reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.554 - Administrative controls: Radiographic exposure

Current through June
				  11, 2024
1. Except for
				  patients who cannot be moved out of the room, only the staff and ancillary
				  personnel required for the medical procedure or training may be in the room
				  during the radiographic exposure. Other than the patient being examined:
(a) All persons must be positioned so that no
				  part of the body which is not protected by 0.5 mm lead equivalent will be
				  struck by the useful beam.
(b)
				  Staff and ancillary personnel must be protected from the direct scatter
				  radiation by protective aprons or whole body protective barriers of not less
				  than 0.25 mm lead equivalent.
(c) A
				  patient who cannot be removed from the room must be protected from the direct
				  scatter radiation by a whole body protective barrier of 0.25 mm lead equivalent
				  or 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.
(d) When a portion of the body of any member
				  of the staff or ancillary personnel is potentially subjected to stray radiation
				  which could result in his or her receiving 10 percent of the maximum
				  permissible dose, as defined in NAC
				  459.320 to
				  459.374, inclusive, additional
				  protective devices must be employed.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.556 - Administrative controls: Minimum exposure techniques

Current through
				  June 11, 2024
1.
				  Procedures and auxiliary equipment designed to minimize exposure to the patient
				  and personnel commensurate with obtaining the needed diagnostic information
				  must be utilized, including the following:
(a)
				  The speed of film or screen and film combinations must be the fastest speed
				  consistent with the diagnostic objective of the examination;
(b) The radiation exposure to the patient
				  must be the minimum exposure required to produce images of good diagnostic
				  quality;
(c) Except as otherwise
				  provided in paragraph (d), portable or mobile equipment may be used only for :
(1) Examinations where it is impractical to
				  transfer the patient to a stationary radiographic installation; and
(2) Its designed purpose, as specified by the
				  manufacturer; and
(d)
				  Portable or mobile equipment may be used in lieu of stationary equipment for a
				  period of not more than 90 days while the facility is awaiting the delivery of
				  new stationary equipment or the repair of registered stationary equipment if
				  the following conditions are satisfied:
(1)
				  The portable or mobile equipment has been registered and the appropriate fee
				  has been paid in accordance with NAC
				  459.154 and
				  459.161; and
(2) The registrant has requested, in writing,
				  and been granted authorization from the Division to use the portable or mobile
				  equipment in lieu of stationary equipment. Such a request must include, without
				  limitation:
(I) The date of installation of
				  the portable or mobile equipment; and
(II) The expected duration of the use of the
				  portable or mobile equipment.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.558 - Personnel monitoring

Current through June 11,
				  2024
All persons who are associated with the
				  operation of an X-ray system are subject to the occupational exposure limits
				  and the requirements for the determination of the doses which are stated in NAC
				  459.325 and 459.365. When protective clothing or devices are worn on portions
				  of the body and a monitoring device or devices are required, at least one
				  device must be utilized as follows:
1.
				  When an apron is worn, the monitoring device must be worn at the collar outside
				  the apron.
2. The dose to the whole
				  body, based on the maximum dose attributed to any one critical organ, which are
				  the gonads, the blood forming organs, head and trunk or lens of the eye, must
				  be recorded in the reports required by NAC 459.3665. If more than one device is
				  used and a record is made of the data, each dose must be identified with the
				  area where the device was worn on the body.
Exposure of a personnel
				  monitoring device to indicate deceptively a dose delivered to a person is
				  prohibited.
Bd. of Health, Radiation Control
				  Reg. §§ 6.3.1.1.10-6.3.1.1.-10.2, eff. 2-28-80-NAC A
				  1-18-94
NRS
				  459.201
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5585 - Instruction on radiation safety

Current through June 11,
				  2024
A registrant shall annually provide instruction
				  on radiation safety to each person who provides patient care and treatment
				  planning for patients. The instruction must include, without limitation:
1. Instruction on the operation of each
				  device used by the person;
2.
				  Safety procedures; and
3. Any
				  updates on clinical use of each of those devices.
Added to NAC by Bd. of Health by
				  R185-08, eff. 5-7-2010
NRS
				  459.201
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.559 - Quality management program

