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This is the second edition of the Medical and Dental Guidance Notes (MDGN), created by an IPEM working group. Following publication of the first edition in 2002, this edition addresses the safe use of ionising radiations (e.g., radioactive substances, X-rays, protons, neutrons, and electron beams) in the UK but does not address lasers, MRI, ultrasound, ultraviolet, or other non-ionising radiations. These notes include general best practices of the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2017, but they do not repeat or interpret legal requirements and guidance in the legislation. Topics covered include safe diagnostic X-ray procedures, radiotherapy, nuclear medicine, Positron Emission Tomography, and radioactive substance contingency planning. Following the instructions is optional but should be enough to comply with the law. Legally responsible parties should familiarise themselves with the legislation through this means.
Key Features
- Retention of current advice where it is still best practice
- Updated advice to cover new radiation regulations
- Updated advice on new imaging modalities and hybrid imaging
- Updated advice on therapeutic nuclear medicine, covering the new radiopharmaceuticals now in use
- Close liaison with the UK regulators in the revision
Preface
Acknowledgements
Editor biography
IPEM working group
List of contributors
Introduction
1 General measures for radiation protection
2 Radiation protection of persons undergoing exposures
3 Diagnostic radiology (excluding dental) and fluoroscopically guided interventions
4 Diagnostic radiology (excluding dental) and fluoroscopically guided interventions x-ray equipment management
5 Dental radiography
6 X-ray equipment for dental radiography
7 Radiotherapy
8 Radiotherapy and brachytherapy equipment
9 Brachytherapy sources
10 Diagnostic uses of open radioactive substances
11 Positron emission tomography
12 Preparation of radiopharmaceuticals
13 Therapeutic uses of open radioactive substances
14 Ionising radiation protection in general laboratories
15 Diagnostic uses of sealed or other solid radioactive sources
16 Patients leaving hospital after administration of radioactive substances
17 Precautions after the death of a patient to whom radioactive substances have been administered
18 Keeping, accounting for, and moving radioactive substances (including transport)
19 Accumulation and disposal of radioactive waste
20 Contingency planning and emergency procedures for radioactive substances activity
Appendix 1: Roles and responsibilities of the employer using ionising radiation
Appendix 2: Ionising radiation protection and medical exposure policy
Appendix 3: The role of the radiation protection adviser
Appendix 4: Examples of dose calculations for risk assessments
Appendix 5: Radiation risk assessment pro-forma
Appendix 6: Designation of controlled and supervised areas
Appendix 7: Warning signs and notices
Appendix 8: Identifying persons exposed to ionising radiation
Appendix 9: Aide memoire to developing a policy on cooperation between employers (CBE)
Appendix 10: Record keeping
Appendix 11: Example pre-work checklists for outside radiation workers and trainees
Appendix 12: Incidents and shared learning
Appendix 13: The life cycle of imaging systems
Appendix 14: Issues to consider when writing IR(ME)R Employers procedures
Appendix 15: Example pre-work checklists for outside radiation workers and trainees
Appendix 16: Example pre-work checklists for outside radiation workers and trainees
Appendix 17: Basic x-ray benefit and risk information
Appendix 18: Example IR(ME)R audit: procedures and document control
Appendix 19: Guidance on medical research exposures
Appendix 20: Dosimetry in radiomolecular therapy
Appendix 21: The role of the radioactive waste adviser
Appendix 22: Authorities and organisations of interest
Appendix 23: Acts and regulations in the United Kingdom
Appendix 24: List of acronyms and abbreviations