Lecture 1: Welcome and Program Overview PDF

**[Lecture 1: Welcome and Program Overview]**\ Additional Details:\ 1. The Diagnostic Imaging (DI) program includes clinical placements in hospitals, providing hands-on experience in imaging modalities such as X-ray, CT, MRI, and Ultrasound.\ 2. Clinical placements are graded and evaluated based on...

**[Lecture 1: Welcome and Program Overview]**\ Additional Details:\ 1. The Diagnostic Imaging (DI) program includes clinical placements in hospitals, providing hands-on experience in imaging modalities such as X-ray, CT, MRI, and Ultrasound.\ 2. Clinical placements are graded and evaluated based on the students\' ability to apply theoretical knowledge in real-world situations, including patient handling and equipment operation.\ 3. The program includes competency assessments, focusing on image quality, safety protocols, and patient care.\ 4. OTIMROEPMQ certification is required for all MITs in Quebec and is awarded after completing a competency exam that includes written, practical, and oral assessments.\ 5. The Canada Health Act\'s core principles, including accessibility and comprehensiveness, affect the delivery of medical imaging services in Canada, ensuring equal access to diagnostic imaging. **Diagnostic Imaging (DI) Program Overview** - **Purpose**: - Provide foundational knowledge and professional training for Medical Imaging Technologists (MITs). - **Learning Outcomes**: - Understand the organization and structure of the college and program. - Comprehend the healthcare system\'s relationship to the Diagnostic Imaging field. **Program Requirements and Policies** - **Student Responsibilities**: - Ensure immunization records are up-to-date. - Maintain membership with OTIMROEPMQ. - Submit required schedules and finalize online registration. - **Core Program Elements**: - **Training and Assessment**: - Combination of lectures, lab work, clinical placements, and competency-based evaluations. - **Key Policies**: - Academic standing, professional conduct, and radiation safety policies. - Comprehensive exams (written, practical, oral) are mandatory for graduation. - **Certification**: - OTIMROEPMQ and CAMRT exams required for professional practice. - French proficiency exam (if applicable) for Quebec practice. **Lecture and Lab Scheduling** - Lectures: Fridays (2:30 PM - 4:00 PM). - Lab Groups: Rotating schedules on Wednesdays. - Students must verify the weeks when labs and lectures alternate. **Healthcare System in Canada** - **Overview**: - Governed by the Canada Health Act and Medicare system. - Divided responsibilities between federal, provincial, and territorial governments. - **Principles of the Canada Health Act**: - Public Administration: Operated by non-profit authorities. - Comprehensiveness: Covers medically necessary services. - Universality: Equal coverage for all residents. - Portability: Ensures coverage across provinces and territories. - Accessibility: Based on need, not ability to pay. - **Challenges**: - Funding gaps, aging population, and limited resources. - Long wait times, outdated equipment, and undercompensation for healthcare workers. - Increased responsibilities for MITs, including nursing tasks and multi-specialty competence (CT, MRI, Angiography, Ultrasound). **Professional Practice in Diagnostic Imaging** - **Scope of Practice**: - Activities MITs are trained, competent, and authorized to perform. - Governed by CAMRT, OTIMROEPMQ, and national competency profiles. - **Certification and Professional Organizations**: - OTIMROEPMQ: Provincial licensing and certification. - CAMRT: National representation for radiation technologists. - **Employment and Career Opportunities**: - Diverse roles in hospitals, private clinics, and specialized institutions. - High demand for specialties such as CT, MRI, and interventional radiology. - Career advancement opportunities in administration, teaching, and research. **Student Support and Development** - **College Resources**: - Academic advisors, tutors, counseling, and financial aid. - Lab resources and technical staff for hands-on training. - **Program Awards**: - Archie Wilkinson Bursary: Financial and performance-based. - DI Award: Top certification exam performer. **[Lecture 2: Radiation Protection]**\ Expanded Details on Radiation Protection:\ 1. ALARA (As Low As Reasonably Achievable) is a fundamental principle in radiology, guiding MITs to minimize radiation exposure to patients and themselves by optimizing imaging techniques.