Current through June 11,
				  2024
1. Each registrant
				  shall establish and maintain a written quality management program to ensure
				  that a radiation therapy system is used as directed by the authorized user. The
				  program must include, without limitation, the following objectives:
(a) Except where a delay to provide a written
				  directive would jeopardize the health of a patient, a written directive must be
				  prepared before a dose of therapeutic radiation is administered;
(b) If the emergent nature of the condition
				  of a patient threatens the health of the patient, an oral directive to
				  administer treatment is acceptable, so long as the information contained in the
				  oral directive is documented immediately in the record of the patient and a
				  written directive is prepared within 24 hours;
(c) If a delay to provide a written revision
				  to an existing written directive jeopardizes the health of a patient, an oral
				  revision to the existing written directive may be given, so long as the oral
				  revision is immediately documented in the record of the patient and a revised
				  written directive is signed by the authorized user within 48 hours;
(d) A written directive which changes an
				  existing written directive may be made for any therapeutic procedure, so long
				  as the revised directive is signed and dated by an authorized user before the
				  next administration of the electronic brachytherapy dose or fractional
				  dose;
(e) The identity of the
				  patient as being the person named in the written directive must be verified by
				  more than one method before the administration of any therapeutic
				  radiation;
(f) The final plans of
				  treatment and any related calculations must be the same as those specified in
				  the written directive;
(g) Each
				  administration of a dose of therapeutic radiation must comply with the written
				  directive; and
(h) Any unintended
				  deviation from the written directive must be identified and evaluated, and
				  appropriate action must be taken.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5595 - Requirements for registrants of portable equipment which is hand-held and facilities which house such equipment

Current through June 11,
				  2024
In addition to the requirements of NAC 459.400
				  to 459.624, inclusive, registrants of portable equipment which is hand-held and
				  facilities which house such equipment must meet the following
				  requirements:
1. A registrant shall
				  establish a safe operating policy, and all operators shall sign a form
				  acknowledging that they understand the policy. The policy must, at a minimum:
(a) Require proper operation of the unit,
				  consistent with the manufacturer's manual;
(b) Ensure that the device is not used in an
				  uncontrolled area, such as a waiting room or hallway;
(c) Require that the device is held without
				  motion throughout radiography using a suitable stand or other method to
				  immobilize portable equipment during the radiography;
(d) Require that any optional, removable
				  secondary radiation block or protection features be installed and used during
				  radiography, if the unit was designed with those features;
(e) Ensure that there are no ancillary
				  persons within a radius of at least 2 meters from the tube head when using the
				  portable equipment which is hand-held; and
(f) Require an operator to comply with the
				  provisions of NAC 459.554 and 459.556, when applicable.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.564 - Diagnostic X-ray systems

Current through June 11,
				  2024
In addition to other requirements of NAC
				  459.400 to
				  459.624, inclusive, and section
				  28, all diagnostic X-ray systems must meet the following requirements:
1. The control panel containing the main
				  power switch must bear the warning statement, legible and accessible to view:
				  "WARNING: This X-ray unit may be dangerous to patient and operator unless safe
				  exposure factors and operating instructions are observed."
2. On battery-powered generators, visual
				  means must be provided on the control panel to indicate whether the battery is
				  in a state of charge adequate for proper operation.
3. The leakage radiation from the diagnostic
				  source assembly measured at a distance of 1 meter in any direction from the
				  source must not exceed 100 milliroentgens in 1 hour when the X-ray tube is
				  operated at its leakage technique factors. Compliance will be determined by
				  measurements averaged over an area of 100 square centimeters with no linear
				  dimension greater than 20 centimeters.
4. The radiation emitted by a component other
				  than the diagnostic source assembly must not exceed 2 milliroentgens in 1 hour
				  at 5 centimeters from any accessible surface of the component when it is
				  operated in an assembled X-ray system under any conditions for which it was
				  designed. Compliance will be determined by measurements averaged over an area
				  of 100 square centimeters with no linear dimension greater than 20
				  centimeters.
5. The requisites for
				  quality of the beam must satisfy the requirements set forth in
				  21 C.F.R.
				  §
										1020.30(m)(1) and
				  Table 1 in that section.
6. Where
				  two or more radiographic tubes are controlled by one exposure switch, the tube
				  or tubes which have been selected must be clearly indicated before initiation
				  of the exposure. This indication must be on the X-ray control.
7. The tube housing assembly supports must be
				  adjusted so that the tube housing assembly will remain stable during an
				  exposure unless the tube housing movement is a designed function of the X-ray
				  system.
8. The technique factors to
				  be used during an exposure must be indicated before the exposure begins. If
				  automatic exposure controls are used, the technique factors which are set
				  before the exposure must be indicated. On equipment having fixed technique
				  factors, this requirement may be met by permanent markings. Indication of
				  technique factors must be visible from the operator's position except in the
				  case of spot films made by the fluoroscopist.
Bd. of Health, Radiation Control
				  Reg. §§ 6.4-6.4.8.2, eff. 2-28-80-NAC A 4-27-84; A by
				  R144-13A,
				  eff. 10/13/2016
NRS
				  459.201
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.566 - Fluoroscopic X-ray systems: Limitation of useful beam; spot filming

