Q: My hospital just purchased a PET/CT scanner. Can I, a certified CNMT, do PET/CT? I am not a radiologic technologist or radiographer ARRT (R).
A: This is dependent on the state in which you live. Some states allow a to perform PET/CT scans using the CT as an anatomical localizer and for attenuation correction. Some states have laws that allow a CNMT to also perform diagnostic CT scans. An example is California. CNMTs can apply to the state to acquire a temporary permit that allows the CNMT to train on CT scanners with the purpose of taking the ARRT (CT) post primary exam. The individual has two years in which to complete the ARRT CT competency requirements and pass the ARRT (CT) post-primary exam. Once certified, the NMT can perform diagnostic CT scans on hybrid scanners only. A non-radiographer NMT in the state of California, even with an ARRT (CT) certification is not permitted to operate a non-hybrid (stand-alone) CT scanner. For more information, please contact the TAG representative from your state for more specific information.
Q: Can a CNMT perform other imaging procedures such as a CT, MR or ultrasound exams?
A: Many states have unique licensing laws. For example, some states specify that only radiologic technologists or radiographers ARRT (R) can perform CT procedures. Other states have enacted legislation that allows CNMTs to perform CT procedures, if they meet specified qualifications. Some states have no regulations or laws and entrust the decision of qualifications to the institution. If your state does not license or have certification regulations for imaging technologists, a NMT, with the proper training and competencies, can perform other types of imaging procedures, provided it is permitted through institutional policy.
Q: I am a NMT with over 25 years of experience working in an outpatient office affiliated with a hospital. As a NMT, am I allowed to take a certification in learning how to give flu shots which the hospital is able to provide for me.
A: Outpatient facilities are usually not licensed as part of the hospital. This means that unless this practice is prohibited in your state, it could be allowed per the clinic’s policy and training requirements (obtaining a certification). However, if your outpatient facility is a hospital licensed outpatient facility, it is not within a NMTs SOP to administer supportive medications. However, if your state allows non-licensed personnel to administer flu shots, then you would be permitted to do this, not under your nuclear medicine license/SOP, but under whatever state regulation allows others to do this (eg, high school graduate and a certification in flu shot administration).
Q: What is the definition of an adjunctive medication used in nuclear medicine studies?
A: Adjunctive medications are defined as medications used to evoke a specific physiological or biochemical response in order to enhance a nuclear medicine study. Contrast enhancing medications used in CT, MRI, and other imaging studies are also considered adjunctive medications and are within the NMT’s scope of practice.
Q: If administering adjunctive medications is within a NMT’s scope of practice, why am I not able to do this at my place of employment?
A: The ability of the technologist to administer adjunctive medications is USUALLY not regulated by state law, but rather institutional policy. Unless a State uses language to explicitly prohibit a NMT from administering any medication other than radiopharmaceuticals or only allows another profession to administer non-radioactive medications, a CNMT can administer adjunctive medications. Health care institutions can limit an individual’s scope of practice by establishing institutional policies through their medical boards.
Q: Is it in a NMTs’ SOP to administer IV sedation medication to a patient who is anxious or needs the medication to assist in the test.
A: No. It is not within the NMT’s Scope of Practice to administer supportive medications. Supportive medications are defined as those pharmaceuticals that are given to treat or support a patient’s medical condition or state. Sedating medication is not adjunctive. It is supportive and as such is not within the NMT’s Scope of Practice.
However, it is within a NMT’s Scope of Practice to administer adjunctive medications. Adjunctive medications are defined as those non-radioactive pharmaceuticals that are given to a patient (undergoing nuclear medicine and molecular imaging exams) to enhance a physiologic or molecular response in the body. These responses are imaged via the radioactive tracer that is given. Examples include: Lasix, Lexiscan, etc.
Please note, however, it is under the purview of the institution that provides nuclear medicine services to permit or limit a particular profession’s scope of practice. This means that your employer could enact policies that would not allow a NMT to handle and administer adjunctive medications, even though this is within the NMT’s Scope of Practice.
Q: Is it within my SOP to administer contrast if my facility authorizes any registered technologist (NM, CT, Rad, MRI, etc.) to inject these agents?
A: This depends on whether another state regulatory body (ex: practice of medicine, practice of nursing, board of pharmacy, etc.) prohibits NMTs from performing this function. For example, if the practice of nursing has a code that only authorizes a RN to inject contrast, then no one but a nurse can do so. If there is no other board that regulates this action, then whether or not you can administer contrast depends on institutional policies.
If this practice is allowed in your institution, please ensure and review that your institution has a policy in place that authorizes you to perform this function.
Q: Is it within my SOP to administer Kinevac?
A: This depends on whether your state regulates nuclear medicine through state legislation or institutional policy. If it regulated by institutional policy, this function is defined in the policies of your institution.
The ability of technologists to administer adjunctive medications is usually not regulated by state law, but rather institutional policy. Unless a State uses language to explicitly prohibit NMTs from administering any medication, other than radiopharmaceuticals or only allows another profession to administer non-radioactive medications, a CNMT can administer adjunctive medications. Health care institutions can limit an individual’s scope of practice by establishing institutional policies through their medical boards.
Please ensure and review that your institution has a policy in place that authorizes you to perform this function.
Q: In the NMT’s Scope of Practice it states: The CNMT is responsible for: “Observing the patient carefully after radiopharmaceutical administration for any side effects, and handling such side effects appropriately as described in established policies or as directed by medical staff.” Does this mean all patients should be continually monitored after injections? Is so, for how long?
A: Unless a patient requires continuous monitoring as ordered by a physician, continuous monitoring is not required after the administration of a radiopharmaceutical. However, before, during, and after radiopharmaceutical injections, and even during performing the procedure, the NMT should be aware of the patient’s condition. Should the patient’s medical condition change during the nuclear medicine procedure, the NMT should be competent in following institutional policy regarding administering care.
Q: How many working hours should a NMT and physician work?
A: This is depends on the labor regulations set by your state and/or institution.