\ 2. Ionizing radiation can lead to deterministic effects (e.g., skin erythema) at higher doses or stochastic effects (e.g., cancer risk) at lower, cumulative doses over time.\ 3. Occupational exposure limits are set to protect the health of medical professionals, with annual limits of 20 mSv for radiation workers, and 1 mSv for the general public.\ 4. Shielding devices like lead aprons, thyroid shields, and gonadal protectors reduce radiation exposure. These are especially critical during fluoroscopy or long imaging sessions.\ 5. The use of grids and compensating filters improves image quality by reducing scatter radiation, thus improving diagnostic accuracy while reducing patient exposure.\ 6. Personal dosimeters are mandatory for radiation workers, and monthly readings should be reviewed to ensure compliance with exposure limits. **Understanding Radiation** - **Definition**: - Energy traveling through space, e.g., X-rays, gamma rays, and nuclear radiation. - **Types of Radiation**: - **Electromagnetic Radiation**: Oscillating electrical and magnetic waves. - **Ionizing Radiation**: Penetrates body tissues and can damage DNA. **Radiation Protection Principles** - **Cardinal Principles**: - **Time**: Minimize exposure duration. - **Distance**: Increase distance from the source (Inverse Square Law). - **Shielding**: Use barriers such as lead walls, aprons, and gloves. - **Optimization**: - Techniques such as higher kVp, lower mAs, and collimation reduce exposure. - ALARA (As Low As Reasonably Achievable) and ALADA (As Low As Diagnostically Acceptable) principles guide practices. **Radiation Dosimetry** - **Personal Dosimeters**: - **OSL (Optically Stimulated Luminescent)**: - Measures exposure via light emission proportional to absorbed radiation. - More sensitive and accurate than TLD. - **TLD (Thermoluminescent Dosimeter)**: - Uses lithium fluoride crystals to track radiation absorption. - Dosimeter Usage: - Worn between shoulders and waist, under protective aprons if required. - Stored on racks when not in use. - **Exposure Limits**: - Workers: 20 mSv/year for the whole body. - Public: 1 mSv/year. **Risks and Biological Effects** - **Radiation Sensitivity**: - Radiosensitive tissues: Gonads, bone marrow. - Radioresistant tissues: Bones, CNS. - Fetal tissues are highly radiosensitive, especially in the first trimester. - **Types of Risks**: - Deterministic: Effects with a threshold dose (e.g., tissue burns). - Stochastic: Probability-based effects like cancer. **Radiation Protection Devices** - **Protective Barriers**: - Lead walls, concrete shielding in high-radiation areas. - **Beam Limiting Devices**: - Collimators and filters to reduce scatter and unnecessary exposure. - **Immobilization Tools**: - Sandbags, straps, and octostop devices to prevent repeat imaging. **Key Safety Practices** - Always avoid standing in the primary beam. - Use gonadal shielding for patients of childbearing age. - Limit pelvic and abdominal imaging for pregnant patients. **Regulatory and Professional Organizations** - **Provincial**: OTIMROEPMQ (Standards of Practice). - **Federal**: - CAMRT: Professional body for radiation technologists. - CNSC: Canadian Nuclear Safety Commission. - **International**: - ICRP: Sets global standards for radiation protection. **Special Considerations** - **Pregnancy Policy**: - Notify program coordinator upon confirmation. - Additional monitoring for fetal exposure. - **Ten Commandments of Radiation Protection**: - A set of guidelines emphasizing minimizing risks, proper use of protective devices, and ethical practices. **[Lecture 3: Hospital Organization & Medical Imaging Department]**\ In-depth Details on Hospital Organization:\ 1. The Board of Governors (BoG) plays a significant role in setting hospital policies, whereas the CEO oversees daily operations. Departmental administrators ensure that imaging services are compliant with hospital policies and healthcare regulations.\ 2. DI departments follow a hierarchical structure, with the Radiology Manager overseeing daily technical operations, including equipment maintenance, staff schedules, and quality control measures.\ 3. The role of clerical staff in the DI department is crucial in scheduling imaging exams, managing patient records, and ensuring accurate documentation for billing and insurance purposes.