Current through Register No. 40, October 3, 2024
(a) A radiation
or MRI machine which does not meet the provisions of these rules shall not be
operated for diagnostic or therapeutic purposes.
(b) Persons who operate radiation or MRI
machines shall be instructed in the manufacturer's safe operating procedures
and be competent in the safe use of the equipment.
(c) All MRI machine and non-medical security
screening system operators shall be able to demonstrate competence in the
operation of the machine as required by (b) above, including, at a minimum,
competence in the following areas:
(1)
Familiarity with equipment to include:
a.
Identification of controls; and
b.
Function of each control; and
(2) Emergency procedures including procedure
termination.
(d) All
diagnostic radiation machine operators shall be able to demonstrate competence
in the operation of the machine as required by (b) above, including, at a
minimum competence in the following areas:
(1) Familiarity with equipment to include:
a. Identification of controls;
b. Function of each control; and
c. Use of a technique chart;
(2) Radiation protection measures
to include:
a. Collimation;
b. Filtration;
c. Lead equivalent material patient
protection devices, if used;
d.
Restriction of x-ray tube radiation to the image receptor;
e. Personnel protection; and
f. Grids;
(3) Film and film processing:
a. Film speed as related to patient
exposure;
b. Film processing
parameters; and
c. Quality
assurance techniques;
(4) Emergency procedures to include
termination of exposure in event of automatic timing device failure;
(5) Proper use of personnel
dosimetry;
(6) An understanding of
the units of radiation and dose; and
(7) An understanding of these
rules.
(e) Specific
technique factors and protocols for any diagnostic radiation machine which
cannot be programmed to select body part, projection, or patient size, shall be
created to include protocols to identify the following:
(1) Patient's body part and anatomical size,
or body part thickness, or age (for pediatric), versus technique factors to be
utilized;
(2) Type and size of the
image receptor;
(3) Type of grid,
if any;
(4) Source to image
receptor distance to be used, except in dental intraoral radiography;
(5) Type and location of placement of patient
shielding used; and
(6) Technique
factors (kVp, mA, time) .
(f) The registrant of a facility shall:
(1) Establish written safety procedures for
the safe operation of radiation or MRI machines;
(2) Make written safety procedures available
to all operators of radiation or MRI machines;
(3) Write safety procedures for use of
machines at the facility which shall include, but not be limited to:
a. Patient holding; and
b. Any restrictions in the operating
techniques required for the safe operation of a particular system.
(g) The radiation or
MRI machine operator shall be able to demonstrate familiarity with the written
safety procedures required in (f) above.
(h) Only staff, other persons required to be
in attendance, and patients who cannot be evacuated shall be in the room during
the radiographic exposure.
(i) All
persons in the room other than the patient being examined shall be positioned
so that no part of the body will be struck by the useful beam and shall be
protected from scatter radiation by either protective aprons or whole body
protective barriers, of not less than 0.5 millimeter lead equivalent
material.
(j) Patients who cannot
be removed from the room shall be positioned so that the nearest portion of the
body is at least 2 meters from the tube head or the image receptor, whichever
is closer.
(k) Gonad shielding of
not less than 0.5 millimeter lead equivalent material shall be used for
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.
(l) Persons shall not be exposed to the
useful beam, except for healing arts purposes when such exposure has been
authorized by a licensed practitioner of the healing arts.
(m) Deliberate exposure of a person shall be
prohibited for the following purposes:
(1)
Exposure of a person for training, demonstration, or other non-healing-arts
purposes; and
(2) Exposure of a
person for the purpose of healing arts screening except as authorized by
He-P
4045.04.
(n) If a patient or image receptor must be
provided with auxiliary support during a radiation exposure:
(1) Mechanical holding devices shall be used
whenever possible;
(2) The written
safety procedures, required by
He-P
4045.03(f) , shall indicate the
requirements for selecting a human holder and the procedure the human holder
shall follow;
(3) The human holder
shall be instructed in personal radiation safety and protected as required by
He-P
4045.03(f) ;
(4) No person shall be used routinely to hold
image receptors or patients;
(5) In
cases where the patient must hold the image receptor, 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;
(6) Each
facility shall have lead equivalent garments or barriers available in
sufficient numbers to provide protection to all personnel who are involved with
radiation machine operations and are not otherwise shielded; and
(7) All protective apparel or barriers shall
be clearly labeled with its lead equivalence.
(o) Procedures and auxiliary equipment
designed to minimize patient and personnel exposure shall be utilized as
follows:
(1) The speed of the screen and film
combinations used shall be the fastest speed consistent with the diagnostic
objective of the examinations;
(2)
Film cassettes without intensifying screens shall not be used for any routine
diagnostic radiological imaging, with the exception of veterinary radiography
and standard film packets for intraoral use in dental radiography;
(3) The radiation exposure to the patient
shall be the minimum exposure required to produce images of high diagnostic
quality;
(4) 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 system;
(5) X-ray systems other than fluoroscopic,
dental, computed tomography or veterinary systems shall not be utilized in
procedures where the source to patient distance is less than 30 centimeters;
and
(6) If grids are used between
the patient and the image receptor, the grid shall:
a. Be positioned properly;
b. Centered to the central ray; and
c. If of the focused type, be of the proper
focal distance for the SIDs being used.
(p) All persons who are associated with the
operation of an x-ray system are subject to the requirements of He-P 4020
through He-P 4022 of these rules.
#6827, eff 8-6-98; ss by #8692, INTERIM, eff 7-27-06,
EXPIRES: 2-2-07; ss by #8808, eff
1-24-07
The amended version of this section by
New
Hampshire Register Volume 42, Number 32, eff.
7/26/2022 is not yet
available.
