Final Review - Fundamentals 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 the stude...

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 student's 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: o Provide foundational knowledge and professional training for Medical Imaging Technologists (MITs). Learning Outcomes: 0. Understand the organization and structure of the college and program. 1. Comprehend the healthcare system's relationship to the Diagnostic Imaging field. Program Requirements and Policies Student Responsibilities: o Ensure immunization records are up-to-date. o Maintain membership with OTIMROEPMQ. o Submit required schedules and finalize online registration. Core Program Elements: o Training and Assessment: ▪ Combination of lectures, lab work, clinical placements, and competency-based evaluations. o Key Policies: ▪ Academic standing, professional conduct, and radiation safety policies. ▪ Comprehensive exams (written, practical, oral) are mandatory for graduation. ▪ Failing a course will result in being out of phase ▪ Failing two courses will result in being “expelled” from the program o Certification: ▪ OTIMROEPMQ and CAMRT exams required for professional practice. ▪ French proficiency exam (if applicable) for Quebec practice. Healthcare System in Canada Overview: o Governed by the Canada Health Act and Medicare system. o Divided responsibilities between federal, provincial, and territorial governments. Principles of the Canada Health Act: 1. Public Administration: Operated by non-profit authorities. 2. Comprehensiveness: Covers medically necessary services. 3. Universality: Equal coverage for all residents. 4. Portability: Ensures coverage across provinces and territories. 5. Accessibility: Based on need, not ability to pay. Challenges: 1. Funding gaps, aging population, and limited resources. 2. Long wait times, outdated equipment, and undercompensation for healthcare workers. 3. Increased responsibilities for MITs, including nursing tasks and multi-specialty competence (CT, MRI, Angiography, Ultrasound). Bloom’s Taxonomy High-order thinking skills to low-order thinking skills ○ evaluate ○ analyze ○ understand ○ knowledge Professional Practice in Diagnostic Imaging Scope of Practice: o Activities MITs are trained, competent, and authorized to perform. o Governed by CAMRT, OTIMROEPMQ, and national competency profiles. Certification and Professional Organizations: o OTIMROEPMQ: Provincial licensing and certification. ▪ its mandate is to protect the public ▪ Ordre des technologues en imagerie médicale, en radio-oncologie et en électrophysiologie médicale du Québec. ▪ L'Ordre regroupe plus de 5800 technologues qui exercent dans quatre domaines ▪ le radiodiagnostic (70%) ▪ la radio-oncologie (11%) ▪ la médecine nucléaire (9%) ▪ l’électrophysiologie médicale (9%) o CAMRT: National representation for radiation technologists.  ▪ Canadian Association of Medical Radiation Technologists ▪ Approx. 11,800 members 75% in DI (does not include MRI techs) Employment and Career Opportunities: o Diverse roles in hospitals, private clinics, and specialized institutions. o High demand for specialties such as CT, MRI, and interventional radiology. o Career advancement opportunities in administration, teaching, and research. Student Support and Development College Resources: o Academic advisors, tutors, counselling, and financial aid. o Lab resources and technical staff for hands-on training. Program Awards: o Archie Wilkinson Bursary: Financial and performance-based. ▪ approx. 2950$ o 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: o Energy traveling through space, e.g., X-rays, gamma rays, and nuclear radiation. Types of Radiation: o Electromagnetic Radiation: Oscillating electrical and magnetic waves. o Ionizing Radiation: Penetrates body tissues and can damage DNA. Radiation Protection Principles Three Cardinal Principles: o Time: Minimize exposure duration.  o Distance: Increase distance from the source (Inverse Square Law). 