\ 4. Imaging modalities in the DI department include X-ray, CT, MRI, mammography, nuclear medicine, and ultrasound, each requiring specialized knowledge and training.\ 5. Quality Assurance programs are integrated into the hospital\'s risk management strategies. These programs ensure that imaging procedures comply with national and international safety standards, such as those set by CAMRT and the ICRP. **Hospital and DI Department Overview** - Hospitals operate as \"communities within communities,\" hosting multidisciplinary teams. - The Board of Governors (BoG) defines hospital policies; the CEO and department administrators ensure implementation. **Organizational Structures** - **Vertical Hierarchy**: Traditional top-down management structure. - **Horizontal Structure**: Broader lines of authority, promoting interdisciplinary collaboration. **Roles in the Medical Imaging Department** - **Medical Staff**: Chief Radiologist, Radiologists, Fellows, Residents. - **Technical Staff**: Radiology Manager, Chief Technologist, Modality Coordinators, Technologists (General/Specialized), Radiology Nurse. - **Clerical Staff**: Receptionists, Transcriptionists. **DI Department Layout** - Areas include: - Reception, changing rooms, and waiting areas. - Imaging modalities: X-ray, CT, MRI, Mammography, Ultrasound, Nuclear Medicine. - Support spaces: Crash cart units, staff lounges, and conference rooms. **Hospital Services** - **Crash Cart Units**: Mobile units for emergencies, equipped with life-saving tools. - **Patient Care Flow**: - Preparation: IV access for certain imaging modalities. - Holding Areas: Pre- and post-procedure monitoring. **Quality Assurance and Risk Management** - Emphasis on error prevention, compliance with protocols, and in-service education programs. - Quality assurance integrates with hospital risk management strategies. **[Lecture 5: Prescription, Identification, and Consent]**\ Expanded Details on Consent and Identification:\ 1. The informed consent process ensures that patients understand the procedure, the risks involved, and any alternatives. MITs must ensure that the patient is not coerced into agreeing and that the consent is obtained before imaging.\ 2. In cases of unconscious patients or emergencies, implied consent is assumed. However, the healthcare team should act in the best interests of the patient to prevent harm.\ 3. Patient identification protocols are essential to prevent misidentification and ensure the correct procedure is performed on the right patient. MITs must verify the patient's identity using two identifiers (e.g., name and date of birth).\ 4. A prescription is required for all imaging procedures. MITs must verify the validity of the prescription before proceeding, including checking for allergies or contraindications (e.g., iodine allergies in contrast media procedures).\ 5. Consent for pediatric patients or those with cognitive impairments requires additional attention to guardianship and clear communication. **Prescription Requirements** - Must include patient details (name, DOB, ID number), physician\'s credentials, exam requested, clinical info, and potential contraindications. - Types: - **Individual Prescription**: Targets a single patient, derived from prior medical assessment. - **Collective Prescription**: Authorized for a group, often used in routine or emergency scenarios. **Patient Identification** - Verification through multiple identifiers: name, DOB, and healthcare ID. - In special cases (e.g., unconscious or pediatric patients), rely on medical records or family input **Consent Types** - **Simple Consent**: - Implied: Based on patient actions. - Expressed: Verbal acknowledgment. - **Informed Consent**: - Required for invasive procedures. - Must detail risks, benefits, and alternatives in clear language. - Patient autonomy and understanding are paramount. - **Special Considerations**: - In emergencies, consent may be implied if immediate intervention is necessary. **MIT Responsibilities** - Verify prescriptions, ensure informed consent, and communicate effectively with patients. - Document all processes according to institutional and legal standards. **[Lecture 6: Interprofessional, Intraprofessional Collaboration & IPE]**\ Further Details on Collaboration:\ 1. Interprofessional collaboration improves the efficiency and effectiveness of patient care. In radiology, collaboration with physicians, nurses, and technologists from other disciplines enhances patient outcomes.