1. Why is CAMRT taking this position now?
Over time, there was mounting research evidence indicating a practice change in gonadal and fetal shielding for patients was required. CAMRT reviewed the literature, consulted with shielding experts, obtained feedback from MRT regulatory bodies and CAMRT members (e.g., Professional Practice Advisory Council and Advocacy Advisory Council), and held discussions with other stakeholder organizations to derive the necessary information for evidence-based decision making. From this information collection process, CAMRT determined it was essential to evaluate and consider its position regarding gonadal and fetal patient shielding to provide best practice information to its membership.
2. Is CAMRT the authority that determines shielding practice within my province, territory or facility?
CAMRT is not the authority that determines shielding practice within a province / territory or facility. MRTs practice is determined at the provincial level and by their employers. It is imperative that MRTs work within the scope of practice as set by their regulatory body (where such organizations exist), be aware of and follow all pertinent legislation related to their practice, and follow their facilities policies and procedures at all times.
3. How can I use this position statement?
This position provides a clear recommendation based on a rigorous assessment of the current scientific literature on shielding. Depending on your local practice, this position, and the literature sources provided within, can either be used to support policies in place or advocate for the suggested change with the appropriate authorities and/or your facility’s medical imaging leadership team.
4. What can I do as changes are made to my facility’s gonadal and fetal shielding policies and procedures?
CAMRT recommends that all frontline imaging personnel be educated as to why practice change in shielding is being made within their facilities.
The CAMRT position statement was not an arbitrary decision. It is based on an accumulation of rigorous research conducted over decades that was reviewed by experts in the field. The position statement contains references to key peer-reviewed articles addressing the professional practice topic, providing the basis for education. In addition, CAMRT has provided some additional education material available to members, such as a continuing professional development webinar.
5. How can I educate patients to help them understand these changes in a long-standing practice?
The best course of action is to approach this patient education as you would any other patient education. CAMRT provides a patient education best practice guideline that can support local efforts. CAMRT has also built a series of MRT resources related to shielding practice that can be used to support plain language conversations with patients.
6. Once our departmental policies have changed to reflect this position statement, should shielding be used on pediatric patients?
Gonadal and fetal shielding of pediatric patients should not occur as described by the evidence presented in the position statement.
7. Once our departmental policies have changed to reflect this position statement, should shielding be used on pregnant patients?
Gonadal and fetal shielding of pregnant patients and their fetus / embryo should not occur as described by the evidence presented in the position statement.
8. How should I respond if a patient demands shielding after I have explained the rationale for the change?
Ultimately it is the patient’s right to choose the care they receive and we would recommend shielding be provided assuming the anatomy of interest would not be obstructed within the intended field of view.
9. Should technologists and other healthcare providers continue to wear lead aprons while working?
Yes, recommendations made within the position statement do not apply to how technologists and other healthcare providers protect themselves from occupational radiation exposure.
10. Should I provide a lead apron to a parent and any companion that attends the appointment?
Yes, as the parent and others attending do not receive any benefit from the imaging examination they should be protected from all unnecessary radiation.