SECTION 435:60-7-3. Health care services performed

(a)   Health care services allowed under general supervision. A radiologist assistant may perform the following health care services under general supervision at the direction of the supervising radiologist. Such services are limited to the following, except as provided in (c) and (d) of this subsection:

(1)   Review the patient's medical record to verify the appropriateness of a specific exam or procedure.

(2)   Interview patient to obtain, verify, or update medical history.

(3)   Explain procedure to patient, significant others, and/or other health care providers including a description of risks, benefits, alternatives, and follow-up.

(4)   Determine patient compliance, if needed, with pre-examination/procedure preparations (diet, medications).

(5)   Assess risk factors that may effect the examination/procedure (medications, pregnancy, pre-existing diseases, etc).

(6)   Obtain and evaluate vital signs.

(7)   Perform history and physical examination with assessment of related laboratory results.

(8)   Evaluate electrocardiograms for the purpose of recognizing abnormalities that might impact the procedure/examination.

(9)   Performing urinary catheterization.

(10)   Perform venipuncture for phlebotomy or IV access.

(11)   Monitor IV for flow rate and complications.

(12)   Position and physically prepare patient for a procedure.

(13)   Observe and assess patients during conscious sedation.

(14)   Recognize and respond to medical emergencies (e.g., drug reactions, cardiac arrest, hypoglycemia), activate emergency response systems, and notify appropriate personnel.

(15)   Administer oxygen as required.

(16)   Operate a fluoroscopic unit and document fluoroscopy time.

(17)   Administer contrast media, radioactive materials, or other medication as directed by the supervising radiologist and monitor for any adverse effects.

(18)   Evaluate images for diagnostic quality and report clinical observations to the radiologist.

(19)   Communicate the radiologist's report to the referring physician consistent with American College of Radiology guidelines.

(20)   Provide physician prescribed post-examination/procedure instruction to the patient.

(21)   Perform follow-up patient evaluation and communicate findings to the radiologist

(22)   Document the appropriate records for review and co-signature by the supervising radiologist.

(23)   Assist with data collection and review for clinical trials or other research.

(b)   Health care services allowed under direct supervision. A radiologist assistant may perform the following health care services under direct supervision at the direction of the supervising radiologist. Such services are limited to the following, except as provided in (c) and (d) of this subsection:

(1)   Upper GI, esophagram, small bowel follow-through

(2)   Small bowel enteroclysis

(3)   Barium enema

(4)   Cystogram, nephrostogram via existing catheter, loopogram, and retrograde cystourethrogram

(5)   Fistulogram/sinogram

(6)   Swallowing study

(7)   Cholangiogram through existing catheter

(8)   Lumbar puncture under fluoroscopic guidance

(9)   Cervical, thoracic and/or lumbar myelogram via lumbar puncture

(10)   Imaging for hysterosalpingography

(11)   Arthrogram and joint aspiration

(12)   Paracentesis and thoracentesis with appropriate image guidance

(13)   Vascular access

(A)   Central line placement

(B)   Tunneled central line placement and removal

(C)   Dialysis access catheter management

(D)   Port access and injection

(E)   Lower and upper extremity venography

(F)   PICC placement

(14)   Nasoenteric and oroenteric feeding tube placement/manipulation

(c)   Other health care services allowed.

(1)   A radiologist assistant may perform the following procedures under direct supervision after documentation of ten cases with satisfactory outcomes and demonstrated competency performed under the personal supervision of the supervising radiologist who must have a full and unrestricted license in the state of Oklahoma:

(A)   Implantation of infusion ports

(B)   Explantation of infusion ports

(C)   Ultrasound guided random liver biopsy

(2)   Other procedures not listed in this subsection may be approved to be performed by the Radiologist Assistant under the direct supervision of the supervising radiologist after review by the Committee for demonstrated competency and approval by the Board.

(d)   Review of health care services performed. The Committee will, at least on an annual basis, review the structure and content of the list of health care services contained in this subsection and make recommendations for approval of revisions to the Board of Medical Licensure and Supervision.

[Source: Added at 26 Ok Reg 681, eff 2-19-09 (emergency); Added at 26 Ok Reg 2578, eff 7-11-09]