\ 2. Key roles in the team include the technologist, who operates the imaging equipment, the radiologist, who interprets the images, and the referring physician, who makes clinical decisions based on imaging results.\ 3. Effective communication within teams ensures that each member is aware of their role and responsibilities, reducing the risk of errors.\ 4. Intraprofessional collaboration between radiologists and MITs ensures alignment in protocols and imaging techniques.\ 5. Continuing professional education (CPE) is essential for staying current with evolving technologies and methodologies. **Interprofessional Collaboration (IPC)** - Defined by the WHO as multiple healthcare workers from diverse fields working together to optimize patient care. - **Advantages**: - Enhances communication, reduces errors, improves patient-centered care, and fosters respect across professions. **Roles in IPC Teams** - Physicians, nurses, pharmacists, social workers, technologists, and therapists collaborate to provide holistic care. - Each profession contributes unique expertise within their regulated scope of practice. **Barriers to Collaboration** - Include power dynamics, professional stereotypes, and communication challenges. - Overcome through education, shared goals, and conflict management. **Interprofessional Education (IPE)** - A structured approach where professionals learn collaboratively to improve team dynamics and patient outcomes. - Effective when real-world scenarios and adult learning principles are used. **MIT Role in Teams** - Promote harmonious relationships, exchange relevant information, and respect each professional\'s contributions. **[Lecture 7: Torts & CAMRT Code of Ethics]**\ Expanded Details on Ethics and Legal Doctrines:\ 1. Unintentional torts (negligence) in radiology may include improper positioning of the patient, incorrect technique, or failure to use adequate shielding.\ 2. Intentional torts, such as battery (performing a procedure without consent) and assault (threatening behavior), can result in legal action and damage to the patient\'s trust.\ 3. The principle of beneficence guides MITs to act in the best interest of patients by ensuring accurate imaging and minimizing harm.\ 4. The principle of nonmaleficence ensures that MITs take all possible precautions to avoid causing harm, particularly in high-risk procedures.\ 5. The principle of justice emphasizes the fair distribution of healthcare resources, ensuring that all patients have equal access to diagnostic imaging services. **Torts in Radiology** - **Unintentional Torts**: Negligence, such as improper patient handling or inadequate radiation protection. - **Intentional Torts**: Include assault (verbal threats), battery (unauthorized touching), and false imprisonment (restraining without consent). **Professional Ethics** - Governed by CAMRT and OTIMROEPMQ codes: - Uphold patient rights, confidentiality, and professional integrity. - Follow legal requirements like the Charter of Rights and Freedoms and provincial laws. **Legal Doctrines** - **Respondeat Superior**: Employers may be liable for employee actions. - **Res Ipsa Loquitur**: Shifts the burden of proof to healthcare providers in cases of evident negligence. **Ethical Principles** - Autonomy, beneficence, nonmaleficence, justice, and fidelity guide professional decisions. **Patient-Centered Care** - Focus on respecting patient dignity, ensuring informed consent, and maintaining safety standards. **[Lecture 8: Immobilization Devices and X-ray Accessories]**\ Additional Details:\ 1. Immobilization tools are essential for pediatric imaging to ensure safety and accuracy. Examples include pediatric papoose boards and immobilization wraps for infants.\ 2. Lead markers used for orientation (e.g., R/L, supine/upright) help maintain accuracy in diagnosis.\ 3. Sandbags are weighted and often used to stabilize limbs, preventing involuntary movements during extremity imaging.\ 4. Radiation protection glasses are crucial for interventional radiology to prevent prolonged ocular exposure. **Learning Objectives** 1. Categorize various diagnostic imaging equipment and accessories. 