Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 21 - Division of Radiological Health › Subpart 78 - Radiological Health › Chapter 1 - REGULATIONS FOR CONTROL OF RADIATION IN MISSISSIPPI › Subchapter 6 - X-Rays In The Healing Arts › Rule 15-21-78-1.6.3 - General and Administrative Requirements

Current through June 25, 2024
1.
					 Radiation Safety Requirements. The registrant shall be responsible for
					 directing the operation of the x-ray system(s) under his administrative
					 control. The registrant or the registrant's agent shall assure that the
					 requirements of these regulations are met in the operation of the x-ray
					 system(s).
a. An x-ray system which does not
					 meet the provisions of these regulations shall not be operated for diagnostic
					 purposes (if so directed by the Agency).
b. Individuals who will be operating the
					 x-ray systems shall be adequately instructed in the safe operating procedures
					 and be competent in the safe use of the equipment. See Appendix A for a list of
					 subject matters pertinent to this requirement. The Agency may use interview,
					 observation and/or testing to determine compliance.
c. A chart shall be provided in the vicinity
					 of the diagnostic x-ray system's control panel which specifies, for all
					 examinations performed with that system, the following information:
i. patient's body part and anatomical size,
					 or body part thickness, or age (for pediatrics), versus technique factors to be
					 utilized;
ii. type and size of the
					 film or screen-film combination to be used;
iii. type and focal distance of the grid to
					 be used, if any;
iv. source to
					 image receptor distance to be used (except for dental intraoral radiography);
					 and
v. type and location of
					 placement of patient shielding (i.e., gonad, etc.) to be
					 used.
d. The registrant
					 of a facility shall establish and make available to x-ray operators written
					 safety procedures, including patient holding and any restrictions of the
					 operating technique required for the safe operation of the particular x-ray
					 system. The operator shall be able to demonstrate familiarity with these
					 procedures.
e. Except for human
					 patients who cannot be moved out of the room, only the staff and ancillary
					 personnel, or other persons, required for the medical procedure or training
					 shall be in the room during the radiographic exposure. Other than the patient
					 being examined:
i. All individuals shall be
					 positioned such that no part of the body will be struck by the useful beam
					 unless protected by not less than 0.5 millimeter lead equivalent
					 material.
ii. The x-ray operator,
					 other staff, ancillary personnel, and other persons required for the medical
					 procedure shall be protected from the direct scatter radiation by protective
					 aprons or whole body protective barriers of not less than 0.25 millimeter lead
					 equivalent material.
iii. Human
					 patients who cannot be removed from the room shall be protected from the direct
					 scatter radiation by whole body protective barriers of not less than 0.25
					 millimeter lead equivalent material, or shall be so positioned that the nearest
					 portion of the body is at least 2 meters from both the tube head and the
					 nearest edge of the image receptor.
f. Gonad shielding of not less than 0.5
					 millimeter lead equivalent material shall be used for human patients, who have
					 not passed the reproductive age, during radiographic procedures in which the
					 gonads are in the useful beam, except for cases in which this would interfere
					 with the diagnostic procedure.
g.
					 Individuals shall not be exposed to the useful beam except for healing arts
					 purposes and unless such exposure has been authorized by a licensed
					 practitioner of the healing arts. This provision specifically prohibits
					 deliberate exposure for the following purposes:
i. exposure of an individual for training,
					 demonstration, or other non-healing-arts purposes; and
ii. exposure of an individual for the purpose
					 of healing arts screening except as authorized by 1.6.3(1)(k).
