Sec. 10.32.10.10. Scope of Practice — Nuclear Medicine Technology

A. The scope of practice of nuclear medicine technology includes the following:

(1) Scope of practice for diagnostic in-vivo procedures and in-vitro procedures which includes:

(a) Analysis and correlation of procedure request and clinical information provided by the referring physician or patient, or both, for determination of appropriate exam, extent, and scope;

(b) Evaluation of the physical and emotional status of the patient with respect to the ability to undergo the procedure requested;

(c) Immediate predose review of patient's identification, prescribed dose quantity and route of administration, and identification of the test agent designed to prevent dose misadministration;

(d) Preparation of the appropriate radiopharmaceutical with measurement of dose activity;

(e) Administration of appropriate diagnostic dose levels of radiopharmaceuticals;

(f) Administration of nonradioactive pharmaceuticals utilized in conjunction with a nuclear medicine imaging or in-vivo procedure, for example, cholecystokinin, furosemide, vitamin B12, in accordance with hospital or facility procedures, excluding narcotic and sedating medication;

(g) Selection of appropriate imaging or test parameters, or both;

(h) Obtaining images according to established protocols and any special views to optimize information as appropriate;

(i) Placement of patient in proper position using supportive materials and immobilizer as necessary;

(j) Assuring appropriate image labeling as to patient identification, position, and appropriate anatomic land marks for each view;

(k) Evaluation of images or data, or both, for technical quality;

(l) Recognition of unusual variances in the images or data, or both, caused by instrumentation malfunction and initiating appropriate action;

(m) Monitoring of patient and equipment during procedure for determination and application of any corrective actions necessary;

(n) Monitoring of data collection and processing and performance of technical analysis of test results;

(o) Preparation and performance of laboratory in-vivo nuclear medicine procedures, inclusive of the selection and operation of laboratory counting equipment, performance of calculations and data processing necessary for completion of lab procedures and the submission of results to the physician or licensee;

(p) Oversight and application of image development; and

(q) Performance of in-vitro testing of serum, plasma, or other body fluids using radio immunoassay, or similar ligand assay methods;

(2) Scope of practice for handling radiopharmaceuticals which includes:

(a) Preparation, by means of tagging, compounding, etc., in accordance with manufacturer's specifications;

(b) Measurement and calculation of activity of radionuclides with a dose calibrator;

(c) Application of radioactive decay calculations to determine required volume or unit form necessary to deliver the prescribed radioactive dose; and

(d) Recording of radiopharmaceutical information on a patient's permanent record;

(3) Scope of practice for radionuclide therapy which includes:

(a) Assisting licensed physician in the preparation and applications of therapeutic radionuclides;

(b) Oversight of radiation safety practices related to the handling and administration of radiopharmaceuticals for therapy of patients;

(c) Management of transportation and handling of therapeutic radiopharmaceuticals;

(d) Calibration of therapeutic radiopharmaceuticals for dose accuracy; and

(e) Radiation monitoring, decontamination, disposal, and patient follow-up as appropriate and required;

(4) Scope of practice for radiation safety which includes:

(a) Maintenance of records of radioactive material receipt, use, storage, and disposal in accordance with regulatory requirements;

(b) Oversight and enforcement of radiation safety policies, practices, and regulations regarding the possession and use of radioactive materials; and

(c) Performance of radiation safety procedures such as radiation survey and wipe testing of incoming radioactive shipments and facility fixtures;

(5) Operation of a hybrid nuclear medicine/CT device for a nondiagnostic attenuation correction CT without intravenous contrast; and

(6) Performing any other duties that the Board determines may be performed by a nuclear medicine technologist.

B. The scope of practice of a nuclear medicine technologist includes operation of a standalone CT or hybrid nuclear medicine/CT device for a diagnostic CT with or without intravenous contrast if the nuclear medicine technologist:

(1) Has successfully passed the ARRT or NMTCB specialty exam for CT; and

(2) Administers contrast media after consultation with, and under the supervision of, a physician who is immediately and physically available.

C. In order to meet the eligibility requirements to sit for the ARRT or the NMTCB post-primary CT examination, a licensed nuclear medicine technologist may perform all procedures involving diagnostic CT with or without intravenous contrast only under the direct supervision of a:

(1) Licensed nuclear medicine technologist with the post-primary CT credential;

(2) Licensed radiographer with the post-primary CT credential; or

(3) Licensed radiologist.