2. Properly utilize immobilization tools and radiation protection devices during imaging. **Key Topics** - **Immobilization Devices**: - **Sponges**: Support specific projections like lateral hand or chest X-rays. - **Sandbags**: Prevent unwanted movement, ideal for extremity imaging. - **Tape and Velcro Straps**: Ensure stability for pediatric and challenging cases. - **Calipers**: Measure patient thickness for accurate exposure settings. - **Radiation Protection Accessories**: - **Lead Aprons, Gloves, and Shields**: Essential for patient and technologist safety. - **Thyroid and Gonadal Protection**: Mandatory during specific exposures. - **Leaded Goggles**: Reduce ocular scatter radiation. - **X-ray Accessories**: - Grids, markers, compensating filters, and tabletop IR holders enhance imaging quality and accuracy. **[Lecture 9: Introduction to Modalities]**\ Expanded Information:\ 1. CT scans can differentiate between acute and chronic conditions using intravenous contrast media (e.g., detecting embolisms).\ 2. MRI excels in neuroimaging and musculoskeletal assessments. For example, it is the gold standard for identifying ligament tears.\ 3. Ultrasound Doppler studies provide detailed information on blood flow and are essential for diagnosing vascular conditions. **Diagnostic Imaging Modalities** 1. **Computed Tomography (CT)**: - Uses a fan-shaped X-ray beam for cross-sectional imaging. - Eliminates structural superimposition, providing detailed images of organs and tissues. - Applications: Trauma, oncology, and vascular imaging. 2. **Magnetic Resonance Imaging (MRI)**: - Non-ionizing modality using magnetic fields and radio waves. - Superior for imaging soft tissues like brain, spine, and muscles. - Challenges: Long exam durations and contraindications due to metallic implants. 3. **Ultrasound (US)**: - Non-ionizing, high-frequency sound waves visualize soft tissues, organs, and blood flow. - Commonly used in obstetrics, vascular studies, and interventional procedures. 4. **Bone Densitometry (DXA)**: - Measures bone mineral density to diagnose osteoporosis and assess fracture risk. 5. **Angiography & Interventional Radiology**: - Focuses on vascular imaging and minimally invasive therapeutic procedures like stent placement and embolization. **[Lecture 10: Terminology and Emergency Codes]** **Important Equipment Terminology** - **Beam Limiting Devices**: Collimators and cones restrict radiation to the area of interest. - **Grid**: Reduces scatter radiation, improving image contrast. - **Image Receptor**: Detects and records X-ray beams (e.g., CR cassettes, DR panels). **Emergency Codes in Healthcare** - **Code Blue**: Medical emergency. - **Code Red**: Fire. - **Code Yellow**: Missing patient. - **Code White**: Violent incident. - **Code Black**: Bomb threat. - **Code Pink**: Pediatric emergency. **[Lecture 11: OTIMROEPMQ Entry-Level Profile and Reserved Acts]**\ Practical Applications:\ 1. Administering IV contrast for CT angiography under physician supervision.\ 2. Monitoring patient vitals post-imaging procedure to observe reactions to contrast media.\ 3. Inserting a catheter using ultrasound guidance for therapeutic drainage. **Scope of Practice (SoP)** - Defines activities MITs are trained and authorized to perform under OTIMROEPMQ guidelines. - Governed by CAMRT Best Practices and provincial regulations like Bill 90. **Reserved Acts** 1. Administering medications as prescribed. 2. Using ionizing radiation for diagnostic and therapeutic purposes. 3. Monitoring reactions to medications and procedures. 4. Inserting instruments for specific interventions under prescription. **Professional Accountability** - Strict adherence to confidentiality, competence, and ethical conduct. **Lecture 12: OTIMROEPMQ Code of Ethics** **Core Ethical Principles** 1. **Integrity**: - Honesty and professionalism in all activities. - Avoid misrepresentation of skills or services. 2. **Confidentiality**: - Protect patient information under all circumstances. - Violations may lead to legal consequences. 3. **Patient-Centered Care**: - Respect for autonomy and informed decision-making. - Clear communication about procedures and outcomes. 4. **Diligence and Professionalism**: - Respond promptly to patient needs. - Maintain competence through ongoing education. 5. **Professional Boundaries**: - Avoid conflicts of interest. - Prioritize patient welfare over personal gain.