Current through June 11, 2024
All
				  fluoroscopic X-ray systems must meet the following requirements:
1. The fluoroscopic tube must not produce X
				  rays unless the primary protective barrier is in position to intercept the
				  entire useful beam at all times.
2.
				  The entire cross section of the useful beam must be intercepted by the primary
				  protective barrier of the fluoroscopic image assembly at any source-image
				  receptor distance.
3. The X-ray
				  field produced by fluoroscopic equipment without image intensification must not
				  extend beyond the entire visible area of the image receptor. This requirement
				  applies to field size during both fluoroscopic procedures and spot-filming
				  procedures.
4. During fluoroscopic
				  or spot-filming procedures, neither the length nor the width of the X-ray field
				  in the plane of the image receptor may exceed the visible area of the image
				  receptor by more than 3 percent of the source-image receptor distance. The sum
				  of the excess length and the excess width must be no greater than 4 percent of
				  the source-image receptor distance.
5. Compliance will be determined with the
				  beam axis perpendicular to the image receptor. For rectangular X-ray fields
				  used with circular image reception, the error in alignment will be determined
				  along the length and width dimensions of the X-ray field which pass through the
				  center of the visible area of the image receptor.
6. In addition to other requirements of NAC
				  459.400 to 459.624, inclusive, for new equipment installed after February 28,
				  1980:
(a) A means must be provided between the
				  source and the patient for adjustment of the X-ray field size in the plane of
				  the film to the size of that portion of the film which has been selected on the
				  spot-film selector. Such an adjustment must be automatically accomplished
				  except when the X-ray field size in the plane of the film is smaller than that
				  of the selected portion of the film.
(b) It must be possible to adjust the X-ray
				  field size in the plane of the film to a size smaller than the selected
				  position of the film. The minimum field size at the greatest source-image
				  receptor distance must be equal to or less than 5 by 5 centimeters.
(c) The center of the X-ray field in the
				  plane of the film must be aligned with the center of the selected portion of
				  the film to within 2 percent of the source-image receptor distance.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.568 - Fluoroscopic X-ray systems: Activation of the tube

Current through
				  June 11, 2024
X-ray production in the fluoroscopic
				  mode must be controlled by a device which requires continuous pressure by the
				  fluoroscopist for the entire time of any exposure. When recording serial
				  fluoroscopic images, the fluoroscopist must be able to terminate the X-ray
				  exposure at any time, but means may be provided to permit completion of any
				  single exposure of the series in process.
Bd. of Health, Radiation Control
				  Reg. § 6.5.2, eff. 2-28-80
NRS
				  459.201
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.570 - Fluoroscopic X-ray systems: Exposure rate limits

Current through
				  June 11, 2024
1. The
				  exposure measured at the point where the center of the useful beam enters the
				  patient must not exceed 10 roentgens (100 millisieverts) per minute, except
				  during recording of fluoroscopic images or when provided with optional high
				  level control.
2. When provided
				  with optional high level control, the equipment must not be operable at any
				  combination of tube potential and current which will result in an exposure
				  rate, measured at the point where the center of the useful beam enters the
				  patient, in excess of:
(a) Five roentgens (50
				  millisieverts) per minute if the high level control is not activated;
				  and
(b) Twenty roentgens (200
				  millisieverts) per minute if the high level control is activated and the unit
				  was manufactured on or after May 19, 1995.
Special means of activation of
				  high level controls, such as additional pressure applied continuously by the
				  operator, will be required to avoid accidental use. A continuous signal audible
				  to the fluoroscopist must indicate activation and use of the high level
				  control.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.572 - Fluoroscopic X-ray systems: Barrier-rate limits

Current through
				  June 11, 2024
1. The
				  exposure rate resulting from transmission through the primary protective
				  barrier with the attenuation block in the useful beam, combined with radiation
				  from the image intensifier, if provided, must not exceed 2 milliroentgens per
				  hour at 10 centimeters from any accessible surface of the fluoroscopic imaging
				  assembly beyond the plane of the image receptor for each roentgen per minute of
				  entrance exposure rate.
2. The
				  exposure rate due to transmission through the primary protective barrier
				  combined with radiation from the image intensifier must be determined by
				  measurements averaged over an area of 100 square centimeters with no linear
				  dimension greater than 20 centimeters.
3. If the source is below the tabletop, the
				  measurement must be made with the input surface of the fluoroscopic imaging
				  assembly positioned 30 centimeters above the tabletop.
4. If the source is above the tabletop and
				  the source-image receptor distance is variable, the measurement must be made
				  with the end of the beam-limiting device or spacer as close to the tabletop as
				  it can be placed, but it must not be closer than 30 centimeters.
5. The attenuation block must be positioned
				  in useful beam 10 centimeters from the point of measurement of entrance
				  exposure rate and between this point and the input surface of the fluoroscopic
				  imaging assembly.
Bd. of Health, Radiation Control
				  Reg. §§ 6.5.4-6.5.4.2.4, eff. 2-28-80
NRS
				  459.201
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.574 - Fluoroscopic X-ray systems: Indication of potential and current; source-skin distance; exceptions for fluoroscopy imaging system