2 𝐼1 𝑑2 ▪ 𝐼2 = 2 𝑑1 ▪ minimum of 6ft away Shielding: Use barriers such as lead walls, aprons, and gloves. o Optimization: o Techniques such as higher kVp, lower mAs, and collimation reduce exposure. o ALARA (As Low As Reasonably Achievable) and ALADA (As Low As Diagnostically Acceptable) principles guide practices. Radiation Dosimetry Personal Dosimeters: o OSL (Optically Stimulated Luminescent): ▪ Measures exposure via light emission proportional to absorbed radiation. ▪ More sensitive and accurate than TLD. o TLD (Thermoluminescent Dosimeter): ▪ Uses lithium fluoride crystals to track radiation absorption. o Dosimeter Usage: ▪ Worn between shoulders and waist, over clothing and under protective aprons if required. ▪ Stored on racks when not in use. Exposure Limits: o Workers: 20 mSv/year for the whole body. o Public: 1 mSv/year. ICRP International Commission on Radiological Protection ○ Fundamental principles of radiological protection limitation optimization justification ○ Benefits vs Risks principles the benefits must outweigh the risks Radiosensitive vs Radioresistent Radiosensitive in adult tissue: o gonads o blood-forming organs o blood Radioresistent in adult tissue: o bone o fat  o CNS Risks Types of Risks: o Deterministic: Certain. o Stochastic: Probability-based effects like cancer. Radiation Protection Devices Protective Barriers: o Lead walls, and concrete shielding in high-radiation areas. Beam Limiting Devices: o Collimators and filters to reduce scatter and unnecessary exposure. Immobilization Tools: o 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: o CAMRT: Professional body for radiation technologists. o CNSC: Canadian Nuclear Safety Commission. International: o ICRP: Sets global standards for radiation protection. Special Considerations Pregnancy Policy: o Notify program coordinator upon confirmation. o Additional monitoring for fetal exposure. Ten Commandments of Radiation Protection: o 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. o Commonly used nowadays in modern hospitals 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: o Reception, changing rooms, and waiting areas. o Imaging modalities: X-ray, CT, MRI, Mammography, Ultrasound, Nuclear Medicine. o 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: Commonly combined areas o Preparation: IV access for certain imaging modalities. o 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: o patient details: name, DOB, ID number o physician's name, license number and signature o issued date o exam requested o clinical info o allergies o pregnancy o mode of transportation Individual Prescription: Targets a single patient, derived from prior medical assessment. It is written or verbal ○ Verbal needs to be transcribed into the patient’s file and the sent to the RIS ○ Text messages from a mobile device is valid Electronic signatures from the MD are not valid No limited time unless specified by the prescriber Collective Prescription: Authorized for a group, often used in routine or emergency scenarios. To promotes interdisciplinarity Does not require to be evaluated by an MD beforehand Patient Identification Verification through multiple identifiers: name, DOB, and healthcare ID. o Double Identification  In special cases (e.g., unconscious or pediatric patients), rely on medical records or family input In the OR the MIT must ask the nurse or the anesthetist to identify the patient o May also refer to the medical chart or hospital card Consent Types Simple Consent: oImplied: Based on patient actions or in the case of an unconscious patient. o Expressed: Verbal acknowledgment, no need for it to be written. Informed Consent: o Special forms need to be signed by the patient ▪ if the patient is incoherent, does not understand the language or is underage at the time of consent it is nulled ▪ must be obtained in patient’s own language oRequired for invasive procedures. o Must detail risks, benefits, and alternatives in clear language. o Patient autonomy and understanding are paramount. Inadequate or Ignorant Consent o When the patient is not informed properly to make a responsible decision ▪ The MIT or MD can be accused of negligence or unintentional tort ▪ if any injury battery can be charged ▪ translation from a translator does not count as consent CAMRT Informed Consent Capability Voluntary Informed ○ information provided must be accurate and reflective of what was discussed 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: o Enhances communication, reduces errors, improves patient-centered care, and fosters respect across professions. Patient-Centred Care Listening to patients and family Engaging them when making care decisions Balance between professional knowledge and personal knowledge Focus on the patient’s goals Interpersonal Skills Verbal and nonverbal communication Handle conflict Teamwork Empathy Listening Positive attitude The Code of Ethics CAMRT and OTIMROEPMQ ○ recognize and respect other members of the healthcare team ○ collaborate with other healthcare members ○ Interprofessional team recognizes one's competence Sop, General Standard ○ interprofessional multidisciplinary team same field or closely related ○ intraprofessional interdisciplinary team different fields overlap and harmonize 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. Critical Thinking Observation Analysis Interference Communication Problem-solving ○ Examples: 1. Analytical thinking: Being able to properly analyze information is the most important aspect of critical thinking. This implies gathering information and interpreting it, but also skeptically evaluating data. 2. Ability to solve problems: The ability to correctly analyze a problem and work on implementing a solution is another valuable skill. 