10A NCAC 15 .0605         OPERATING REQUIREMENTS

(a)  Radiation machines shall only be operated by individuals who meet the operator requirements of Rule .0604 of this Section.

(b)  Exposures of individuals to the primary beam:

(1)           Individuals shall not be exposed to the primary beam except for diagnostic imaging purposes. Such exposures shall have been authorized by a licensed practitioner as defined in Rule .0103(b)(7) of this Chapter.

(2)           Students or candidates in training under the personal supervision of an individual that meets the requirements of Rule .0604 of this Chapter shall not be permitted to perform radiographic imaging unless such exposures have been authorized by a licensed practitioner as defined in Rule .0103(b)(7) of this Chapter.

(3)           Deliberate exposure of an individual for training, demonstration, or other non-diagnostic imaging purposes is prohibited.

(4)           Radiation exposures for non-human use, used for forensic medicine, or by service providers for demonstration purposes are exempt from Subparagraphs (b)(1) and (2) of this Rule.

(c)  The radiation exposure to the patient shall be the minimum exposure required to produce images of optimal diagnostic quality.

(d)  Individuals who operate radiation machines shall:

(1)           be familiar with the radiation protection program procedures established in accordance with Rule .0603(d)(3) of this Section;

(2)           use collimation to limit the primary beam to the area of clinical interest or to the image receptor, whichever is smaller;

(3)           use technique factors and dose reduction technologies, according to patient sizes and clinical indication, to optimize patient dose while maintaining optimal image quality;

(4)           use mechanical holding devices, whenever medical circumstances permit, when a patient or image receptor must be provided with auxiliary support during a radiation exposure; and

(5)           control the area during radiation exposures.

(e)  Except for dental handheld radiation machines, individuals who operate radiation machines shall not hold either the X-Ray tube housing or the collimating device during radiation exposures.

(f)  No occupational worker shall be designated as the individual who always holds patients or image receptors during radiation exposures. Operators of veterinary radiation machines are exempt from this Rule.

(g)  If a human holder is required, they shall be provided with instructions:

(1)           for supporting the patient during the radiation exposure;

(2)           to wear a lead apron equivalent to 0.25 mm or greater for protection from scatter radiation during the exposure; and

(3)           to avoid extremity exposure to the primary beam, or to wear protective gloves equivalent to 0.5 mm of lead or more.

(h)  Except for Dual Energy X-Ray Absorptiometry (DEXA or DXA) and intraoral dental handheld radiation machine operators, only the professional staff and individuals required for the medical procedure or those in training shall be in the room of the patient being examined during the radiographic and fluoroscopic exposures.

(1)           All individuals other than the patient being examined shall be:

(A)          positioned such that no part of the body, including the extremities, which are not protected by 0.5 mm lead equivalent or greater material will be exposed to the primary beam; and

(B)          protected from scatter radiation by protective apparel or whole-body protective equipment of 0.25 mm lead equivalent or greater material.

(2)           When a mobile or portable radiation machine is used during radiographic or fluoroscopy exposures, patients other than the individual examined who cannot be removed from the room shall be protected from the scatter radiation by:

(A)          protective apparel or equipment; or

(B)          be positioned so that the nearest portion of the body is six feet or greater from both the tube head and the nearest edge of the image receptor.

(i)  CT operators shall have the following made readily accessible during the use of the CT radiation machine and while performing routine QC:

(1)           instructions on performing routine QC;

(2)           a schedule of routine QC;

(3)           any allowable variations set by the CT QE for the indicated parameters;

(4)           the results of the most recent routine QC completed on the system; and

(5)           established scanning protocols.

(j)  Intraoral dental radiation machine operators shall use patient and film holding devices when the techniques permit.

(k)  Intraoral dental handheld radiation machine operators shall ensure the following additional requirements are met:

(1)           When making an exposure, all individuals other than the patient undergoing the procedure remain at a distance greater than six feet from the patient.

(2)           Use an individual monitoring device. When protective apparel is required in accordance with Subparagraph (3) of this Rule, the individual monitoring device shall be used in accordance with Paragraph (m) of this Rule.

(3)           Wear protective apparel of 0.25 mm or greater lead equivalent material when the backscatter shield is not parallel to the operator while making an exposure.

(l)  Veterinary radiation machine operators shall ensure the following additional requirements are met.

(1)           A dead‑man type of exposure switch shall be provided, tethered with a cord of a length so that the operator can stand out of the primary beam and six feet or greater from the animal during all X-Ray exposures or behind a protective barrier adequate to assure compliance with dose limit requirements of Rules .1601(a)(8) and .1601(a)(15) of this Chapter are not exceeded.

(2)           No individual other than the operator shall be in the X-ray room while exposures are being made unless such an individual's assistance is required.

(m)  When protective apparel or equipment is used and an individual monitoring device(s) is required, at least one such monitoring device shall be used as follows:

(1)           The individual monitoring device shall be worn at the collar, outside the apparel.

(2)           If protective equipment is used in place of protective apparel, the individual radiation monitoring device shall be worn on the torso.

(3)           A fetal monitoring device shall be worn at the waist. If protective apparel is worn, the individual radiation monitoring device shall be worn under the protective apparel at the waist.

(4)           The dose to the whole body shall be recorded in the reports in accordance with Rule .1601(a)(53) of this Chapter. If more than one device is used, each dose shall be identified with the area where the device was worn on the body.

History Note:        Authority G.S. 104E‑7;

Eff. February 1, 1980;

Amended Eff. May 1, 1993; May 1, 1992; October 1, 1980;

Transferred and Recodified from 15A NCAC 11 .0605 Eff. February 1, 2015;

Readopted Eff. August 1, 2026.