Current
				  through June 11, 2024
1.
				  During fluoroscopy and cinefluorography, X-ray tube potential and current must
				  be continuously indicated.
2.
				  Except as otherwise provided in subsection 3, the source to skin distance must
				  not be less than:
(a) Thirty-eight
				  centimeters on stationary fluoroscopes installed after February 28,
				  1980;
(b) Thirty-five and
				  five-tenths centimeters on stationary fluoroscopes which are in operation
				  before February 28, 1980;
(c)
				  Thirty centimeters on all mobile fluoroscopes; and
(d) Twenty centimeters for image intensified
				  fluoroscopes used for specific surgical application. The users' operating
				  manual must provide precautionary measures to be followed during the use of
				  this device.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.576 - Fluoroscopic X-ray systems: Fluoroscopic timer; mobile fluoroscopes

Current through June 11, 2024
1. A means must be provided to preset the
				  cumulative on-time of the fluoroscopic tube. The maximum cumulative time of the
				  timing device must not exceed 5 minutes without resetting.
2. A signal audible to the fluoroscopist must
				  indicate the completion of any preset cumulative on-time. Such a signal must
				  continue to sound while X rays are produced until the timing device is reset.
				  In addition to the other requirements of NAC 459.566 to 459.578, inclusive,
				  mobile fluoroscopes must provide image intensification.
Bd. of Health, Radiation Control
				  Reg. §§ 6.5.7-6.5.8, eff. 2-28-80
NRS
				  459.201
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.578 - Fluoroscopic X-ray systems: Control of scattered radiation

Current
				  through June 11, 2024
1.
				  Fluoroscopic table designs when combined with procedures utilized, must be such
				  that no unprotected part of any staff or ancillary person's body will be
				  exposed to unattenuated scattered radiation which originates from under the
				  table. The attenuation required must be not less than 0.25 mm lead
				  equivalent.
2. Equipment
				  configuration, when combined with procedures, must be such that no portion of
				  any staff or ancillary person's body, except the extremities, are exposed to
				  the unattenuated scatter radiation emanating from above the tabletop unless the
				  person:
(a) Is at least 120 cm from the
				  center of the useful beam; or
(b)
				  The radiation has passed through not less than 0.25 mm lead equivalent
				  material, for example, drapes, Bucky-slot cover, sliding or folding panel or
				  self-supporting curtains, in addition to any lead equivalency provided by the
				  protective apron referred to in subsection 1 of NAC 459.554.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.580 - Intraoral dental radiographic systems

Current through June 11,
				  2024
1. In addition to
				  the provisions of NAC
				  459.552 to
				  459.558, inclusive, and
				  459.564, these requirements apply
				  to X-ray equipment and associated facilities used for dental radiography. The
				  criteria for extraoral dental radiographic systems are covered in NAC
				  459.616 to
				  459.624, inclusive.
2. Intraoral dental radiographic machines may
				  be used only for intraoral dental radiography.
3. X-ray systems designed for use with an
				  intraoral image receptor must be provided with means to limit source-to-skin
				  distance of not less than 18 centimeters.
4. Radiographic systems which are designed
				  for use with an intraoral image receptor must be provided with means to limit
				  the X-ray beam so that:
(a) If the minimum
				  source-to-skin distance is 18 centimeters or more, the X-ray field at the
				  minimum source-to-skin distance is containable in a circle having a diameter of
				  no more than 7 centimeters; and
(b)
				  If the minimum source-to-skin distance is less than 18 centimeters, the X-ray
				  field at the minimum source-to-skin distance is containable in a circle having
				  a diameter of no more than 6 centimeters.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.581 - Registration of electronic brachytherapy systems or additional therapeutic X-ray systems

