核子醫學科醫事放射師臨床作業範疇之爭議探討

Radiologic technologists' practice controversial issues in nuclear medicine

一般認知而言，核醫科醫放師工作包括核醫造影、影像處理等。但礙於經營成本，部份單位將靜脈注射、放射免疫分析等業務委由醫放師執行。就實務層面，並非全然不可，但醫放師養成教育並未對此有深入紮根，又其游走於相關法規之邊緣。故本文就以養成教育與法律層面針對核醫科醫放師之臨床作業範疇進行探討。目前核醫科醫放師常見執業範疇爭議包括：醫放師執行靜脈注射給予同位素藥物和血管擴張劑(Dipyridamol) 以及執行放射免疫分析。養成教育面而言，綜觀各校系課程著重於放射技術專業培養。但對於本文提出之爭議處，除放射免疫分析外並無專門課程之訓練。而在未有學理知識背景支持下操作靜脈注射可能具安全疑慮。法律面而言，核醫科醫放師是否可操作靜脈注射目前仍無明確法規規範，但醫事放射師法已明確規範放射免疫分析為醫放師業務範圍之ㄧ。為符合臨床實務需求，本文建議包括：（一）將靜脈注射、無菌技術置入核子醫學技術或其他相關課程之教學大綱中、（二）獨立增加教授有關病安預防與處理之課程、（三）增強放射免疫分析課程分量、（四）由學會或公會制定必修課程或學群，並使其成為報考資格門檻、（五）由公會組織推動修法，使執行核醫技術業務相關之靜脈注射包含於執業範疇中、（六）未來朝建立專科醫事放射師認證制度方向邁進。

General cognitive terms, nuclear medicine radiologic technologist work includes nuclear medicine imaging, image processing. However, due to the operating costs, intravenous injection and radioimmunoassay analysis performed by the radiologic technologists in some nuclear medicine unit. But the radiologic technologists' educations have not deeply rooted in the field, and its walk on the edge of the relevant laws and regulations. Therefore, we discussed the job category of nuclear medicine radiologic technologists in educations, relevant laws and regulations. Currently, nuclear medicine radiologic technologists' practice controversial issues include that administered intravenously drugs and performed radioimmunoassay by radiologic technologists. On education, an overview of every school curriculum focuses on radiology technology professional training. However, except radioimmunoassay, there were no training of specialized courses with the controversial issues in this context. And in the absence of theoretical background support, that may be unsafe in operating with intravenous injection. Legal side, there is still no clear norms and regulations explicitly prohibit nuclear medicine radiologist operating intravenous injection, and the medical radiation technologists law has defined that radioimmunoassay is included in radiologic technologist job category. To meet the needs of clinical practice, we made several recommendations: Taking the intravenous injection technology into the education curriculum, set up the courses on patient safety incident prevention and treatment, increasing the weight of radioimmunoassay course, making the required course formulate by association of medical radiation technologists for the qualification of license examination, making the nuclear medicine radiologic technologists job category includes intravenous injection by amending the law, establishing of specialist radiographer certification system.