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13/05/2020

To date, questions from CT radiographers have all been related to PPE but the following resources are likely to be particularly useful if you are working in CT.

Good governance during this pandemic will ensure that everyone understands their responsibilities, stays safe and ensure patients continue to receive safe and high quality care. It will also help to make the best use of resources available.

The following links to our regularly updated information pages may be of use to CT Service Leads:

  • Joint guidance on performing CT colonography in the early recovery phase of the Covid-19 pandemic:British Society of Gastrointestinal and Abdominal Radiology & Society of radiographers May 2020 
  • SoR guidance on Personal protective equipment (PPE)
  • Guidance for Pre-Operative Chest CT imaging for elective cancer surgery during the COVID-19 Pandemic
  • Clinical guide for the management of Radiology patients during the coronavirus pandemic (which includes a radiology decision making tool)
  • SoR Article: Summary of current and emerging issues for radiographers
  • RCR advice on non-urgent and cancer imaging during the coronavirus pandemic
  • SoR guidance on IR(ME)R
  • SoR guidance for returners to practice; retired radiographers; registered radiographers in other work areas

Please also see our FAQs on common employment questions here.

For guidance on infection control, please see the following webpages:

  • SoR advice on contact with infected patients or suspected cases
  • SoR guidance on infection prevention and control responsibilities
  • Government guidance for health professionals

Further information:

A role for CT in COVID-19? What data really tell us so far

CT chest screening for Covid-19

The Royal College of Radiologists (RCR) have released guidance for the increase in requests for pre-operative chest CT for Covid-19.

“The relatively low pick up rate of Covid-19 in asymptomatic patients with positive RT-PCR and a 20% false negative rate in symptomatic patients, indicates that pre-operative CT chest is of limited utility,” the guidance says.

Read the full Statement on use of CT chest to screen for Covid-19 in pre-operative patients.
 

  • Can I can work on a diagnostic CT scanner as a therapeutic radiographer?

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    Q. I am a therapeutic radiographer and I have completed a post-grad qualification in CT. Does this mean I can work on a diagnostic CT scanner?

    A. The Society and College of Radiographers has received requests from members about the need for clarification on whether a therapeutic radiographer who uses CT as part of radiotherapy planning for cancer patients, can then also use a diagnostic CT scanner to image non-cancer patients with the aim to diagnose other conditions.

    SCoR does not advocate this change in or transfer of skills for any therapeutic radiographer to 'effectively' work as a diagnostic radiographer.

    There are many reasons for this stance:

    • There are two distinct radiography professions: Diagnostic or Therapeutic Radiography with two distinct UK regulated protected titles from the Health and Care Professions Council.
    • The Ionising Radiations (Medical Exposure) Regulations 2017 (2018 in Northern Ireland) defines 'adequate training' in Schedule 3 as the skills and underpinning knowledge both in a theoretical and practical comprehension. Therapeutic radiographers use CT as an imaging tool in the planning and preparation of a radiotherapy treatment regime only. The knowledge and skills required to use CT in this way relate solely to cancer treatment planning as the 'pathology' that has already been diagnosed and staged. In this way CT, as the imaging tool, is used to geometrically and dosimetrically plan the Gross Tumour Volume, the Planning Target Volume, and the relevant Organs at Risk before any type of radiotherapy is delivered to a patient with cancer. SCoR see the Scope of Practice of a Therapeutic Radiographer working and practising within a patients’ cancer pathway.
    • The Standards of Proficiency from the Health and Care Professions Council (as the regulatory body for radiographers working in the UK ) are quite different in the approach to using a CT scanner as an imaging tool in the two radiography professions:
      • Therapeutic Radiographers must have a knowledge of cross sectional anatomy and use CT to define targets; verify optimal radiotherapy beam positions with appropriate immobilisation techniques; and prepare final radiotherapy prescriptions aiming to optimise effective tumourcidal doses whilst minimising doses to normal anatomical structures. Radiotherapy CT is both a planning and a verification (simulator) tool prior to delivery of treatment and is a requirement for complex treatment regimens such as image guided radiotherapy; stereotactic radiotherapy, and SABR.
      • Diagnostic Radiographers use CT to diagnose various other pathologies as well as cancer and as such must have a detailed knowledge of cross sectional anatomy and be able to distinguish disease and trauma processes as they manifest on diagnostic images. Recognition and identification of abnormality are skills that improve with experience. The diagnostic CT radiographer must understand medical terminology and abbreviations across a very broad range of pathologies, some of which will be related to cancer, but others will not. Diagnostic radiographers often draw upon a body of knowledge acquired whilst experiencing a wide range of imaging techniques pre and post registration. In order to produce high quality CT images safely and with an optimised dose in keeping with the principles of ALARP, they will apply their anatomical, physiological and radiographic knowledge to ensure the scan is appropriate, justified and meets the needs of the patient. Patients who require diagnostic CT imaging are often very sick and may present with immediate life limiting and life changing conditions as well as being trained in Advanced Trauma Life Support (ATLS) or Advanced Life Support (ALS) or Intermediate Life Support (ILS). The CT Radiographer must demonstrate an aptitude for rapid and effective, sometimes complex decision making, to pre-empt and avoid non-intended outcomes. The workload in diagnostic CT services can demand rapid turnaround and flexibility to adapt workflow to meet dynamically changing priorities. CT radiographers require additional training to operate peripheral devices such as electrocardiogram (ECG) machines and contrast agent delivery systems safely. Radiographers must be aware of the national and local diagnostic reference levels (DRLs) and dose constraints established for the examinations they undertake, particularly in relation to children and young adults.

