OAR 811-030-0030: X-Ray Departments, Equipment, and Procedures

(1) All X-ray departments, equipment, and procedures, including fluoroscopy, shall be in compliance with the current rules and regulations of the Oregon Board of Medical Imaging and Oregon Radiation Protection Services, including, but not limited to: the physical design of the department, occupational exposure, collimation, shielding, and exposure charts. (2) In addition: (a) The patient shall be an adequate candidate for the radiographic or fluoroscopic procedure employed; (b) The radiographic field shall be restricted to the area of clinical interest; (c) Specialized views shall be used any time the area of clinical interest is not clearly visualized on a standard film or image; (d) Every exposure, including post-treatment exposures, and scanograms, shall have clinical justification with adequate documentation consistent with the patient's case history; (e) The operator shall maintain a record on each exposure of each patient containing the patient's name, the date, the operator's name or initials, the type of exposure, and the radiation factors of time, mA, kVp and target film distance, including those exposures resulting in the necessity of repeat exposure for better diagnostic information, such as patient motion or poor technical factors. For computerized and automated systems, the recording of technique factors is not necessary as long as the equipment is calibrated and maintained. OAR 333-106-0045 requires the facility to determine the typical patient exposure for their most common radiographic examinations, i.e. technique chart. (f) Each film or image shall be properly identified by date of exposure, location of X-ray department, patient's name or number, patient's age, right or left marker, postural position marker, and indication of the position of the patient; (g) A patient with tremors must be immobilized; (h) The radiographs of a patient with an antalgic posture may be taken in an upright position only if the patient is adequately supported and immobilized to insure diagnostic quality. Otherwise, the recumbent position shall be used; (i) Upright or postural views shall not be used for any patient whose size exceeds the capacity of the X-ray equipment. Penetration must be adequate on all films; (j) Sectional views shall be taken in preference to a single 14 x 36 inch film or image if the patient's size or height prevents diagnostic quality on a single 14 x 36 inch film; (k) If two exposures are made on a single film, the area of exposure shall be critically collimated to avoid double exposure of the overlapping area; (l) All views shall employ graduated filtration or adequate devices to attenuate the primary beam for the purpose of reducing unnecessary radiation and to improve film quality. Split screens, gradient or graded screens, paper light barriers inside the cassette, or any other attenuating device in the beam between the patient and the film shall not be permitted, other than the grid controlling scattered radiation; (m) A record of radiographic findings on every set of radiographs reviewed shall be included in the patient's medical record; and (n) Radiographs shall be kept and available for review for a minimum of seven years or until a minor becomes 18 years of age, whichever is longer.