3. Good communication: good communication is crucial in the critical thinking process. Getting people to share their ideas and information. If you’re making a work-related decision, proper communication with your coworkers will help you gather the information you need to make the right choice. 4. Creative thinking: Being able to discover certain patterns of information and make abstract connections between seemingly unrelated data will improve your critical thinking by identifying trends. When analyzing a work procedure or process, you can creatively come up with ways to make it faster and more efficient. Creativity is a skill that can be strengthened over time. 5. Open-mindedness: By acknowledging the biases that may be caused by previous education and life experiences, your ability to objectively evaluate certain situations improves thus your critical thinking and overall decision process gets better 6. Asking thoughtful questions: In both private and professional situations, asking the right questions is a crucial step in formulating correct conclusions  Open-ended questions: Asking open-ended questions can help the person you’re communicating with provide you with relevant and necessary information. These are questions that don’t allow a simple “yes” or “no” answer, requiring the person who receives the question to elaborate on the answer. Outcome-based questions: When you feel like another person’s experience and skills could help you work more effectively, consider asking outcome-based questions. Asking someone how they would act in a certain hypothetical situation will give you an insight into their own critical thinking skills and help you see things you hadn’t thought about before. Reflective questions: You can gain insight by asking a person to reflect and evaluate an experience and explain their thought processes during that time. This can help you develop your critical thinking by providing you real-world examples. Structural questions: An easy way to understand something is to ask how something works. Any working system results from a long process of trial and error and properly understanding the steps that needed to be taken for a positive result could help you be more efficient in your own endeavors. 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. The Law  Rules to protect the rights of the public Statutory law ○ written law set down by governing authorities Common law ○ body of law that has involved judgement in individual legal disputes Two major classifications: Criminal law ○ criminal behaviour against society or a member of society that is prohibited by common law Civil law ○ broken when another’s private legal rights have been offended Litigation Act, process or practice of settling a dispute in court Most common in radiology ○ patient falls ○ error in medication Torts in Radiology Torts mean wrong or injustice purpose is not to punish the wrongdoer but to provide compensation to victims of their losses o civil harm that causes a claimant/patient to suffer a loss or harm Unintentional Torts: o Associated with negligence and occurs when the wrongdoers do not intend to cause harm, such as improper patient handling or inadequate radiation protection. ▪ negligence is a failure of care resulting in injury to another person or to others ▪ MIT is 100% responsible in civil law for negligence Intentional Torts: o Forcing unwanted medical care on a patient o Including assault (verbal threats), battery (unauthorized touching), and false imprisonment (restraining without consent). o Battery is defined as offensive touching without consent causing bodily harm ▪ most common intentional tort is batter o False imprisonment is when a patient wants to leave and is not allowed to do so o Most common in patients who are unable to cooperate: intoxicated patients, senile and pediatric Defamation A breach in patient confidentiality two actions that create apprehension in a patient are ○ haste and lack of preparation Libel  ○ written defamation about a patient Slander ○ untruthful oral statement about a patient Professional Ethics Governed by