h. When a patient or
					 film must be provided with auxiliary support during a radiation exposure:
i. mechanical holding devices shall be used
					 when the technique permits. The written safety procedures, required by
					 1.6.3(1)(d), shall list individual projections where holding devices cannot be
					 utilized;
ii. written safety
					 procedures, as required by 1.6.3(1)(d), shall indicate the requirements for
					 selecting a holder and the procedure the holder shall follow;
iii. the human holder shall be instructed in
					 personal radiation safety and protected as required by 1.6.3(1)(e);
iv. no individual shall be used routinely to
					 hold film or patients;
v. in those
					 cases where the patient must hold the film, except during intraoral
					 examinations, any portion of the body other than the area of clinical interest
					 struck by the useful beam shall be protected by not less than 0.5 millimeter
					 lead equivalent material;
vi. when
					 an animal must be held by an individual during an exposure, that individual
					 shall be protected with appropriate shielding devices, such as leaded aprons
					 and gloves, and shall be positioned such that no part of his or her body shall
					 be struck by the useful beam; and
vii. each facility must have leaded aprons
					 and gloves available in sufficient numbers to provide protection to all
					 personnel who are involved with x-ray operations and who are otherwise not
					 shielded.
i. Procedures
					 and auxiliary equipment designed to minimize patient and personnel exposure
					 commensurate with the needed diagnostic information shall be utilized.
i. The speed of the screen and film
					 combinations used shall be the fastest speed consistent with the diagnostic
					 objective of the examinations. Film cassettes without intensifying screens
					 shall not be used for any routine diagnostic radiological imaging, with the
					 exception of standard film packets for intraoral use in dental
					 radiography.
ii. The radiation
					 exposure to the patient shall be the minimum exposure required to produce
					 images of good diagnostic quality.
iii. Portable or mobile x-ray equipment shall
					 be used only for examinations where it is impractical to transfer the
					 patient(s) to a stationary x-ray installation.
iv. X-ray systems subject to 1.6.6 shall not
					 be utilized in procedures where the source to patient distance is less than 30
					 centimeters except for veterinary systems.
v. If grids are used between the patient and
					 the image receptor to decrease scatter to the film and improve contrast the
					 grid shall:
vi. Be positioned
					 properly, i.e., tube side facing the right direction, and grid centered to the
					 central ray.
vii. If of the focused
					 type, be of the proper focal distance for the SIDs being
					 used.
j. All individuals
					 who are associated with the operation of an x-ray system are subject to the
					 requirements of 1.4.5 and 1.4.7 of these regulations. In addition:
i. When protective clothing or devices are
					 worn on portions of the body and a personnel monitoring device(s) is required,
					 at least one such monitoring device shall be utilized as follows:
i. When an apron is worn, the monitoring
					 device shall be worn at the collar outside of the apron.
ii. The dose to the whole body based on the
					 maximum dose attributed to the most critical organ shall be recorded in the
					 reports required by 1.4.6 of these regulations. If more than one device is used
					 and a record is made of the data, each dose shall be identified with the area
					 where the device was worn on the body.
ii. Exposure of a personnel monitoring device
					 to deceptively indicate a dose delivered to an individual is
					 prohibited.
k. Healing
					 Arts Screening. Any person proposing to conduct a healing arts screening
					 program shall not initiate such a program without prior approval of the Agency.
					 When requesting such approval, that person shall submit the information
					 outlined in Appendix B of this Subchapter. If any information submitted to the
					 Agency becomes invalid or outdated, the Agency shall be immediately
					 notified.
l. Information and
					 Maintenance Record and Associated Information. The registrant shall maintain
					 the following information for each x-ray system for inspection by the Agency:
i. model and serial numbers of all major
					 components, and user's manuals for those components;
ii. tube rating charts and cooling
					 curves;
iii. records of surveys,
					 calibrations, maintenance, and modifications performed on the x-ray system(s);
					 and
iv. a copy of all
					 correspondence with this Agency regarding that x-ray system.
m. X-Ray Log. Each facility shall
					 maintain an x-ray log containing the patient's name, the type of examinations,
					 and the dates the examinations were performed. When the patient or film must be
					 provided with human auxiliary support, the name of the human holder shall be
					 recorded.
n. A sign shall be posted
					 in a conspicuous area so as to be easily seen by the patient to the effect that
					 if there is a pregnancy or the possibility of a pregnancy, the physician should
					 be notified. Prescription of x-ray examinations of pregnant or possibly
					 pregnant patients shall assure that medical consideration has been given to
					 possible fetal exposure and appropriate protective measures are taken.
