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].
Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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