CAMRT and OTIMROEPMQ codes: o Uphold patient rights, confidentiality, and professional integrity. o Follow legal requirements like the Charter of Rights and Freedoms and provincial laws. Medical Law Respondent Superior: Employers may be liable for employee actions. o master speaks for the servant Res Ipsa Loquitur: Shifts the burden of proof to healthcare providers in cases of evident negligence. o patient could not have contributed to their injury in any way o the thing speaks for itself Code of Ethics Utilitarianism o maximize benefits or minimize harm o the largest number of persons is benefitted Deontology o duty/obligation o rules are to be always followed Ethical Dilemmas Autonomy ○ Patients have the right to make decisions concerning their lives Beneficence ○ All acts are meant to attain beneficial results, prevent harm or do the greatest good for the patient Confidentiality ○ All patients have the right to have information concerning their state of health and personal information kept private Double effect ○ Some actions may produce a good or bad effect Fidelity ○ The duty to fulfill one’s commitments Justice ○ All persons being treated equally according to need Nonmaleficence ○ The duty to abstain from inflicting harm Paternalism  ○ To make justifiable decisions without consulting the person affected Sanctity of Life ○ Life is the highest good and nobody has the right to judge another person’s quality of life Veracity ○ Honesty in all aspects Respect for Property ○ Keeping patients’ belongings safe ○ Not intentionally damaging/wasting equipment/supplies Rights of Patients Acting as a Diagnostician: o MITs must not provide results, impressions, or diagnoses; this is the radiologist's responsibility. Obtaining Consent: o Secure consent from women of childbearing age before performing diagnostic imaging. Screening for Contraindications: o Collect a complete medical history, especially before administering iodinated contrast agents, to check for allergies or medication interactions. Procedure Explanation: o Clearly explain the diagnostic imaging procedure to the patient beforehand. Patient Identification: o Accurately identify the patient before conducting any examination. Documenting Technical Factors: o Record technical parameters to assist with dose calculations if needed. Maintaining Privacy: o Protect the patient’s physical privacy during the procedure to uphold dignity. Radiation Safety: o Deliver the lowest radiation dose possible while ensuring diagnostic-quality images. 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: o Sponges: Support specific projections like lateral hand or chest X-rays. o Sandbags: Prevent unwanted movement, ideal for extremity imaging. o Tape and Velcro Straps: Ensure stability for pediatric and challenging cases. o Callipers: Measure patient thickness for accurate exposure settings. Radiation Protection Accessories: o Lead Aprons, Gloves, and Shields: Essential for patient and technologist safety. o Thyroid and Gonadal Protection: Mandatory during specific exposures. o Leaded Goggles: Reduce ocular scatter radiation. X-ray Accessories: o 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): o Uses a fan-shaped X-ray beam for cross-sectional imaging. o Eliminates structural superimposition, providing detailed images of organs and tissues. o Each time the X-ray tube and detector make a 360°, one image is acquired o Applications: Trauma, oncology, and vascular imaging. 2. Magnetic Resonance Imaging (MRI): o MRI screening questionnaire MRI uses very strong magnetic fields therefore strict attention is used to evaluate whether the patient is suitable to enter the MRI suite o Non-ionizing modality using magnetic fields and radio waves. o Another computed-based cross-sectional imaging modality is the most advanced and highly demanding medical procedure practiced in Canada o Superior for imaging soft tissues like the brain, spine, and muscles. o Challenges: Long exam durations (15 mins to one hour) and contraindications due to metallic implants. o MRI advantages compared to CT:  o Direct multi-planar imaging No bone or air artifacts nonionizing radiation o Disadvantages: There are more contraindications for MRI exams than CT exams MRI is also a noisy exam; intolerable for many. Earplugs are given to the patient or Headphones can help claustrophobic patients 3. Ultrasound (US): o Also known as sonography o Non-ionizing, high-frequency sound waves that penetrate the body (can not penetrate bone) to visualize soft tissues, organs, and blood flow. o A transducer is placed against the patient’s skin and swept back and forth at different angles to image the area of interest o The transducer also detects back sound waves as they bounce or “echo” off the different tissues in the scan area. o A clear acoustic gel is applied to the area of interest before the transducer comes in contact with the skin to create an air-free “connection” between the transducer & skin o Commonly used in obstetrics, vascular studies, and interventional procedures. 