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The National Council of Radiation Protection and Measurement (NCRP Report No. 39-1971), recommends that during the entire gestation period, the maximum permissible dose equivalent to the fetus from occupational exposure of the expectant mother, should not exceed 0.5 rem (500 millirems during the nine months of pregnancy).
If a radiographer uses the proper radiation protection measures, which include remaining in shielded areas, refraining from holding patients or image receptors during x-ray exposures she should not receive more than 30 millirems/ month. (This converts to approximately 360 millirems, or 0.36 rems per year, which is considerably below the limits of the cited NCRP report.) In keeping with the United States Nuclear Regulatory Commission Regulatory Guide 8:13, if a student becomes pregnant it is her choice whether to notify the Radiography Program and the clinical education site of her pregnancy.
If the student decides to notify the radiography program, she must do so in writing to the program director. The program director will in turn notify the clinical education site and schedule an appointment for the student with the radiation safety officer at the clinical education site. The radiation safety officer will advise the student of potential radiation risks to herself and her unborn fetus and explain the necessary radiation protection measures. The program director and radiation safety officer shall collaborate in a review of the previous occupational radiation exposure of the pregnant student.
Upon confirmation of pregnancy, the student will submit a statement from her physician, verifying the pregnancy and the expected due date. Following written declaration and formal verification of pregnancy, the student will review the following options regarding their continuance in the program with the program director:
- Immediate withdrawal from the radiography program
- Leave of absence from the program
- Continued full-time status with limited rotation in fluoroscopy, portable/surgery procedures, special procedures, CT scanning, including appropriate radiation safety precautions.
- Continued participation in the program without modification
The decision regarding the preceding options will ultimately be the student’s decision; tempered by the gestation period and the student’s level of progress in the program. The student will be required to sign a statement acknowledging explanation of options and her elected option.
If the pregnant student elects to continue, program faculty will make every attempt to schedule the student, at least for the first trimester of gestation, in areas which do not involve fluoroscopy, mobile/operating procedures, specialized procedures, or CT scanning. When it is necessary for the student to be scheduled in the aforementioned procedures, she must wear a lead apron of at least 0.25 mm lead equivalency, when performing radiologic procedures that do not permit protection by structural shielding (i.e. control booth).
In addition, the student will be monitored with a radiation monitoring device worn outside the lead apron, at the collar region, and another radiation monitoring device at the waist level, under the apron. A dosimeter may also be required by the Radiation Safety Office. These monitoring devices shall be worn during the entire gestation period, and the maximum permissible dose, equivalent to the expectant mother from occupational exposure, shall not exceed 0.5 rem (500 mrem). While not required, radiologic procedures and activities may be restricted when possible.
The program director will monitor the student’s radiation dosage to insure that compliance with stated radiation standards is being met. A student, who has previously notified the program director of her pregnancy in writing, may rescind her declaration of pregnancy at any time. The student, however, must notify the program director in writing of her decision to revoke her declaration of pregnancy. Following the student’s official retraction of her declaration of pregnancy, the lower dose limit for the embryo/fetus will no longer apply.
The physician’s statement shall be attached to this copy of the policy. The student must sign this copy as proof that she has read and understands the procedure. If the student withdraws from the program due to a pregnancy, she shall be given the option to reapply for reinstatement within a two-year period. A readmitted student, with a past good-standing status, shall be required to repeat that semester during which she left.
Pregnant students who elect to participate in all education phases with or without modifications are required to review the U.S. Nuclear Regulatory Commission “Regulatory Guide 8.13” which can be located at http://www.nrc.gov/docs/ML0037/ML003739505.pdf .
Safety Statement – Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI) is a diagnostic tool that utilizes a powerful magnet and radio waves to generate images of the body. The magnet used in MRI imaging is always turned on and certain implanted devices are considered incompatible with this technology. All students considering a career in medical imaging should be aware of the potential hazards of exposure to the MRI scanner and the need for careful metal screening prior to entering the AS in Radiography Program. For safety reasons, all students must be screened for metal, complete a metal screening history form and basic MRI safety training prior to entering clinical practicum. Additional information can be found at www.mrisafety.com or you may contact Lori Balmer with any questions at firstname.lastname@example.org.
MRI Metal Screening Form
Students with a positive metal history, as indicated by answering yes to questions on the Metal Screening Form will need to undergo additional screening by program faculty prior to beginning their MRI clinical rotation. Students should never enter the MRI scan area prior to completing the full screening process. Students may be asked to provide documentation of positive metal history prior to the start of their assigned MRI rotation. Certain implanted devices are contraindicated and should not be exposed to the magnetic field. Examples of these devices include:
- Neuro stimulators/Biostimulators
- Implanted Infusion Pumps/Pain pumps
- Aneurysm Clips
- Certain Stents, Coils and Filters
- Metallic Foreign Bodies
- Intraorbital Metallic Foreign Bodies
MRI Screening Policy
- All students enrolled in the medical imaging programs must complete an MRI Screening Form prior to beginning their scheduled MRI clinical rotation.
- Students who answer "yes" to any of the questions on the MRI Screening Form may be required to undergo additional screening to insure their safety.
- Additional screening may consist of further questions, documentation of metal and/or orbit x-rays for students with a history of intra-orbital metallic foreign bodies
- Students must complete a screening orbit x-ray exam (at their own expense) and provide written documentation to clinical faculty prior to the start of their MRI rotation.
- In the event the orbit x-rays are positive for metal, the student will need to complete an observation-only MRI rotation as a requirement of AHLT-R290.
- Students who refuse to complete orbit x-rays or provide written documentation will need to sign a refusal form which will be kept in the student’s file at IU South Bend. Their MRI rotation will be considered observation only. The student must agree not to enter the scan room under any circumstances.
- Faculty will notify the MRI Department of the student’s positive metal history and the need to complete an observation only clinical rotation in MRI.
All students enrolled in our medical imaging programs are required to a complete a clinical rotation in MRI as a requirement of successful completion of AHLT-R290. Failure to complete your scheduled MRI rotation will result in a grade of “I” incomplete which could delay your graduation.