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Dose documentation and dose creep
Record the dose the equipment reports, watch the exposure indicator trend, and never let a forgiving detector hide a technique that keeps creeping up.
What gets recorded
Every exam leaves a dose record. For radiography, the DICOM header stores the kVp, mAs, SID, exposure indicator (EI) and deviation index (DI), and the dose-area product (DAP, also called kerma-area product, KAP) when the unit has a DAP meter. Many units also send a DICOM Radiation Dose Structured Report (RDSR) to PACS or a dose-monitoring program, which lets the department track each patient's and each room's doses over time. Departments may also send dose data to a national registry, such as the ACR Dose Index Registry for CT and fluoroscopy, to compare with other sites. Follow department policy for what you document in the patient's record, and never change a recorded value to make an exam look better.