not apply to comforters of
patients, i.e.,
to individuals knowingly exposed while voluntarily helping (other than in
their
employment or occupation) in the care, support and comfort of patients
undergoing
medical diagnosis or treatment, or to visitors of such patients. However,
the dose of
any such comforter or visitor of patients shall be constrained so that it is
unlikely that
his or her dose will exceed 5 mSv during the period of a patient's
diagnostic examination
or treatment. The dose to children visiting patients who have ingested
radioactive materials should be similarly constrained to less than 1 mSv.

To those interested to go ahead, please look at the site
http://www-pub.iaea.org/MTCD/publications/PDF/Pub1117_scr.pdf

to download the Radiological Protection for Medical Exposure to Ionizing
Radiation
IAEA SAFETY GUIDE No. RS-G-1.5

Please look also at RADIATION SAFETY
http://www.iaea.org/Publications/Reports/Anrep2002/radiation_safety.pdf

Radiological Protection of Patients

A Safety Guide on radiological protection for medical exposure to ionizing
radiation, jointly sponsored by the Agency, PAHO and WHO, was published. It
provides recommendations on how safety requirements can be applied to
protect patients, comforters and visitors of patients against exposure to
ionizing radiation in medical practice in compliance with the BSS.
Specifically, recommendations cover the establishment of guidance levels for
diagnostic medical exposures, acceptance testing processes for radiation
equipment, calibration of radiotherapy units and the reporting of accidental
medical exposures.
As recommended by the 2001 Málaga conference on the radiological protection
of patients in diagnostic and interventional radiology, nuclear medicine and
radiotherapy, the Agency formulated an action plan based on the findings of
the conference. The Board of Governors approved the plan in September 2002,
and implementation is proceeding. Areas highlighted in the action plan
include education and training, information exchange, provision of guidance
and assistance to Member States in the implementation of safety standards,
research on radiation doses in new technologies, and the collection and
dissemination of
information on accidental medical exposure.

Jose Julio Rozental
joseroze at netvision.net.il
Israel

----- Original Message -----
From: "Paul Lavely" <lavelyp at uclink.berkeley.edu>
To: "John Jacobus" <crispy_bird at yahoo.com>
Cc: <radsafe at radlab.nl>
Sent: Saturday, June 25, 2005 4:17 AM
Subject: Re: [ RadSafe ] RE: Medical Radiological Technician Oversight

> John,
>
> I missed the intentional part.
>
> >What mechanisims are in place to prevent Medical Radiological Techs
> >from intentionally or unintentionally overexposing their patients to
> >X-rays?
>
> I looked only to the issue of unnecessary exposures. My experience
> was the rad tech who took 7 sequential x-rays of my 2 year old son
> that "didn't come our right." At that point, I intervened and said
> that no more x-rays would be taken until the problem was determined
> and addressed. In this case it was movement. The tech refused to
> allow me (or anyone else) to be in the room with the child while the
> x-ray was taken. The kid was hurt, scared, and in a place (and alone)
> that he had never been before. I knew that my dose would be in the 1
> to 2 mrem range, but it took the hospital's head of radiology
> involvement to get that permission. Additionally the struggle and
> delay did not help.
>
> However, you are clearly correct - why. There was a popular fiction
> book (maybe by Cook) that had a HMO provider killing off selected
> patients with a BIG rad source in a ridiculously small shield under a
> special hospital bed.  Perhaps questions such as this (or irrational
> fears) are spawned by the fiction around us on TV, in movies, and in
> print.
>
> It seems that hospitals offer a variety of "potentially undetectable
> lethal weapon(s)." A person could choose from pain med overdose,
> equipment failure, insulin dosing, succinylcholine, administration of
> a med a person with an extreme allergic (they are noted on the
> charts). and the list goes on. Would they be found out? Perhaps and
> perhaps not. The death of a very sick patient of apparent natureal
> causes would no necessitate calling in Quincy or CSI. However, why
> would someone do these things and why would they select radiation as
> their weapon?
>
> I have had a couple of aspiring writers ask me about the use of
> radiation as a poison and I have told them about time, distance,
> shielding, and access to the material. A "dirty bomb" story sounds
> good; however, it is far from practical. For most people large
> amounts of radiation or radioactive materials is hard to get' but,
> your ACE hardware store can provide a variety of poisons.
>
> By the way, a California legislator is proposing a law that would
> require tracking of patient medical exposures and that MDs consider
> the history in making a decision as to tests.
>
> Paul
>
> >I cannot imagine why a technologist would overdose a
> >patient.  Do you have a reason?  Are looking to sue
> >someone?
> >
> >--- A <ab19283 at excite.com> wrote:
> >
> >>
> >>  Of all the millions of radiological procedures
> >>  performed by the many thousands of (possibly
> >>  uncertified) technicians, is no one concerned that
> >>  foul play is not occurring?
> >>
> >>  Imagine for a moment that one tech decided not to be
> >>  upstanding and trustworthy, for whatever reason...
> >>
> >>  They could easily overdose a patient and suffer
> >>  absolutely no risk of being caught or exposed.  If
> >>  they are careful to keep the dose under a certain
> >>  level, there would be no immediate evidence.  The
> >>  harm would come many months or even years later, and
> >>  even then, there would be no way to link the harm to
> >>  them.  Most patients are woefully unaware of how
> >>  many exposures (and of what duration) any radiologic
> >>  procedure requires.  I understand that exposure
> >>  records are not kept and that patient dosimetry is
> >>  not required.  It is also likely that a technician
> >>  see the same patient over their lifetime.  The
> >>  opportunity for abuse is tremendous.
> >>
> >>  The lack of oversight of someone with a potentially
> >>  undetectable lethal weapon is utterly appauling.
> >>
> >>  Arthur
> >>
> >>
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> >
> >
> >+++++++++++++++++++
> >"Every now and then a man's mind is stretched by a new idea and
> >never shrinks back to its original proportion." -- Oliver Wendell
> >Holmes, Jr.
> >
> >-- John
> >John Jacobus, MS
> >Certified Health Physicist
> >e-mail:  crispy_bird at yahoo.com
> >
> >
> >
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>
> --
>
>
> ****
> Paul Lavely
> Radiation Safety Officer
> Environment, Health & Safety
> UC Berkeley, Berkeley, CA 94720-1150
> Tel: (510) 643-7976
> Fax: (510) 643-9495
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