Kansas Administrative Regulations › Agency 28 - DEPARTMENT OF HEALTH AND ENVIRONMENT › Article 35 - RADIATION › Section 28-35-242a - Administrative requirements

Current through Register Vol. 43, No. 28, July 11,
			 2024
(a) Radiation
			 safety requirements. Each registrant shall be responsible for directing the
			 operation of each X-ray system under the registrant's administrative control.
			 The registrant or the registrant's agent shall ensure that the requirements of
			 this part, which shall include the following requirements, are met.
(1) An X-ray system not meeting the
			 provisions of these regulations shall not be operated for diagnostic purposes.
(2) Each individual who operates
			 any X-ray system shall be instructed in the safe operating procedures and shall
			 be competent in the safe use of the equipment. This instruction shall include
			 the relevant topics specified in K.A.R. 28-35-256. Any combination of
			 interview, observation, and testing may be used by the secretary to determine
			 compliance. Each individual that operates an X-ray system shall be licensed if
			 required by the board of healing arts.
(3) A chart shall be made available to the
			 operator of each diagnostic X-ray system that specifies, for each examination
			 performed with the system, the following information:
(A) The technique factors to be utilized,
			 taking into account the patient's body part and anatomical size, body part
			 thickness, and age;
(B) the type
			 and size of the film or film-screen combination to be used;
(C) the type and focal distance of the grid
			 to be used, if any;
(D) the
			 source-image receptor distance to be used, except for dental intraoral
			 radiography; and
(E) the type and
			 placement of patient shielding to be used.
(4) The registrant of a facility shall create
			 and make available to all X-ray operators written safety procedures, including
			 patient holding procedures and any restrictions on the operating techniques
			 required for the safe operation of the particular X-ray system. The registrant
			 shall ensure that the operator demonstrates familiarity with these procedures.
(5) Except for patients who cannot
			 be moved out of the room, only the staff, ancillary personnel, and any other
			 individuals required for the medical procedure or training shall be in the room
			 during the radiographic exposure. All of the following requirements shall be
			 met for each individual other than the patient being examined:
(A) Each individual shall be positioned so
			 that no part of the body will be struck by the useful beam unless the body part
			 is protected by not less than 0.5 millimeter of lead-equivalent material.
(B) The X-ray operator, other
			 staff, ancillary personnel, and all other individuals required for the medical
			 procedure shall be protected from the direct scattered radiation by protective
			 aprons or whole-body protective barriers of not less than 0.25 millimeter of
			 lead-equivalent material.
(C) All
			 human patients who cannot be removed from the room shall be protected from the
			 direct scattered radiation by whole-body protective barriers of not less than
			 0.25 millimeter of lead-equivalent material or shall be positioned so that the
			 nearest portion of the body is at least two meters from both the tube head and
			 the nearest edge of the image receptor.
(6) Gonad shielding of not less than 0.5
			 millimeter of lead-equivalent material shall be used during radiographic
			 procedures in which the gonads are in the useful beam for all human patients
			 who have not passed the reproductive age, except for cases in which this
			 shielding would interfere with the diagnostic procedure.
(7) If a patient or film requires auxiliary
			 support during a radiation exposure, all of the following safety requirements
			 shall be met:
(A) Mechanical holding devices
			 shall be used when the technique permits the use of these devices. The written
			 safety procedures required by this regulation shall list the individual
			 techniques for which holding devices cannot be utilized.
(B) The written safety procedures required by
			 this regulation shall indicate the requirements for selecting a human holder
			 and the procedure that the holder shall follow.
(C) The human holder shall be instructed in
			 personal radiation safety and shall be protected in accordance with these
			 regulations.
(D) No individual
			 shall be used routinely to hold film or patients.
(E) If the patient holds the film, each
			 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 of
			 lead-equivalent material, except during intraoral examinations.
(F) Each facility shall have a sufficient
			 number of leaded aprons and gloves available to provide protection to all
			 personnel who are involved with X-ray operations and who are otherwise not
			 shielded.
(8) The
			 procedures and auxiliary equipment designed to minimize patient and personnel
			 exposure shall be commensurate with the needed diagnostic information and shall
			 be utilized according to all of the following requirements:
(A) The speed of the screen and film
			 combinations used shall be the fastest speed that is consistent with the
			 diagnostic objective of the examinations. Film cassettes without intensifying
			 screens shall not be used for any routine diagnostic imaging, with the
			 exception of veterinary radiography and standard film packets for intraoral use
			 in dental radiography.
(B) The
			 radiation exposure to the patient shall be the minimum exposure required to
			 produce images of good diagnostic quality.
(C) Portable or mobile X-ray equipment shall
			 be used only for examinations during which transferring the patient or patients
			 to a stationary X-ray installation is impractical.
(D) X-ray systems other than fluoroscopic
			 dental intraoral systems and computed tomography X-ray systems shall not be
			 utilized in any procedure in which the source-to-patient distance is less than
			 30 centimeters, unless specifically approved by the FDA. Veterinary systems
			 shall not be subject to this limitation.
(E) If grids are used between the patient and
			 the image receptor to decrease the amount of scattered radiation to the film
			 and improve contrast, the grid shall be as follows:
(i) Positioned properly, including the tube
			 side facing the right direction, with the grid centered to the central ray; and
(ii) if of the focused type,
			 positioned at the proper focal distance for the SIDs being used.
(9) Each individual who
			 is associated with the operation of an X-ray system shall be subject to the
			 requirements of part 4 of these regulations.