Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 20 - Division of Community and Public Health › Chapter 10 - Protection Against Ionizing Radiation › Section 19 CSR 20-10.130 - Special Requirements for Medical Fluoroscopic Installations

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes special requirements
				  for medical fluoroscopic installations.
(1) All fluoroscopes shall be so constructed
				that the entire cross-section of the useful beam is attenuated by a primary
				barrier. Collimators and adjustable diaphragms or shutters shall be provided to
				restrict the size of the useful beam to less than the area of the barrier. For
				conventional fluoroscopes, this requirement is met if, when the adjustable
				diaphragm is open to its fullest extent, an unilluminated two centimeter (2 cm)
				margin is left on the fluorescent screen with the screen centered in the beam
				at a distance of thirty-five centimeters (35 cm) (fourteen inches (14")) from
				the panel or table top. The margin requirement does not apply to installations
				where image amplifiers are used but a protective shield shall be provided in
				these installations so that the useful beam does not produce a radiation
				hazard.
(2) Accessory shielding
				devices (such as cones, curtains, bucky slot covers, shielding between patient
				and fluoroscopist) shall be used as required to reduce the exposure dose rate
				to not more than fifty (50) milliroentgens per hour in the area adjacent to the
				machine normally occupied by the fluoroscopist and his/her assistants during
				fluoroscopy.
(3) The target to
				panel distance shall not be less than eighteen inches (18").
(4) A manually reset cumulative timing device
				shall be used which will either indicate elapsed time by an audible signal or
				turn off the apparatus when the total exposure exceeds a predetermined limit
				given in one (1) or a series of exposures. The device shall have a maximum
				range of five (5) minutes.
(5) The
				primary beam barrier should have a lead equivalent of at least 2.0 millimeters
				(mm) and shall not be less than 1.5 mm for one hundred (100) kvp, should be at
				least 2.4 mm and shall be not less than 1.8 mm for one hundred twenty-five
				(125) kvp, and should be at least 2.7 mm and shall be not less than 2.0 mm for
				one hundred fifty (150) kvp. For conventional fluoroscopes, this requirement
				may be assumed to have been met if the exposure-dose rate measured at the
				viewing surface of the fluorescent screen does not exceed fifty (50)
				milliroentgens per hour with the screen in the primary beam of the fluoroscope
				without a patient, under normal operating conditions.
(6) Collimators and adjustable diaphragms or
				shutters to restrict the size of the useful beam shall provide a minimum of 2.0
				mm lead equivalent protection for one hundred (100) kvp, 2.4 mm for one hundred
				twenty-five (125) kvp and 2.7 mm for one hundred fifty (150) kvp.
(7) For routine fluoroscopy, the dose rate
				measured at the panel or table top shall not exceed six (6) roentgens per
				minute.
(8) Mobile fluoroscopic
				equipment shall meet the requirements of sections (1)-(7) of this rule except
				that-
(A) In the absence of panel or table
				top, a cone or spacer frame hall limit the target-to-skin distance to not less
				than twelve inches (12");
(B) It
				shall be impossible to operate the machine when the collimating cone or
				diaphragm is not in place; and
(C)
				The maximum permissible exposure-dose rate of six (6) roentgens per minute
				shall be measured at the minimum target-to-skin distance.