Guide · checked October 2026
Radiation dose recording in the cath lab under IR(ME)R
Under IR(ME)R 2017, the employer's procedures must cover assessing patient dose and recording a clinical evaluation of each exposure that includes, where appropriate, factors relevant to patient dose; in a cath lab that normally means recording the dose-area product and fluoroscopy time for every procedure in the clinical record.
What the regulations require
- Schedule 2(e): procedures for the assessment of patient dose.
- Schedule 2(f): procedures for the use and review of diagnostic reference levels.
- Schedule 2(j): procedures for carrying out and recording a clinical evaluation of each exposure, including, where appropriate, factors relevant to patient dose.
- Schedule 2(o): procedures for clinical audit and any resulting action, inserted from 1 October 2024.
DHSC's guidance adds that dose factors should go in the recorded clinical evaluation and that stored exposure data should allow a later estimate of dose.
What to record in practice
Cath labs commonly record the dose-area product (in Gy·cm²) and fluoroscopy time for each case. UKHSA's national diagnostic reference levels express interventional values as dose-area product per exam. Your Medical Physics Expert and employer's procedures decide the exact fields; the point is that the same values are captured every time, from a known source.
Most modern systems produce a radiation dose structured report (RDSR) that can be stored in PACS. Taking the value from the RDSR rather than retyping it from the console reduces transcription errors, and comparing the two is a useful check.
Using the data
Recorded doses feed local diagnostic reference levels, dose audits and investigation of unusually high exposures. IR(ME)R regulation 6(7) requires a review whenever DRLs are consistently exceeded, with corrective action where appropriate.
What this does not mean
- IR(ME)R does not list the exact dose fields; your employer's procedures do.
- A dose above a local level is not automatically a reportable incident.
- Staying below national values does not by itself meet the optimisation duty, as DHSC's guidance notes.
Where Cath Copilot fits
Cath Copilot reads dose reports (RDSR) through its PACS connector and the value entered in the physiology system, shows both on the timeline, and reconciles them before the note is signed. The confirmed dose-area product and fluoroscopy time appear in the cited procedure note and the audit return. A local rule can flag a dose above a notification level set by the site, for a named person to own and close.
Cath Copilot is a prototype on synthetic data only. It is not a medical device and is not for clinical use.
Questions
Which IR(ME)R provision covers recording dose?
Schedule 2(j), procedures for recording a clinical evaluation of each exposure including factors relevant to patient dose, with Schedule 2(e) on assessing patient dose.
What units are national interventional DRLs given in?
UKHSA gives interventional national DRLs as dose-area product per exam in Gy·cm².
Sources
Official pages, checked October 2026. Guidance changes, so check the current version before you rely on it.
General information for healthcare managers and clinical teams, checked October 2026. It is not legal, regulatory or clinical advice; follow the current official guidance and your organisation's own policies. No patient data is used in these examples. Cath Copilot is a prototype running on synthetic data only. It is not a medical device and is not for clinical use. It recommends, drafts, and routes; it never diagnoses, orders, or decides. A clinical safety and information-governance process precedes any use with real patient data.