<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.32.10.09" title_num="10" subtitle_num="32" chapter_num="10" heading="Scope of Practice — Radiography.">
  <paragraph num="A.">
    <text>The scope of practice of radiography includes the following:</text>
    <paragraph num="(1)">
      <text>Analysis and correlation of procedure requests and clinical information provided by a physician or patient, or both, for preprocedure determination of the appropriate exam, its extent, and its scope;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Evaluation of the physical and emotional status of the patient with respect to the ability to undergo the procedure requested;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Selection, preparation, and operation of radiography equipment and accessories to perform procedures;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Positioning patient to best demonstrate anatomy of interest, while respecting patient's physical limitations and comfort;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Determination of radiographic exposure factors, setting of factors on control panel, and application of x-ray exposures;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Application of radiation protection principles to minimize radiation exposure to patient, self, and others;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Evaluation of images for technical quality;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Performance of noninterpretive fluoroscopic procedures according to institutional policy;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Oversight of image processing standards and the appropriate labeling of images;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Administering contrast media after consultation with, and under the supervision of, a physician who is immediately and physically available; and</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Performing any other duties that the Board determines may be performed by a radiographer.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The scope of practice of radiography includes the administration of intravenous medications and other patient care procedures as directed by the physician if the:</text>
    <paragraph num="(1)">
      <text>Radiographer is:</text>
      <paragraph num="(a)">
        <text>Registered by the ARRT in advanced qualifications in cardiac-interventional radiography, vascular-interventional radiography, or cardiovascular-interventional radiography;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Working in a cardiac catheterization laboratory or interventional radiographic laboratory while cardiac catheterization or interventional procedures are ongoing; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Administering the medication or performing a patient care procedure at the direction of a physician while the physician is present in the room directing the administration and dosage of medication or performance of the patient care procedure;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Supervising physician in the cardiac catheterization or interventional laboratory is responsible for the acts of the radiographer when delegating the administration of intravenous medications or performance of a patient care procedure; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Facility where the procedure is performed:</text>
      <paragraph num="(a)">
        <text>Has protocols available for review by the Board;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Documents the training provided to the radiographer; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Evaluates the radiographer on a regular basis for competency, documents the results of these tests, and makes the results available for inspection by the Board.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The scope of practice of radiography includes the insertion and removal of peripherally inserted central catheters with or without fluoroscopic guidance if the:</text>
    <paragraph num="(1)">
      <text>Radiographer is:</text>
      <paragraph num="(a)">
        <text>Registered by the ARRT in advanced qualifications in cardiac-interventional radiography, vascular-interventional radiography, or cardiovascular-interventional radiography;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Working in a cardiac catheterization laboratory or interventional radiographic laboratory while cardiac catheterization or interventional procedures are ongoing; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Under the onsite supervision of the supervising physician;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Supervising physician in the cardiac catheterization or interventional laboratory is responsible for the acts of the radiographer with respect to insertion or removal of peripherally inserted central catheters; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Facility where the procedure is performed:</text>
      <paragraph num="(a)">
        <text>Has protocols available for review by the Board;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Documents the training provided to the radiographer; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Evaluates the radiographer on a regular basis for competency, documents the results of these tests, and makes the results available for inspection by the Board.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>