Answer to Question #10462 Submitted to "Ask the Experts"
Category: Medical and Dental Equipment and Shielding — Shielding
The following question was answered by an expert in the appropriate field:
We have a C-arm that we use for imaging patients prior to giving them radiation therapy. We are trying to find a policy for not using the spacer during exposure. Is there any regulation that speaks to C-arm spacer use in therapeutic imaging?
The answer to your question depends on a number of items. The state that you are located in regulates the use of x-ray generating equipment. Those rules vary from state, and may or may not address your use of the C-arm. Also, you did not indicate if your C-arm is used for imaging or therapy simulation. Typically, rules for simulator units are not the same as for diagnostic units.
If you were in Ohio, for example, the regulations require a spacer cone on all full-size C-arms (diagnostic imaging use) unless they interfere with the clinical procedure (this usually occurs in an operating room setting when the design of the table may knock the spacer cone off when the C-arm is put into position). If this is the case, the regulatory body may grant an exemption to the rule if your safe operating procedure indicates that situation and there is a commitment to not allow the patient to get within 30 centimeters of the x-ray tube target under any circumstances.
Therapy simulator rules may exempt you from some of the rules that are typically in place for diagnostic fluoroscopy units.
In any case, you should review the rules from the state you are in as they pertain to your application of the C-arm in the Radiation Therapy Department.
Kennith "Duke" Lovins, CHP
Reference
Ohio Department of Health. Available at: www.odh.ohio.gov.