<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".08" citation="COMAR 10.32.10.08" title_num="10" subtitle_num="32" chapter_num="10" heading="Scope of Practice — Radiation Therapy.">
  <text>The practice of radiation therapy includes the following:</text>
  <paragraph num="A.">
    <text>Scope of practice for simulation procedures and for operation of external beam treatment devices, CT simulator, and fluoroscopic simulator for patient therapy which includes:</text>
    <paragraph num="(1)">
      <text>Preparation of machine for patient procedure;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Positioning patient for treatment or localization, or both;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Adjustment of machine components and systems;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Application of machine adjustments while patient is on the table;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Attachment or removal of any machine device or machine accessory for patient service, or both;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Manipulation of machine controls for patient exposure for localization or treatment, or both;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Production of radiation for tumor or field localization on, or treatment of, a patient, or both;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Documentation of technical set up used on a patient;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Monitoring of patient and equipment during the simulation or treatment procedures for application of corrective actions;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Oversight and application of image development standards and appropriate labeling of images regarding patient identification, date, and documentation of technical parameters;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Performance of patient or image measurements, or both;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Application of technical procedures in accordance with accepted radiation safety standards and regulations;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Performance of dosimetric and geometric calculations related to patient treatment; and</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Manipulation, data entry, or other use of computer-accelerator interfaced hardware or software for patient treatment;</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Scope of practice for preparation of patient treatment devices which includes:</text>
    <paragraph num="(1)">
      <text>Oversight of in-facility manufacture of devices or device accessories for use in patient treatment; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Approval of devices for use in patient simulation and treatment;</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Scope of practice for brachytherapy and radiopharmaceutical procedures which includes:</text>
    <paragraph num="(1)">
      <text>Removal, return, or handling of radiation sources or medical applicators, or both, containing radioactive material;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Transportation of radioactive materials;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Documentation for the accountability and use of the radiation sources;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Insertion and removal of sources from medical applicators;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Preparation of sealed radiopharmaceuticals for therapeutic administration to patients under physician supervision;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Assisting the licensed physician in the preparation and administration of sealed therapeutic radiopharmaceuticals for brachytherapy;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Documentation of the therapeutic application of radiopharmaceuticals;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Oversight of radiation safety practices related to the handling and administration of radiopharmaceuticals for therapy of patients;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Management of transportation and handling of therapeutic radiopharmaceuticals, immediate management and appropriate notifications for any spills or other accidents involving radiopharmaceuticals;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Calibration of therapeutic radiopharmaceuticals for dose accuracy; and</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Preparation of unsealed radiopharmaceuticals for therapeutic administration to patients under direct supervision by a licensed physician if the radiation therapist has received on-site training from an authorized user; and</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Performance of any other duties that the Board determines may be performed by a radiation therapist.</text>
  </paragraph>
</regulation>