New Mexico Administrative Code › Title 20 - ENVIRONMENTAL PROTECTION › Chapter 3 - RADIATION PROTECTION › Part 6 - X-RAYS IN HEALING ARTS › Section 20.3.6.602 - GENERAL REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Administrative Controls:
(1) Registrant: The
				registrant shall be responsible for directing the operation of the x-ray
				machines which he has registered with the Department. 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 provision of these regulations shall not be operated for
				diagnostic or therapeutic purposes, if so directed by the Department.
(b) Individuals who will be operating the
				x-ray equipment shall be adequately instructed in the safe operating procedures
				and be competent in the safe use of the equipment.
(c) In the vicinity of each x-ray system's
				control panel a chart shall be provided which specifies for all examinations
				which are performed by that system a listing of information, including but not
				limited to the following, for each projection within that examination:
(i) patient's anatomical size versus
				technique factors to be utilized;
(ii) type of and size of the film or
				film-screen combination to be used;
(iii) type of grid to be used if any, and
				focal distance;
(iv) source to
				image receptor distance to be used; and
(v) type and location of placement of gonad
				shielding to be used.
(d) Written safety procedures and rules shall
				be provided to each individual operating x-ray equipment under his control,
				including 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 rules.
(e) Except for patients who cannot be moved
				out of the room, only the staff and ancillary personnel 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 including the extremities not protected by 0.5 mm lead
				equivalent, will be struck by the useful beam;
(ii) 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 and 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 2 meters from both the tube head
				and the nearest edge of the image receptor;
(iv) when a portion of the body of any staff
				or ancillary personnel is potentially subjected to stray radiation which could
				result in that individual receiving one quarter of the maximum permissible dose
				as defined in Subpart 4 [Part 4] additional protective devices may be required
				by the Department;
(f)
				Gonad shielding of not less than 0.25 mm lead equivalent shall be used for
				patients who have not passed the reproductive age during radiographic
				procedures in which the gonads are in the direct (useful) beam, except for
				cases in which this would interfere with the diagnostic procedures;
(g) Patients shall not be exposed to the
				useful beam except for healing arts purposes, each exposure of which 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 purpose unless there are also healing arts requirements
				and proper prescription has been provided; and
(ii) exposure of an individual for the
				purpose of healing arts screening without prior written approval of the
				Department. (Screening means an exposure of a person without a prior
				examination by a licensed practitioner).
(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 safety rules, required by 602 [ Section 602 of
				20.3.6.602 NMAC]. shall list individual projections where holding devices
				cannot be utilized;
(ii) written
				safety procedures, as required by 602.A.1.d [Subparagraph (d), Paragraph (1),
				Subsection A., Section 602 of 20.3.6.602 NMAC], shall indicate the requirements
				for selecting a holder and the procedure the holder shall follow;
(iii) the human holder shall be protected as
				required by 602.A.1.e [Subparagraph (e), Paragraph (1), Subsection A., Section
				602 of 20.3.6.602 NMAC];
(iv) no
				person shall be used routinely to hold film or patients;
(v) such holding shall be permitted only in
				very unusual and rare situations; and
(vi) all x-ray room doors shall be closed
				before an exposure is made;
(i) Procedures and auxiliary equipment
				designed to minimize patient and personnel exposure commensurate with the
				needed diagnostic information shall be utilized. This is interpreted to include
				but is not limited to:
(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; and
(iii) portable or
				mobile equipment shall be used only for examinations where it is impractical to
				transfer the patient(s) to a stationary installation;
(j) Personnel monitoring. 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 405 and 412 [ Section 405 and 412 of 20.3.4.405 and
				412 NMAC]. In addition, the following requirements are made:
(i) when protective clothing or devices are
				worn on portions of the body and a monitoring device(s) is required, at least
				one such device shall be utilized as follows:
1) when an apron is worn, the monitoring
				device shall be worn at collar level outside of the apron; and
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) shall be recorded in
				the reports required by 452 [Section 452 of 20.3.4.452 NMAC]. If more than one
				device is used, each dose shall be identified with the area of the body where
				the device was worn;
(ii) exposure of a personnel monitoring
				device to deceptively indicate a dose delivered to an individual is
				prohibited.