Current through June 11,
				  2024
1. Except as
				  otherwise provided in subsection 4, each person who acquires an electronic
				  brachytherapy system or an additional therapeutic X-ray system shall apply to
				  the Division for registration of the machine within 30 days after installing
				  the machine. The application must include, without limitation:
(a) A list of all authorized users, radiation
				  therapy physicists and operators;
(b) The name of the radiation safety officer
				  and radiation safety committee members;
(c) A copy of the most recent record of
				  surveys, calculations and quality assurance checks on each machine;
(d) A current copy of the quality management
				  program created pursuant to NAC 459.559;
(e) A current copy of the quality assurance
				  program created pursuant to NAC 459.5937; and
(f) The manufacturer's
				  certification.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.582 - Therapeutic X-ray systems: Leakage radiation; diaphragms and beam-limiting devices

Current through June 11,
				  2024
1. When the tube is
				  operated at its leakage technique factors, the leakage radiation must not
				  exceed the value specified at the distance specified for the classification of
				  that X-ray system.
2. For systems
				  of contact therapy, leakage radiation must not exceed 100 mR/hr at 5
				  centimeters from the tube housing and must meet the following standards:
(a) In 0-150 kVp systems which are
				  manufactured or installed prior to February 28, 1980, the leakage radiation
				  must not exceed 1 R in 1 hour at 1 meter from the source.
(b) In 0-150 kVp systems which are
				  manufactured on or after February 28, 1980, the leakage radiation must not
				  exceed 100 mR in 1 hour at 1 meter from the source.
(c) In 151 to 999 kVp systems, the leakage
				  radiation must not exceed 1 R in 1 hour at 1 meter from the source except
				  systems that operate in excess of 500 kVp may have a leakage radiation at 1
				  meter from the source equivalent to the useful beam multiplied by a factor of
				  0.001.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.584 - Therapeutic X-ray systems: Filter systems, tube housing

Current
				  through June 11, 2024
1.
				  The filter system must be designed so that:
(a) Filters cannot be accidentally displaced
				  from the useful beam at any possible tube orientation.
(b) Each filter is marked as to its material
				  of construction and its thickness or wedge angle for wedge filters. The filters
				  must be individually distinguishable.
(c) The operator must be able to determine
				  the presence or absence of each filter and the orientation of each wedge filter
				  in the useful beam when the operator is at his or her position at the control
				  panel either by display at the control panel or by direct
				  observation.
(d) The filters and
				  filter insertion slot opening must be so designed that the radiation at 5 cm
				  from the filter insertion slot opening does not exceed 30 roentgens per hour
				  under all operating conditions.
(e)
				  Each machine equipped with a beryllium or other low filtration window must be
				  clearly labeled as such upon the tube head housing and upon the control
				  panel.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.586 - Therapeutic X-ray systems: Beam monitor

Current through June 11,
				  2024
Equipment installed after February 28, 1980, of
				  greater than 150 kVp must be provided with a beam monitor system as
				  follows:
1. It must include a
				  transmission detector which is a full beam detector and which is placed on the
				  patient side of any fixed added filters other than a wedge filter;
2. It must have the detector interlocked to
				  prevent incorrect positioning in the useful beam;
3. It must have a display at the control
				  panel from whose reading in dose monitor units the absorbed dose at a reference
				  point in the treatment volume can be calculated;
4. The control panel display must maintain
				  the reading until intentionally reset to zero;
5. In the event of electrical power failure
				  the reading at the control panel display must be recoverable at a later
				  time;
6. Irradiation may be allowed
				  only after a selection of a number of dose monitor units has been made at the
				  treatment control panel;
7. It must
				  be capable of independently terminating irradiation when a preselected number
				  of dose monitor units has been reached; and
8. The control panel display must have only
				  one scale, no scale multiplying factors, and be designed so that an increasing
				  dose is displayed by increasing numbers and that in the event of an overdosage
				  of radiation the absorbed dose may be accurately determined.
Bd. of Health, Radiation Control
				  Reg. §§ 6.8.1.8-6.8.1.8.8, eff. 2-28-80
NRS
				  459.201
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.588 - Therapeutic X-ray systems: Timer; control panel

Current through
				  June 11, 2024
1. A timer
				  must be provided which has a display at the treatment control panel. The timer
				  must have a preset timer selector and an elapsed time indicator.
2. The timer must be a cumulative timer which
				  switches on and off with the radiation and retains its reading after
				  irradiation is interrupted or terminated. It must be necessary to zero the
				  elapsed time indicator and the preset time selector after irradiation is
				  terminated.
3. The timer must
				  terminate irradiation when a preselected time has elapsed.
4. The control panel must have:
(a) An indication of whether electrical power
				  is present and activation of the X-ray tube is possible;
(b) An indication of whether X rays are being
				  produced;
(c) The means for
				  indicating kilovoltage and X-ray tube current;
(d) The means for terminating an exposure at
				  any time;
(e) A locking device
				  which will prevent unauthorized use of the X-ray system; and
(f) For new equipment installed after
				  February 28, 1980, a positive display of specific filter or filters in the
				  beam.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.590 - Therapeutic X-ray systems: Requirements for design of treatment room