2
X-ray Film Processing Facilities and
						Practices.
Each installation using a radiographic x-ray system and using
						analog image receptors (radiographic film) shall have available suitable
						equipment for handling and processing radiographic film in accordance with the
						following provisions:
a. Manually
					 developed film:
i. Processing tanks shall be
					 constructed of mechanically rigid, corrosion resistant material; and
ii. The temperature of solutions in the tanks
					 shall be maintained within the range of 60°F to 80°F (16°C to
					 27°C). Film shall be developed in accordance with the time-temperature
					 relationships recommended by the film manufacturer, or, in the absence of such
					 recommendations, with the time-temperature chart below:
Time-Temperature Chart
Thermometer Reading (Degrees)
Minimum Developing Time (Minutes)
°C
°F
26.7
80
2
26.1
79
2
25.6
78
2 1/2
25.0
77
2 1/2
24.4
76
3
23.9
75
3
23.3
74
3 1/2
22.8
73
3 1/2
22.2
72
4
21.7
71
4
21.1
70
4 1/2
20.6
69
4 1/2
20.0
68
5
19.4
67
5 1/2
18.9
66
5 1/2
18.3
65
6
17.8
64
6 1/2
17.2
63
7
16.7
62
8
16.1
61
8 1/2
15.6
60
9 1/2
iii. Devices shall be utilized which will:
i. Indicate the actual temperature of the
					 developer; and
ii. Signal the
					 passage of a preset time appropriate to the developing time required.
b. Automatic Processors
					 and Other Closed Processing Systems:
i. Films
					 shall be developed in accordance with the time-temperature relationships
					 recommended by the film manufacturer; in the absence of such recommendations,
					 the film shall be developed using the chart below:
Developer Temperature (Degrees)
Minimum Immersion Time:* (Seconds)
°C
°F
35.5
96
19
35
95
20
34.5
94
21
34
93
22
33.5
92
23
33
91
24
32
90
25
31.5
89
26
31
88
27
30.5
87
28
30
86
29
29.5
85
30
*Immersion time only, no crossover time included.
ii. The specified developer
					 temperature and immersion time shall be posted in the darkroom or on the
					 automatic processor.
c.
					 Other Requirements
i. Pass boxes, if
					 provided, shall be so constructed as to exclude light from the darkroom when
					 cassettes are placed in or removed from the boxes, and shall incorporate
					 adequate shielding from stray radiation to prevent exposure of undeveloped
					 film.
ii. The darkroom shall be
					 light tight and use proper safelighting such that any film type in use exposed
					 in a cassette to x-radiation sufficient to produce an optical density from 1 to
					 2 when processed shall not suffer an increase in density greater than 0.1 (0.02
					 for mammography) when exposed in the darkroom for 2 minutes with all safelights
					 on. If used, daylight film handling boxes shall preclude fogging of the
					 film.
iii. Darkrooms typically used
					 by more than one individual shall be provided a positive method to prevent
					 accidental entry while undeveloped films are being handled or
					 processed.
iv. Film shall be stored
					 in a cool, dry place and shall be protected from exposure to stray radiation.
					 Film in open packages shall be stored in a light tight container.
i. Film cassettes and intensifying screens
					 shall be inspected periodically and shall be cleaned and replaced as necessary
					 to best assure radiographs of good diagnostic quality.
ii. Outdated x-ray film shall not be used for
					 human diagnostic radiographs, unless the film has been stored in accordance
					 with the manufacturer's recommendations and a sample of the film passes a
					 sensitometric test for normal ranges of base plus fog and speed.
iii. Film developing solutions shall be
					 prepared in accordance with the directions given by the manufacturer, and shall
					 be maintained in strength by replenishment or renewal so that full development
					 is accomplished within the time specified by the manufacturer.