North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 15 - RADIATION PROTECTION › Section .0600 - X RAYS IN THE HEALING ARTS › Section 15 .0603 - GENERAL REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Administrative
				controls
(1) The registrant shall be
				responsible for directing the operation of the x-ray machines which he has
				registered with the agency. He or his agent shall assure that the following
				provisions are met in the operation of the x-ray machine(s):
(A) An x-ray machine which does not meet the
				provisions of these Rules shall not be operated for diagnostic or therapeutic
				purposes, if so ordered by the agency in accordance with Rules.0109 and.0110 of
				this Chapter.
(B) Individuals who
				will be operating the x-ray equipment shall be instructed in the safe operating
				procedures and use of the equipment and demonstrate an understanding thereof to
				the registrant.
(C) In the vicinity
				of each diagnostic x-ray system's control panel, a chart shall be provided,
				which specifies for all usual examinations and associated projections which are
				performed by that system, a listing of information including patient's
				anatomical size versus technique factors to be utilized at a given source to
				image receptor distance. The chart shall also provide:
(i) type and size of the film or film-screen
				combination to be used,
(ii) type
				and ratio of grid to be used, if any, and focal spot to film
				distance,
(iii) type and placement
				of gonad shielding to be used.
(D) Written safety procedures and rules shall
				be established and made available to each individual operating x-ray equipment
				under his control. The operator shall be familiar with these rules.
(E) Only the professional staff and ancillary
				personnel required for the medical procedure or for 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 including the extremities which is not protected by
				0.5 mm lead equivalent will be exposed to the useful beam.
(ii) Professional staff and ancillary
				personnel shall be protected from the direct scatter radiation by protective
				aprons or whole body protective barriers of not less than 0.25 mm lead
				equivalent.
(iii) Patients who
				cannot be removed from the room shall be protected from the direct scatter
				radiation by whole body protective barriers of 0.25 mm lead equivalent or shall
				be so positioned that the nearest portion of the body is at least six feet from
				both the tube head and the nearest edge of the image receptor.
(iv) When a portion of the body of a non-
				occupationally exposed professional staff or ancillary personnel is potentially
				subjected to stray radiation which would result in that individual receiving
				one-fourth of the maximum permissible dose as defined in Rule.1604 of this
				Chapter, additional protective measures shall be employed.
(v) Upon written application to the agency,
				the agency may waive the requirements in Subparts (a)(1)(E)(ii) and
				(a)(1)(E)(iii) of this Rule if the registrant demonstrates that such waiver is
				necessary for best management of patients and will not result in violation of
				the public and occupational dose limits established in the rules in this
				Chapter.
(F) Gonad
				shielding of not less than 0.5 mm lead equivalent shall be used for potentially
				procreative patients during radiographic procedures in which the gonads are in
				the direct, or useful beam, except for cases in which this would interfere with
				the diagnostic procedures.
(G)
				Individuals shall not be exposed to the useful beam except for healing arts
				purposes. Such exposures shall have been authorized by a licensed practitioner
				of the healing arts. This provision specifically prohibits deliberate exposure
				of an individual for training, demonstration or other nonhealing arts
				purposes.
(H) When a patient or
				film must be provided with auxiliary support during a radiographic exposure:
(i) Mechanical holding devices shall be used
				whenever medical circumstances permit. Written safety procedures, as required
				in Part (a)(1)(D) of this Rule shall indicate the requirements for selecting a
				holder;
(ii) If a human holder is
				required, written safety procedures as required in Part (a)(1)(D) of this Rule,
				shall indicate the instructions provided to the holder;
(iii) The human holder shall be protected as
				required in Part (a)(1)(E) of this Rule;
(iv) No individual shall be used routinely to
				hold patients or film.
(I) Procedures and auxiliary equipment
				designed to minimize patient and personnel exposure commensurate with the
				needed diagnostic information shall be utilized. This includes, but is not
				limited to, the following requirements:
(i)
				The speed of film or screen and film combinations shall be the fastest speed
				consistent with the diagnostic objective of the examinations.
(ii) The radiation exposure to the patient
				shall be the minimum exposure required to produce images of good diagnostic
				quality.
(iii) Portable or mobile
				equipment shall be used only for examinations where it is impractical for
				medical reasons to transfer the patient to a stationary radiographic
				installation.
(J) All
				persons who are associated with the operation of an x-ray system are subject to
				the occupational exposure limits as defined in Rules.1604 and.1638 of this
				Chapter, and personnel monitoring procedures in Rule.1614 of this Chapter. In
				addition, when protective clothing or equipment is worn on portions of the body
				and a 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 the
				apron.
(ii) The dose to the whole
				body shall be recorded in the reports required in Rule.1640 of this Chapter. If
				more than one device is used, each dose shall be identified with the area where
				the device was worn on the body.