4. Bone Densitometry (DXA): o a general term that encompasses the art and science of measuring the bone mineral content (BMC) and bone mineral density (BMD) of specific skeletal sites or the whole body o The information acquired through these exams is used to assess bone strength, assist with the diagnosis of diseases associated with low bone density (especially osteoporosis), monitor the effects of therapy for such diseases, and predict the risk of future fractures. o The imaging technique that is mostly used in bone densitometry is dual-energy x-ray absorptiometry (DXA) o This procedure has the advantages of low radiation dose, wide availability, ease of use, short scan time, high-resolution images, good precision, and stable calibration. 5. Angiography & Interventional Radiology: o Focuses on vascular imaging and minimally invasive therapeutic procedures like stent placement and embolization. o Diagnosis of blood vessel diseases such as arteriosclerosis and atherosclerosis o Angioplasty of blocked vessels: Re-expansion of narrowed or closed passages, often in vessels but it can be in other body regions o Stent placement in blocked vessels: permanent implanted devices that prevent stricture narrowing or closure of openings in anatomy or vessels o Filter placement: prevents blood clots from traveling in the body to critical organs like the lungs, heart and brain via the circulatory system o Stroke analysis and treatment o Chemoembolization/radiotherapy  o Embolization of blood vessels o Pain management/therapeutic injections o Catheter placement for administration of meds o Catheter placement for dialysis Drainage catheter placements Biopsies 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 Pink: Pediatric emergency. Code Lavender: Neonatal emergency. Code Red: Fire. Code White: Violent incident. Code Yellow: Missing patient. Code Black: Bomb threat. Code Brown: Dangerous material spill Code Orange: External disaster Code Grey: External toxic gas Code Green: Evacuation Code Silver: Active shooter 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. o function of OTIMROEPMQ: ▪ Supervise the admission to the profession (competencies of candidates) and the practice of the profession ▪ Support continuing professional development ▪ Watch over illegal practices of the profession (sanctions) 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. OTIMROEPMQ Code of Ethics & Professional Conduct DIVISION II INTEGRITY ○ 10. An MIT shall carry out his professional duties with integrity. (honesty) Having honesty and integrity not only creates value in every communication, but it also leads to build the foundation of trust and confidence. ○ 11. An MIT shall avoid any false representation with respect to his level of competence or the efficacy of his services or those generally provided by the members of the Order or persons who carry on their professional activities within the same partnership or joint-stock company as him. If the good of a client so requires, he shall refer the client to another member of the Order, to a member of another professional order or another competent person ○ 12. An MIT shall seek to obtain full knowledge of the facts where a client or another professional asks his advice or opinion in the practice of his profession. Legis Quebec: ○ the legislature of the province of Quebec an organized body having the authority to make laws for a political unit o Consists of two elements: ○ the monarch of Canada, represented by the Lieutenant Governor of Quebec ○ the National Assembly of Quebec. Lecture 12: OTIMROEPMQ Code of Ethics Core Ethical Principles 1. Integrity: o Honesty and professionalism in all activities. o Avoid misrepresentation of skills or services. 2. Confidentiality: o Protect patient information under all circumstances. o Violations may lead to legal consequences. 3. Patient-Centered Care: o Respect for autonomy and informed decision-making. o Clear communication about procedures and outcomes. 4. Diligence and Professionalism: o Respond promptly to patient needs. o Maintain competence through ongoing education. 5. Professional Boundaries: o Avoid conflicts of interest. o Prioritize patient welfare over personal gain.