Radiology department is one of the important and focal point of any hospital or a medical setup.
Importance of modern radiology setup is not only limited to imaging, but has a therapeutic role in the form of minimal invasive IR setup
So it requires a careful planning and a vision for future.
•Preferably in basement or ground floor.
•Away from traffic.
•Easy access to OPD, emergency and IPD.
•Depend on the hospital size.
•Types of services provided.
•No of machines to be installed
•Patient waiting area, reception,
•Office of HOD,
•Office of nursing & technical staff,
•Store for supplies
Whether it is a diagnostic center or a hospital, there should be pre planning for setting up of radiation equipments there like;
If it’s a diagnostic center.
Need for such services in that area.
Presence of other centres.
Status & acceptability of referring physicians.
Presence of large no of hospitals in that area.
AERB that was constituted on nov 15, 1983 by the president of India under the atomic energy act, 1962.
Its mission is to ensure use of ionization radiation & nuclear energy in India does not cause undue risk to the health of people & the environment.
Functions of AERB is to define a particular layout of Xray installation.
AERB of India recommends & lays down guidelines regarding the specification of medical Xray equipment.
Regarding the work practices in x ray department, the protective devices & also the responsibilities of the radiation personnel, employer and RSO.
Regulatory authority for registration & commissioning of new Xray equipment’s, inspection & decommissioning of Xray installation, certification of RSO, & of service engineers & also for imposing penalties on any person contravening these rules.
GUIDELINES FOR SUBMISSION OF LAYOUT PLAN IN RADIOLOGY DEPARTMENT
•Decide a suitable room for housing an Xray unit.
•Room should have preferably one entrance having inter locking mechanism during examination.
•In fluoroscopy and radiography rooms chest stand should be placed opposite to entrance door & console room.
•Mobile protective barriers should be present .
•Control panel should be far from x ray tube as much as possible.
•In CT & INTERVENTIONAL RADIOLOGY Gantry/ C-arm, should be separated from control console room. Viewing window should be placed in such a way that patient should be clearly visible from the console room during examination.
•MAMMOGRAPHY/OPG/CBCT ; Equipments should be as far as from the console room as possible.
•For radiation protection ALARA concept is used.
•Plan radio protection prior to construction.
•Promote awareness among doctors & staff.
•Demarcation of restricted areas to prevent radiation hazards like;
•Acute & chronic,
•Somatic & genetic,
•Deterministic[not depending on dose]
X RAY ROOMS
•Must be large enough for the equipment.
•Must locate the operator”s console where the primary beam will never be directed towards it,but where the patient can be easily observed.
•Must be able to accommodate large beds/trolleys,& any anaesthetic equipment likely to be used.
•Must have radiation warning signs on all doors.
•Should have radiation warning lights outside for fluoroscopy, angiography & CT.
X RAY & CT ROOM CONSTRUCTION
•shielding of wall of Xray room with lead equivalent of 1 mm.
•Concrete wall – 8-12 cm thick.
•Brick wall – 12-15 cm thick.
•2 important areas must be looked into;
wall behind chest wall.
wall of dark room.
•Lead glass window between operator & x ray tube.
•Distance between xray table & console room should be as far as possible between 10ft to 15ft.
•The room housing an x ray unit shall not be less than 18 m2
•Size of CT room shall not be less than 25m2 ,& no more than 1 equipment should be installed in the same room.s
•In mammography room, room size shall not be kless then 10m2,& no single dimension should be less than 3m.
•If the x ray installation is located in residential complex,it shall be ensured that;
•Walls of x ray room on which primary beam falls aren’t less then 35cm or 14inchs thick brick equivalent.
•Walls of x ray room on which scattered rays fall should not have less than 23 cm or 9inchs thick brick or equivalent.
•Doors should have a min pb thickness of 23 cm & if windows are present…..1.6g/cc.
•Ceiling must have a concrete thickness not less than 6inches or 13.5cm
•For equipments operating at 125kvp or above,should have a separate control room,& provided with approprait shielding.
•The x ray units operating below 125 kvp ,should be behind a protective barrier of adequate thickness.
•Doors are lined with 2mm thick pb sheet with proper overlapping at the joint & jnc .
Pb glass of suitable dimensions are provided as viewing windows with 1.5mm lead equivalent.
MOBILE PROTECTIVE BARRIERS
Control panel should be kept behind MPB having pb equivalence of 2mm.
With a height of 2.1m and size of viewing glass of 45*45cm.
PRINCIPLE OF MACHINE INSTALLATION
•X RAY tube should never point towards the control unit.
•It shouldn’t point towards dark room .
•It shouldn’t point towards door,window or towards corridor wall.
•Pb lying upto 4.5 of wall of patient waiting space.
•Fluoroscopy equipments are usually operated at potentials ranging from 60-120 kvp.
•A primary barrier is incorporated into the fluoroscopic image receptor,so it considers only secondary protective barriers against leakage & scattered radiations.
•Most fluoroscopic x ray imaging systems also employ radiography, for such rooms shielding depends on the combined workload of both fluoroscopy & radiography.
•Mammography units are typically operated between 25-30 kvp.
•Walls are constructed with bricks or gypsum board.
•Adequate protective barrier of pb acrylic or pb glass are incorporated into mammographic units.
•Gypsum wall board may contain voids and non-uniform areas, hence higher thickness of gypsum wall board is recommended than that calculated.
•CT employs a collimated x ray fan beam that is intercepted by patient & by detector array.
•Consequently only secondary radiation is incident on protective devices.
•The operating potential , typically in the range of 80-140 kvp ,as well as the workload are much higher then for GR & fluoroscopy.
•Due to large amount of secondary radiation ,floors,walls,& ceilings need special consideration.
All walls & doors to be painted with good quality washable paints.
•Minimum furniture to be kept.
•Adequate no of pb containing bricks to be used.
•Drainage pipe should be directly connected to sewage.
• waiting area away from circulatory corridor.
•Toilets separate from radioactive & non-radioactive patients.
•3 PHASE electrical supply.
•Separate connection from main.
•Generator/backup facilities —CPU.
•water supply ——— continuos.
RESPONSIBILITIES OF MANUFACTURER
RESPONSIBILTIES OF SUPPLIER OF X RAY EQUIPMENT
Authorization from the competent authority
- NOC for import
- type approval certificate
type approved diagnostic x-ray equipment ,
- installation ,
- commissioning ,
- acceptance testing/quality
- servicing and maintenance (life-time)
supply of radiation protection devices
- protective barrier,
- protective apron,
- lead rubber flaps etc.
TYPE APPROVAL/ NO OBJECTION CERTIFICATE
Prior to marketing the x-ray equipment, the manufacturer/local supplier of imported equipment shall obtain a Type Approval Certificate from the competent authority, on demonstration of performance of the prototype of x-ray equipment.
Import of prototype of x-ray equipment, meant for Type Approval, shall be carried out by the local supplier only after obtaining NOC for import for Type Approval, from the competent authority.
Type Approval/NOC will be issued only if the equipment satisfies the safety specifications of this Code and the standards in force.
Import of every Type Approved x-ray machine by supplier or any other importing agency, shall be carried out only after obtaining NOC for import of x-ray equipment, from the competent authority.
Only type-approved and NOC-validated equipment shall be marketed and used in the country.
For import of x-ray tube(s), the importing agency shall obtain NOC for import of x-ray tubes from the competent authority.