Section He-P 4045.03 - Administrative Controls(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; andb. 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; andc. Use of a technique chart;(2) Radiation protection measures to include: c. Lead equivalent material patient protection devices, if used;d. Restriction of x-ray tube radiation to the image receptor;e. Personnel protection; and(3) Film and film processing: a. Film speed as related to patient exposure;b. Film processing parameters; andc. 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: 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; andc. 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.N.H. Admin. Code § He-P 4045.03
#6827, eff 8-6-98; ss by #8692, INTERIM, eff 7-27-06, EXPIRES: 2-2-07; ss by #8808, eff 1-24-07
Amended byVolume XXXV Number 06, Filed February 12, 2015, Proposed by #10763, Effective 1/23/2015, Expires7/22/2015.Amended by Volume XXXV Number 32, Filed August 13, 2015, Proposed by #10893, Effective 7/21/2015, Expires7/21/2025.Amended by Volume XXXVII Number 28, Filed July 13, 2017, Proposed by #12215, Effective 6/20/2017, Expires 6/20/2027.The amended version of this section by New Hampshire Register Volume 42, Number 32, eff. 7/26/2022 is not yet available.