Current through June 11, 2024
In addition
				  to providing shielding adequate to meet the requirements of NAC 459.320 to
				  459.374, inclusive, the design of the treatment room must meet the following
				  requirements:
1. Treatment rooms to
				  which access is possible through more than one entrance must be provided with
				  warning lights in a readily observable position near the outside of all access
				  doors, preferably at eye level, which will indicate when the useful beam is
				  on.
2. Provision must be made for
				  two-way aural communication with the patient from the control room.
3. Windows, mirror systems or closed-circuit
				  television viewing screens or equivalent systems must be provided to permit
				  continuous observation of the patient during irradiation and must be so located
				  that the operator may see the patient and the control panel from the same
				  position. When the viewing system is by electronic means, for example,
				  television, an alternate viewing system must be available as a backup in case
				  of electronic failure.
4.
				  Facilities which contain an X-ray system which may be operated above 150 kVp
				  must:
(a) Have all necessary shielding, except
				  for any beam interceptor, provided by fixed barriers;
(b) Have the control panel in a protected
				  area which is outside the treatment room or within a protective booth which has
				  a door electrically connected to the control panel so that X-ray production
				  cannot occur unless the door is closed;
(c) Have all entrance doors of the treatment
				  room electrically connected to the control panel so that X-ray production
				  cannot occur unless all doors are closed;
(d) Be arranged so that if the doors referred
				  to in paragraphs (b) and (c) are opened when the therapy tubehead is activated:
(1) The machine will shut off within 2
				  seconds; or
(2) The radiation at a
				  distance of 1 meter from the target will be reduced to 10 mR/hr or less within
				  2 seconds; and
(e) Be so
				  designed that if the radiation output of the tubehead is affected by any door
				  opening, the machine can be restored to full operation only by:
(1) Closing the door; and
(2) Subsequently reinitiating the exposure by
				  manual action at the control panel.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.592 - Therapeutic X-ray systems: Surveys; calibration; operating procedures

Current through June 11, 2024
1. All new facilities and existing facilities
				  not previously surveyed must have a radiation protection survey made by, or
				  under the direction of, a qualified expert. This survey must also be done after
				  any change in the facility which might produce a radiation hazard. The expert
				  shall report his or her findings, in writing, to the person in charge of the
				  facility and a copy of the report must be transmitted by the registrant to the
				  Division within 30 days.
2. The
				  radiation output of each therapeutic radiation machine must be calibrated by,
				  or under the direction of, a qualified expert who is physically present at the
				  facility during the calibration procedure. The calibration must be repeated
				  after any change in, or replacement of, components of the X-ray generating
				  equipment which could cause a change in X-ray output. Calibration of the
				  therapy beam must be performed with a measuring instrument the calibration of
				  which is directly traceable to national standards of exposure or absorbed dose
				  and which has been calibrated within the preceding year. Records of the
				  calibrations must be provided to and maintained by the registrant. In addition:
(a) Each therapeutic radiation machine must
				  have the calibrations repeated at time intervals not exceeding 1 year. The
				  calibration must include at least the following determinations:
(1) The accurate determination of the air
				  dose rate or the dose rate in a suitable phantom, as appropriate, for a
				  sufficient number of operating parameters for each effective energy to permit
				  the determination of the dose received by the patient;
(2) Verification that the equipment is
				  operating in accordance with the design specifications concerning the
				  congruence between the radiation field and light localizer, when a localizer is
				  used, and for beam flatness and symmetry at the specified depths;
(3) The effective energy, for example,
				  half-value layer when appropriate, for every combination of kVp and filter used
				  for radiation therapy;
(4) The
				  uniformity of the radiation field and its dependence upon the direction of the
				  useful beam; and
(5) The
				  calibration determinations must be provided in sufficient detail so that the
				  absorbed dose in rads to tissue adjacent to, as well as in the useful beam, may
				  be calculated to within ±5 percent of the intended absorbed
				  dose.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5921 - Therapeutic X-ray systems: Submission of certain information to Division before installation of certain devices

