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Medical Ionising Radiation and the Role of the Medical Council

Following the introduction of the European Communities (Medical Ionising Radiation) Regulations 1988 SI No 189 of 1988, the Medical Council was deemed to be the competent authority to oversee the regulations in Ireland.  Both SI No 189 of 1988 and SI No 250 of 1998, relating to MIR, were revoked with the introduction of SI No 478 of 2002

The Council must ensure compliance with SI 478 of 2002 and maintain standards in individual practice. 

The Council identified the following key areas:

  • Criteria for Clinical Audit
  • Written Protocols
  • Diagnostic Reference Levels
  • Dose Constraints for “Helpers”
  • Guidelines on Procedures to be conducted on Pregnant and Breast Feeding Females
  • Fluoroscopic Devices
  • Radiation Safety Courses
  • Medical Council Policy Document

The following documents were adopted by Council :

  • Criteria for Clinical Audit were adopted by Council in October 2004 and the first clinical audit was due by 11 October 2007. 
  • A document entitled:  “Protocols for Standard Radiological Practice – Good Practice Guidelines as defined by SI 478 of 2002” was adopted by Council in November 2004.   
  • Position Paper on Diagnostic Reference Levels (DRLS) under Article 11.1 of SI 478 of 2002 – the new procedures outlined in this document were adopted by Council in September 2004 and their use must be promoted by circulation to the profession
  • Position Paper on Dose Constraints for ‘Helpers’ under Article 4.2, 12.1 and 12.2 of SI 478 of 2002 – adopted by Council in September 2004
  • Fluoroscopic Devices - Correspondence was received from the Faculty of Radiologists confirming that no fluoroscopy equipment without image intensification are in use within the State and there are no circumstances that would warrant the use of fluoroscopic devices which do not have a dose control device.  This correspondence was deemed satisfactory by Council.
  • A revised Medical Council Policy Document was adopted by Council in October 2004. 

WHO CAN ADMINISTER MEDICAL IONISING RADIATION PROCEDURES?

Medical Ionising procedures may be prescribed by a registered medical practitioner or registered dental practitioner.

Medical Ionising procedures may be carried out by:

  • A Practitioner who is recognised by Comhairle na nOspideal as qualified for consultant appointments in the specialties of Radiology and Radiation Oncology;
  • A trainee Radiologist or Radiation Oncologist under the guidance of a qualified Practitioner (as referred to above);
  • Certain practical aspects of any MIR procedure may be delegated by a qualified Practitioner (as referred to above) to other qualified persons.  These ‘other qualified persons’ are defined in Articles 7 and 13 of SI 478 of 2002.  They must have successfully completed a course in Radiation Safety recognised jointly by the Medical Council and the Faculty of Radiologists.  However, they can only perform these procedures in the presence of a Radiographer.

All of the above must ensure that the benefits of the procedure outweigh any detrimental effects caused by exposure to radiation.  They must also administer as low a dose  as possible.


MEDICAL IONISING RADIATION SAFETY COURSES

All individuals who use radiology equipment must successfully complete a course in radiation safety recognised by either the Medical or Dental Council.  It is the responsibility of all organisations employing individuals to operate radiation equipment to ensure that such operators have completed an appropriate course.  The hospitals notify the Medical Council of every radiation course they hold and provide a list of attendees.