| (a) General. This section identifies radiologic procedures
which are dangerous or hazardous and may only be performed by a practitioner,
medical radiologic technologist (MRT) or limited medical radiologic
technologist (LMRT). A person trained under §194.13 of this chapter
(relating to Mandatory Training Programs for Non-Certified Technicians)
is not an MRT, LMRT or otherwise certified under the Act and shall
not perform a dangerous or hazardous procedure identified in this
section unless expressly permitted by this section.
(b) Dangerous procedures. Except as otherwise provided
in this chapter, the list of dangerous procedures which may only be
performed by a practitioner or MRT are:
(1) nuclear medicine studies to include positron emission
tomography (PET);
(2) administration of radio-pharmaceuticals; administration
does not include preparation or dispensing except as regulated under
the authority of the Texas State Board of Pharmacy;
(3) radiation therapy, including simulation, brachytherapy
and all external radiation therapy beams including Grenz rays:
(4) computed tomography (CT) or any variation thereof;
(5) interventional radiographic procedures, including
angiography, unless performed by an LMRT with a certificate issued
in the cardiovascular category;
(6) fluoroscopy unless performed by an LMRT with a
certificate issued in the cardiovascular category; and
(7) cineradiography (including digital acquisition
techniques), unless performed by an LMRT with a certificate issued
in the cardiovascular category.
(c) Hazardous procedures. Unless otherwise noted, the
list of hazardous procedures which may only be performed by a practitioner
or MRT are:
(1) conventional tomography;
(2) skull radiography, excluding anterior-posterior/posterior-anterior
(AP/PA), lateral, Townes, Caldwell, and Waters views;
(3) portable x-ray equipment;
(4) spine radiography, excluding AP/PA, lateral and
lateral flexion/extension views;
(5) shoulder girdle radiographs, excluding AP and lateral
shoulder views, AP clavicle and AP scapula;
(6) pelvic girdle radiographs, excluding AP or PA views;
(7) sternum radiographs; and
(8) radiographic procedures which utilize contrast
media;
(9) pediatric radiography, excluding extremities, unless
performed by an LMRT with the appropriate category. Pediatric studies
must be performed with radioprotection so that proper collimation
and shielding is utilized during all exposures sequences during pediatric
studies. If an emergency condition exists which threatens serious
bodily injury, protracted loss of use of a bodily function or death
of a pediatric patient unless the procedure is performed without delay,
or if other extenuating circumstances deemed by the practitioner exist,
a pediatric radiographic procedure is also excluded. The emergency
condition or extenuating circumstance must be documented by the ordering
practitioner in the patient's clinical record and the record must
document that a regularly scheduled MRT, LMRT, RN or physician assistant
is not reasonably available to perform the procedure.
(d) Performance of a hazardous procedure by an LMRT.
An LMRT may perform a radiologic procedure listed in subsection (c)
of this section only if the procedure is within the scope of the LMRT's
certification, as described in §194.6 of this chapter (relating
to Procedural Rules and Minimum Eligibility Requirements for Applicants
for a Certificate or Placement on the Board's Non-Certified Technician
General Registry).
(e) Performance of a dangerous or hazardous procedure
by a practitioner. This section does not authorize a practitioner
to perform a radiologic procedure which is outside the scope of the
practitioner's license.
(f) Dental radiography. This section does not apply
to a radiologic procedure involving a dental x-ray machine, including
panarex or other equipment designed and manufactured only for use
in dental radiography.
(g) Mammography. In accordance with the Health and
Safety Code, §401.421 et seq, mammography is a radiologic procedure
which may only be performed by an MRT who meets the qualifications
set out in 25 TAC Chapter 289 (relating to Radiation Control) of the
Radiation Control Program rules specific to mammography. Mammography
shall not be performed by an LMRT, an NCT, or any other person.
(h) Student performance of dangerous or hazardous procedures.
The procedures identified in this section are not considered dangerous
and hazardous for purposes of §601.056(a) of the Act if the person
performing the procedures is a student enrolled in a program which
meets the minimum standards adopted under §601.056 of the Act
and if the person is performing radiologic procedures in an academic
or clinical setting as part of the program. Therefore, such students
may perform these procedures in such settings. Students may not perform
procedures in an employment setting.
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