Current through June
				  11, 2024
1. Before a
				  facility may install a new therapeutic X-ray device, or installs a therapeutic
				  X-ray device with a higher energy output into an existing room, the facility
				  must submit the following information for approval by the Division:
(a) General information concerning the
				  facility, including, without limitation:
(1)
				  The legal name of the facility;
(2)
				  A telephone number and street address for the facility;
(3) The name, address, telephone number and
				  registration or license number of the authorized medical physicist for
				  electronic brachytherapy responsible for the preparation of the shielding
				  plan;
(4) The name and telephone
				  number of the facility supervisor; and
(5) A statement indicating whether or not the
				  installation is for a new facility or a modification to an existing
				  facility;
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5922 - Therapeutic X-ray systems: Requirements for authorized users

Current through June 11, 2024
1. A registrant for any therapeutic X-ray
				  device shall require an authorized user to:
(a) Be an authorized user of radioactive
				  sources for electronic brachytherapy pursuant to the radioactive material
				  license of the registrant who had completed specific training on the device
				  provided by the manufacturer and approved by the Division; or
(b) Be a physician who:
(1) Is licensed by this State as a physician
				  pursuant to chapter 630 of NRS or an osteopathic physician pursuant to chapter
				  633 of NRS;
(2) Is certified in:
(I) Radiation oncology or therapeutic
				  radiology by the American Board of Radiology;
(II) Radiation oncology by the American
				  Osteopathic Board of Radiology;
(III) Radiology, with specialization in
				  radiotherapy, as a Fellow of the Faculty of Radiology or Fellow of the Royal
				  College of Radiologists of the United Kingdom; or
(IV) Therapeutic radiology by the Royal
				  College of Physicians and Surgeons of Canada;
(3) Has completed specific training on the
				  system provided by the manufacturer and approved by the Division; and
(4) Has had his or her training reviewed and
				  approved by the Division.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5923 - Therapeutic X-ray systems: Requirements for authorized medical physicist for electronic brachytherapy

Current through June 11,
				  2024
1. A registrant for
				  any therapeutic X-ray device shall require an authorized medical physicist for
				  electronic brachytherapy to:
(a) Be currently
				  licensed as a therapeutic radiological physicist by a professional organization
				  specified by the Division or in another state;
(b) Have completed specific training on the
				  device provided by the manufacturer and approved by the Division; and
(c) Have had his or her training reviewed and
				  approved by the Division.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5924 - Therapeutic X-ray systems: Requirements for radiation safety officers

Current through June 11, 2024
1. A registrant for any therapeutic X-ray
				  system shall appoint a radiation safety officer and require the radiation
				  safety officer to:
(a) Have completed specific
				  training on the system provided by the manufacturer and approved by the
				  Division;
(b) Be an authorized user
				  or authorized medical physicist for electronic brachytherapy;
(c) Be certified by:
(1) The American Board of Health Physics in
				  Comprehensive Health Physics;
(2)
				  The American Board of Radiology in Diagnostic Radiologic Physics, Therapeutic
				  Radiological Physics or Medical Nuclear Physics, or possess another certificate
				  issued by the American Board of Radiology that the Division deems
				  sufficient;
(3) The American Board
				  of Nuclear Medicine;
(4) The
				  American Board of Science in Nuclear Medicine; or
(5) The American Board of Medical Physics;
				  or
(d) Have completed
				  classroom and laboratory training, including, without limitation:
(1) One hundred hours of radiation physics
				  and instrumentation;
(2) Thirty
				  hours of radiation protection;
(3)
				  Twenty hours of mathematics pertaining to the use and measurement of
				  radiation;
(4) Twenty hours of
				  radiation biology;
(5) Thirty hours
				  of medical therapy training; and
(6) One year of full-time experience in
				  radiation safety at a medical institution under the supervision of a radiation
				  safety officer.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5925 - Therapeutic X-ray systems: Requirements for persons who are not authorized users

Current through June 11,
				  2024
1. A registrant for
				  any therapeutic X-ray system shall require a person who is not an authorized
				  user to:
(a) Operate the therapeutic X-ray
				  system solely under the direct supervision of an authorized user;
(b) Be certified as a radiation therapy
				  technologist by the American Registry of Radiologic Technologists or a
				  certifying organization accepted by the American Registry of Radiologic
				  Technologists; and
(c) Have
				  completed specific training on the system provided by the manufacturer and
				  approved by the Division.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5926 - Therapeutic X-ray systems: Requirements for use; posting of certain procedures; duties of registrants

