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

Universal Citation: 20 NM Admin Code 20.3.6.602

Current through Register Vol. 35, No. 18, September 24, 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.

(2) Information and Maintenance Record and Associated Information: The registrant shall maintain at least the following information for each x-ray machine:
(a) Maximum rating of technique factors;

(b) Model numbers of all certifiable components;

(c) Aluminum equivalent filtration of the useful beam; including any routine variation;

(d) Tube rating charts and cooling curves;

(e) Record of surveys, calibrations, maintenance, modifications (from the original schematics and drawings) performed on the x-ray machine after the effective date of these regulations, along with the names of persons who performed the service;

(f) A scale drawing of the room in which a stationary x-ray system is located. The drawing shall denote the type of materials and their thickness (or lead equivalence) provided by each barrier of the room (walls, ceilings, floors, doors, windows). The drawing shall also denote the type of occupancy of adjacent areas to include above and below the x-ray room of concern (e.g., hallways, office, parking lots, and toilets). Estimates of the frequency of such occupancy shall also be noted on the drawing; and

(g) A copy of all correspondence with this Department regarding that x-ray machine.

(3) X-ray Log. Each facility shall maintain an x-ray log containing the examinations and the dates those examinations were performed. The log shall indicate when techniques for procedures vary from those specified in the technique chart required in 602.A.1.c [Subparagraph (c), Paragraph (1), Subsection A. , Section 602 of 20.3.6.602 NMAC].

B. Plan Review:

(1) Prior to construction, the floor plans and equipment arrangement of all installations (new or modifications of existing installations) utilizing x-rays for diagnostic or therapeutic purposes shall be submitted to the Department for review and approval. The required information is denoted in Subpart 6, 610 and 611 [Part 6,Sections 610 and 611 of 20.3.6.610 and 611].

(2) The Department may require the applicant to utilize the services of a qualified expert to determine the shielding requirement prior to the plan review and approval.

(3) The approval of such plans shall not preclude the requirement of additional modifications should a subsequent analysis of operating conditions indicate the possibility of an individual receiving a dose in excess of the limits prescribed in 405 to 412 [Sections 405 to 412 of 20.3.4.405 to 412 NMAC].

(4) For all medical facilities in hospitals or clinics, interlocks shall be required on all doors leading into diagnostic x-ray rooms when the doors cannot be seen by the operator at the control station.

C. Chemicals, film processing and darkroom will be complied with in accordance with Subpart 6, 612 [Part 6, Section 612 of 20.3.6.612 NMAC].

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