OAR 333-106-0045: General Requirements: Use of Best Procedures and Equipment

(1) Procedures and auxiliary equipment designed to minimize patient and personnel exposure commensurate with the needed diagnostic information shall be utilized. (2) The speed of film or screen and film combinations shall be the fastest speed consistent with the diagnostic objective of the examinations. (3) The radiation exposure to the patient shall be the minimum exposure required to produce images of good diagnostic quality, see Tables 1, 2 and 3. The referenced tables are available on the Program's website: www.healthoregon.org/rps. (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 installation due to the medical status of the patient or the inability of the patient to be left alone during the imaging procedure except as permitted under section (5) of this rule. (5) Hand-held dental units may be used at facilities or programs as defined in ORS 680.205(1) and (2). (6) X-ray systems subject to OAR 333-106-0301 shall not be utilized in procedures where the source to patient distance is less than 30 centimeters (cm). (7) Cardboard cassettes without screens shall not be used (dental intraoral excluded). (8) The number of radiographs taken for any radiographic examination should be the minimum number needed to adequately diagnose the clinical condition. (9) Use of techniques designed to compensate for anatomical thickness variations after the primary beam has exited the patient is specifically prohibited. This includes "split screen" imaging techniques whereby multiple speed intensifying screens are placed in the same cassette, or any techniques which rely on attenuation of secondary (remnant) radiation for compensatory purposes. Lead lined grids, which are designed to reduce scattered radiation are excluded from this provision. (10) Filter slot covers shall be provided for the X-ray operator's protection. (11) Facilities shall determine or cause to be measured the typical patient exposure for their most common radiographic examinations. The exposures shall be recorded as milliroentgens measured in free air at the point of skin entrance for an average patient. These exposure amounts must then be compared to existing guidelines and rules, and if they exceed such guidelines or rules, action must be taken to reduce the exposure while at the same time maintaining or improving diagnostic image quality. In addition, typical patient exposure values shall be posted in the radiographic examination rooms so that they are readily available to administrators, X-ray operators, patients and practitioners. (12) Protective equipment including aprons, gloves and shields shall be checked annually for defects, such as holes, cracks and tears to assure reliability and integrity. A record of this test shall be made and maintained for inspection by the Authority. If such defect is found, equipment shall be replaced or removed from service until repaired. Fluoroscopy shall only be used for this purpose if a visual and manual check indicated a potential problem. (13) Dental X-ray machines designed and manufactured to be used for dental purposes shall be restricted to dental use only. (14) An X-ray quality control program shall be implemented when required by the Authority. (15) All X-ray equipment must be capable of functioning at the manufacturer's intended specifications. (16) All patients' radiographic images or copies shall be made available for review by any practitioner of the healing arts, currently licensed by the appropriate Oregon licensing board, upon request of the patient. [ED. NOTE: Tables referenced are available from the agency.] [ED. NOTE: To view attachments referenced in rule text, click here to view rule.]