EXAMPLE OF RADIATION SAFETY RULES

This is an example of Radiation Safety Rules which might be modified for use to meet the requirements of 7 AAC 18.410(b) of the Alaska Radiation Protection Regulations. Different facilities will have different needs so that it should be modified to conform to your own specific situation. This particular example might apply to a veterinarian facility. It serves to illustrate that the regulation is concerned with assuring that everyone involved understands how to use the radiation device safely. It is not intended to be an onerous task to create a book on the subject.

Remember, actions which maintain exposures As Low As Reasonably Achievable (ALARA) protect not only the patient, but also operators, the general public, and unborn babies.

1. Minimize the amount of time in a radiation area by reducing the number of repeat exposures as much as possible;
2. Use shielding/protective barriers whenever possible to reduce exposures, such as standing behind a control booth when x-rays are produced, wearing a lead protective apron if you must be in the room (such as when performing mobile radiography), using gonadal shielding on patients of reproductive age;
3. Use mechanical restraints whenever possible to avoid holding a patient yourself;
4. Never stand or place a portion of your own body within the primary beam;
5. No individual should be routinely assigned to restrain patients during radiographic procedures;
6. Lead protective aprons should be x-rayed periodically, such as annually, to insure cracks or other loss of protective integrity has not developed;
7. Only those persons essential to the performance of the radiographic procedure should be in the room when the x-ray machine is energized;
8. Never x-ray each other, or any person, for training purposes. The deliberate exposure of humans to ionizing radiation must be under the order of a qualified healing arts practitioner for the purpose of medical diagnostic and/or therapeutic benefit;
9. Radiation workers must wear a radiation monitoring badge when working in the radiation area;
10. Whenever an x-ray machine is energized the door to the room must be closed;
11. Always adjust the size of the x-ray beam to the smallest area necessary for the procedure performed. This would normally leave a one-half inch margin on three sides of the image. If an Automatic Exposure Controller (AEC) device is used the margin may not be visible, but is acceptable when testing demonstrates the AEC functions correctly. Still, even with AEC there will be procedures, such as extremity radiography or mobile radiography, when manual collimation is necessary to insure safe use of radiation;
12. Gonadal shielding must be used with patients of either sex who are of childbearing age, and when such shielding does not interfere with the purpose of the examination;
13. Female patients of reproductive age should receive necessary x-ray examinations within the first 14 days following normal menstruation whenever possible to avoid potential exposure to an unborn baby;
14. Use optimum kilovoltage in order to reduce the total quantity of radiation necessary to obtain diagnostic images;
15. If using film,insure that the developer temperature is optimum for your processor so that films are fully processed and exposures are not increased in order to compensate for incompletely developed images (Never use a mercury thermometer to measure processing chemical temperatures);
16. If using a film based system, instensifying screens should be cleaned regularly, with the frequency dependent on usage;
17. For film systems, whenever possible, and when replacing old screens, the fastest screens and films that provide satisfactory diagnostic images should be used to keep exposures low, reduce stress on the x-ray machine, and reduce potential movement of the patient that might require a repeat exposure;
18. For digital and computer-based imaging systems follow the manufacturers quality control procedures;
19. X-ray equipment should be checked annually and recalibrated as necessary;
20. A quality control/quality assurance program should be established to insure optimum performance of x-ray equipment, processing equipment, safety equipment and procedures;
21. Use a technique chart that is specific and appropriate to each individual machine, taking into account the screens, film, processing and machine output at specific distances, grid conditions, and related factors that affect radiation exposure;
22. If using automaticc exposure control devices, you should still develop a back-up manual technique chart in the event the AEC fails, or you are performing procedures that don't use the AEC;
23. Perform repeat analysis when ever the discard file has accumulated 250 or more images in order to identify problem areas that may be addressed and reduce exposures;
24. Conduct periodic inservice presentations related to radiography and radiation safety. These may be in the form of an in-house presentation by staff or physicians, showing a video movie, completing a directing reading and quiz from the national organization, attending a workshop or annual meeting, or other methods. The internet has become a useful resource for information on radiological health issues as well, and should be explored whenever possible;
25. When using film, insure that the type of film used and the instensifying screens are spectrally matched. Never use blue sensitive film with green sensitive screens, or vice versa;
26. Measure patients when determining the exposure technique to use, and apply the result to interpretation of the technique chart;
27. Use tube rating and cooling charts to insure tube limits are not exceeded;
28. Use positioning to reduce exposure whenever possible to do so. For example, radiography of the hand, patella, and skull are particularly amenable to performance in ways that significantly reduce exposures yet the resulting image appears identical to one obtained without consideration of positioning;
29. Use medium ratio grids to improve radiographic contrast, being sure that the central ray is centered to the grid, the source-image receptor –distance is appropriate for that grid, and the grid is perpendicular to the central ray;
30. When aiming the x-ray beam toward the grid or Bucky always direct the central ray parallel to the direction of the lead strips as indicated by the line on the grid face, and insure the grid is not inverted;
31. Use the shortest exposure times available to reduce the possibility of patient motion causing motion artifacts that require re-exposing the patient;
32. Periodically check the congruency of the x-ray beam and localizer light, especially with mobile x-ray machines;