Answer to Question #348 Submitted to "Ask the Experts"

Q

The NCRP Report #54 does not clearly present guidelines for ascertaining pregnancy status. I am looking for any model procedure or policy for screening women of childbearing age or pregnancy prior to having an x ray. My facility currently has a policy to x ray everyone regardless of her pregnancy status. "If the doctor orders the x ray there is a reason, and the x-ray technicians should not question that judgement." How can the x-ray technologists legally protect themselves from being held liable? Thank you for your assistance.

A

We went to the American College of Radiology (ACR) for information on this topic. The ACR has two policy statements regarding pregnancy. Both basically say that the facility should have a policy. I am copying the pertinent parts of the statements given by the ACR. You may wish to visit its site by clicking on the ACR name above. The ones I am reproducing and other information can be found on the site under "Products."

Facility Policy on Imaging Pregnant Women—"The following statement regarding pregnancy is to be included in all of the standards of the American College of Radiology involving the use of ionizing radiation, with the exception of Radiation Oncology. All existing ACR standards involving ionizing radiation will be revised to include this statement. 'All imaging facilities should have policies and procedures to reasonably attempt to identify pregnant patients prior to the performance of any diagnostic examination involving ionizing radiation. If the patient is known to be pregnant, the potential radiation risks to the fetus and clinical benefits of the procedure should be considered before proceeding with the study.'" (Res. 24, 1995)

Abdominal Radiologic Examinations of Women of Childbearing Age and Potential—"The interruption of pregnancy is rarely justified because of radiation risk to the embryo or fetus from a radiologic examination, these examinations having been carefully planned with full consideration of the clinical status, including the possibility of pregnancy. The appropriateness and extent of the examination should be guided by the informational requirements predicated by the patient’s current illness; 1988 - (Res. 36)."

Genevieve S. Roessler, PhD
Editor HPS website