Produce single photon emission computed tomography (spect) and single photon emission computed tomography (spect/ct) images for diagnostic purposes

SFHCI.L SFHCI.L This standard is concerned with the use of Single Photon Emission Computed Tomography (for gamma rays only) and Single Photon Emission Computed Tomography (for both gamma and X-rays) equipment and procedures to produce images for diagnostic purposes. It includes selecting the most appropriate scan protocol depending on the individual's condition and clinical history. Key people are those involved in the individual's care and others involved in provision of services. Users of this standard will need to ensure that practice reflects up to date information and policies.

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1. apply standard precautions for infection control and other appropriate

   health and safety measures

2. ensure all necessary preparations have been made by the individual

   and staff before starting the procedure

3. check and prepare the equipment required for the examination

4. ensure the environment is conducive to maintaining the privacy and

   dignity of the individual

5. check the identification details before commencing the procedure in

   accordance with local policies and procedures

6. introduce yourself and other members of staff present during the

   examination

7. communicate with the individual / key people to facilitate their

   understanding of and co-operation with the examination

8. establish the individuals capacity to understand the procedure with

   the help of key people if necessary

9. obtain valid consent for the procedure in accordance with national

   and local guidelines

10. respect the individuals privacy, dignity, beliefs and decisions

11. check individuals of child-bearing potential for pregnancy or

    possible pregnancy and breast feeding status, if appropriate to the

    examination, and take action in accordance with local protocols

12. confirm the status of key people before the examination and, where

    their presence is required, adhering to local guidelines

13. clearly explain the procedure and possible outcomes, including risk,

    benefits and limitations

14. check for any contraindications for the proposed procedure and

    take appropriate action in response to identified risks

15. prepare the site for intravenous access

16. obtain intravenous access using cannulation

17. administer radioisotopes using the appropriate equipment

18. obtain blood samples for radiolabeling and reinject radioactive blood

    into the individual

19. correctly place ECG stickers onto an individual in order to obtain a

    quality ECG trace

20. enter the identification details of the individual into the SPECT and

    SPECT/CT scanners or, if details have previously been entered, check

    them for accuracy

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21. accurately select all parameters required for the scan according to

    local scan protocols for the procedure, assess for any required

    modifications and take appropriate action

22. position the individual and adjust their clothing according to the

    protocols for the examination to be performed in a manner which allows

    an optimal outcome to be achieved while:

    22.1 recognising the individuals need to retain their dignity and selfrespect

    22.2 ensuring their comfort as far as possible

    22.3 preventing the appearance of artefacts

23. check the room prior to making the exposure to ensure that only

    essential, protected persons remain with the individual, that all local

    protocols have been adhered to and take appropriate action if this does

    not occur

24. commence the scan and monitor the individuals condition and

    compliance throughout the procedure and take action appropriate to

    their needs

25. view the images on completion of the scan to ensure they are

    technically acceptable and suitable for diagnostic purposes

26. create multi-planar reformats (MPR) from the relevant datasets as

    appropriate

27. review images for clinical acceptability, take appropriate action,

    including further imaging if required

28. monitor and record the individuals exposure to ionising radiation

    throughout the procedure according to local protocols

29. observe the individuals condition and well-being at all times and

    take appropriate action

30. following the preliminary imaging examination, inform the referring

    or reporting clinician if an abnormality is observed on the image which

    is likely to require further investigation or treatment

31. provide the individual with information relating to the procedure and

    aftercare where necessary

32. explain the process for obtaining results

33. optimise, record, collate and prepare appropriate information,

    documentation and images for transfer or storage according to local

    protocols

34. verify that the images have arrived/been stored according to local

    protocols

35. recognise where help or advice is required and obtain this from

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    appropriate sources

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1. legal, organisational and policy requirements relevant to your role,

   the role of others in your organisation and the activities being

   carried out.

2. the relevant national and local standards, guidelines, policies and

   procedures that are available and how and when they should be

   accessed.

3. the importance of respecting individuals culture, privacy, dignity,

   wishes, beliefs and decisions

4. the limitations of your own knowledge and experience and the

   importance of operating within your scope of practice

5. the roles and responsibilities of other team members

6. the importance of obtaining valid consent in line with national and

   local guidelines

7. clinical appropriateness of the examination request and the action

   to take when the request is not appropriate

8. the gross surface and cross-sectional anatomy of the areas to be

   scanned

9. the relevant physiology of the areas to be scanned

10. the harmful effects of radiation to the human body and use of

    radiation protection equipment

11. how to apply the principles of time, shielding and distance to

    reduce radiation exposure to staff

12. the medical terminology relevant to the examination including

    abbreviations

13. contra-indications to SPECT and SPECT/CT scanning including

    the clinical implications of any allergies, pregnancy status and

    breastfeeding status relevant to the examination

14. the aseptic techniques involving in intravenous cannulation

15. the care and preparation of intravenous access routes for dose

    administration

16. the physiological uptake pathways and half-life for different

    SPECT radioisotopes and the impact upon optimal image quality

17. the physical, biological and effective half-life of the radioisotopes

    used and consequently the radiation protection aftercare advice

    for individuals and key people

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18. the calculation of administered radioactivity to an individual

19. the calculation of residual radioactivity post injection of

    radioisotope

20. the different energy levels of the radioisotopes employed and the

    subsequent choice of collimator to optimise image quality.

21. the identification of an optimal ECG trace for gated SPECT and

    SPECT/CT scans

22. the process and technique for radiolabeling individuals blood cells

23. the common normal variants and their appearance on SPECT and

    SPECT/CT images

24. common pathologies of the areas to be scanned and their

    appearance on SPECT and SPECT/CT images

25. manifestations of individuals physical and emotional status

26. when additional images are required to aid diagnosis and to

    enhance the examination

27. production, interactions and properties of x-rays and gamma rays.

28. the physical processes involved in the production of SPECT and

    SPECT/CT images, scanning techniques and protocols

29. the ways in which SPECT and SPECT/CT images can be

    captured, processed and permanently stored

30. the physical principles of SPECT and SPECT/CT scanning

31. alternative imaging examinations that may be employed alongside

    SPECT and SPECT/CT

32. the technical and diagnostic quality requirements of the image

33. artefacts on images - their causes and avoidance strategies

34. factors which influence the decision to repeat images or take

    additional SPECT and SPECT/CT images

35. the safe operation of the SPECT and SPECT/CT scanners and

    accessories in their use

36. the use of quality assurance equipment, recording results and

    taking appropriate action

37. equipment capabilities, limitations and routine maintenance

    including the quality control processes required by the operator

38. the importance of timely equipment fault recognition and local

    procedures for reporting these

39. how to adapt communication styles, ask questions, and listen

    carefully in ways which are appropriate to the needs of the

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    individual

40. methods of communicating difficult and complex information to

    individuals and key people

41. the importance of providing individuals and key people with

    opportunities to ask questions and increase their understanding

42. the importance of respecting individuals culture, privacy, dignity,

    wishes, beliefs and decisions

43. the information that should be given to individuals before, during

    and on completion of the examination

44. preparation of the environment, individual and equipment for

    SPECT and SPECT/CT scanning

45. procedures relating to recording, collating and preparing

    appropriate information, documentation and images for transfer or

    storage according to local protocols

46. how to keep full, accurate and clear records in line with

    organisational procedures

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This standard links with the following dimension within the NHS

Knowledge and Skills Framework (October 2004):

Dimension: HWB6 Assessment and treatment planning

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