    All Radiographers have a duty to practice safely and effectively within their own scope of practice. This relates to both the range of patient morbidities and the imaging tools used to either diagnose or treat patients.

    The CoR document, The role of the Radiographer in CT, is recommended reading for all radiographers. It includes details of the National Occupational Standards (NOS) in CT.

  • Where can I find image appearances of COVID 19?

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    Radiopaedia has summary information and a quick reference guide to COVID 19 including case studies

    A special report by the European Society of Radiology (ESR) dedicated to radiology fighting COVID-19

    e-Learning for Healthcare has new Covid-19 specific material to support radiographers

     

  • Workforce, Governance and Regulations

    • MHRA website for reporting medicine side-effects and equipment incidents
    • Common employment questions
    • COVID testing for staff
    • Health and Safety Executive: Covid-19 RIDDOR Advice
    • Information governance
    • IR(ME)R
    • Guidance for the clinically extremely vulnerable (CEV)
    • Pregnancy
    • Radiology Service Managers
    • Returners to practice; retired radiographers; registered radiographers in other work areas; and volunteers
    • Sick leave and time off
    • Social Partnership Forum pandemic working guidance
    • National staff council terms and conditions
    • SoR members administering covid-19 vaccines
    • The Quality Standard for Imaging (QSI)
  • Infection control and PPE

    • Cleaning and decontamination of equipment
    • Contact with infected patients or suspected cases
    • Infection prevention and control responsibilities
    • Personal Protective Equipment (PPE)
    • PPE and the importance of workplace risk assessments
    • PPE guidance posters for imaging and oncology teams
    • PPE: Urgent update for members
    • NHS staff urged to have flu vaccine
    • Resuscitation Council UK Statement on PHE PPE Guidance
    • SoR backs call for upgrade in PPE for healthcare staff
    • Treating patients who refuse to wear a mask or suitable face covering
  • Radiotherapy

    • Radiotherapy services
  • Diagnostic Radiography

    • Imaging and interventional radiology
    • Breast screening and mammography
    • IV administration
    • MRI
    • Nuclear medicine
    • Nuclear medicine hints and tips
    • Screening restart
    • Ultrasound
    • CT
    • General radiography
  • Education and students

    • e-Learning for Healthcare
    • Image interpretation resources
    • Planned placement arrangements
    • Pre-registration education providers
    • Students: What you need to know
    • Student dos and don'ts during Covid-19
    • Student support guidance
    • CoR advice to education providers during the Covid-19 pandemic
  • Clinical Guidelines

    • RCR Guidance
    • Royal College of Surgeons Clinical guide to surgical prioritisation
  • HSC Northern Ireland

    • Breast screening
    • Guidance and Information
    • HSC questions and answers for health and social care staff
  • NHS Scotland

    • Covid special leave arrangements
    • National guidance for staff and managers
    • Covid-19 recruitment portal for former health staff and final year students
    • Scottish Terms and Conditions Committee
    • NHS pauses screening programmes across Scotland
    • NHS Scotland Psychosocial support and wellbeing - Looking after people, yourself, and your staff
    • COVID-19 eUpdates
  • NHS Wales

    • Health and Social Care in Wales – COVID-19: Looking Forward
    • Compassion starts with me - wellbeing resources, toolkits and guidance from across Wales
    • NHS Wales Colleague Health and Wellbeing
    • Student support guidance
    • FAQs
  • Wellbeing, emotional and mental health

    • Resilience and wellbeing
    • Wellbeing, emotional and mental health support and resources

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