Current through June 11,
				  2024
1. A therapeutic
				  X-ray system must not be used for the irradiation of patients unless the
				  facility complies with the criteria of the United States Food and Drug
				  Administration for systems approved for human use.
2. When not in use, the therapeutic X-ray
				  system must be secured and unauthorized use or access prevented.
3. When a patient must be held in position
				  for radiation therapy, mechanical supporting or restraining devices must be
				  used.
4. A copy of the current
				  operating and emergency procedures must be kept in a visible place in the
				  treatment room.
5. Except for the
				  patient, a person must not be exposed to radiation during the treatment and the
				  facility must use portable shielding to reduce the occupational dose.
6. A registrant shall:
(a) Notify the radiation safety officer
				  specified in NAC
				  459.5924, or the officer's
				  designee, and an authorized user as soon as practicable, if a patient or human
				  research subject has a medical emergency or dies;
(b) Allow a person in the treatment room
				  during treatment only after obtaining the approval of the authorized user, the
				  radiation safety officer specified in NAC
				  459.5924 or the authorized
				  medical physicist for electronic brachytherapy;
(c) Prevent the operation of more than one
				  device which produces radiation in a treatment room; and
(d) Develop, implement and maintain written
				  procedures for responding to a situation in which an operator is unable to
				  complete the treatment in compliance with the written directive. The procedures
				  must include, without limitation:
(1)
				  Instructions for responding to equipment failures and the names of the persons
				  who are responsible for carrying out any corrective actions;
(2) The process for restricting access to and
				  marking the treatment area to minimize the risk of inadvertent exposure to
				  radiation; and
(3) The names and
				  telephone numbers of the authorized users, the authorized medical physicist for
				  electronic brachytherapy and the radiation safety officer specified in NAC
				  459.5924 who must be contacted if
				  the system operates abnormally.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5927 - Therapeutic X-ray systems: Radiation protection survey; portable monitoring equipment

Current through June 11,
				  2024
1. The registrant
				  shall perform, or cause to be performed, a radiation protection survey on each
				  new facility or any existing facility which has not been previously
				  surveyed.
2. Each facility location
				  authorized to use a therapeutic X-ray device must possess portable monitoring
				  equipment which has been calibrated appropriately and which includes, without
				  limitation, a radiation measurement survey instrument capable of measuring dose
				  rates over the range 0.1 µSv (0.01 mrem) per hour to 10 mSv (1000 mrem)
				  per hour. The instrument must be calibrated annually.
3. The radiation protection survey must:
(a) Be performed by, or under the direction
				  of, an authorized medical physicist for electronic brachytherapy or the
				  radiation safety officer specified in NAC 459.5924;
(b) Be performed under the following
				  conditions:
(1) The beam must be on;
(2) The largest clinically available
				  treatment field must be used;
(3) A
				  scattering phantom in the useful beam of radiation for secondary barriers must
				  be present;
(4) A phantom must not
				  be used for primary barriers; and
(5) Portable shielding in the primary and
				  secondary beams must be taken into consideration; and
(c) Ensure that the levels of radiation in
				  both restricted and unrestricted areas are not likely to cause exposures to
				  persons in excess of the limits set by this chapter.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.593 - Electronic brachytherapy devices: Requirements for installation, maintenance, adjustment, service or repair

Current through June 11,
				  2024
1. Only a
				  manufacturer's representative who is registered as a service provider with the
				  State may install the electronic brachytherapy device if the installation
				  includes work on:
(a) The shielding of the
				  source of radiation;
(b) The
				  driving unit of the source of radiation; or
(c) Any other electronic or mechanical
				  component which may expose the source of radiation, reduce the shielding around
				  the source of radiation or compromise the radiation safety of the system or the
				  source of radiation.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5931 - Electronic brachytherapy devices: Fees

Current through June 11,
				  2024
1. A registrant
				  shall pay an annual fee for the registration and inspection of an electronic
				  brachytherapy device in the amount of $4,400.
2. The registration fee is due within 30 days
				  after the acquisition of the electronic brachytherapy system.
3. An annual renewal fee must be paid not
				  later than the date on which the registration expires. If the fee is not
				  received by that date, the registrant shall:
(a) Cease operating the radiation machine on
				  that date; and
(b) Within 5 days
				  after the registration expires, submit to the Division:
(1) An application for a renewal of the
				  registration;
(2) The fee set forth
				  in subsection 1; and
(3) A fee for
				  late payment that is equal to twice the amount of the registration
				  fee.
Nevada Administrative Code › Chapter 459 - Hazardous Materials › RADIATION CONTROL › X-Rays in the Healing Arts › Section 459.5932 - Electronic brachytherapy devices: Validation of output; calibration

Current through June 11, 2024
1. An authorized medical physicist for
				  electronic brachytherapy shall validate the output of an electronic
				  brachytherapy system.
2.
				  Measurements for calibration must be made:
(a)
				  For each X-ray tube;
(b) After any
				  repair which affects the generation of the X-ray beam; or
(c) At any time indicated by the spot check
				  required by NAC 459.5934.