DHS 157.74(2)(b)4. 4. Except for dental intra-oral radiography, source to image receptor distance to be used.

DHS 157.74(2)(b)5. 5. Type and location of placement of patient shielding to be used.

DHS 157.74 Note Note: This chart may be electronic in the form of pre-programmed controls.

DHS 157.74(2)(c) (c) The registrant of a facility shall create and make available to x-ray operators written safety procedures, including patient holding procedures and any restrictions of the operating technique required for the safe operation of the particular x-ray system. The operator shall be able to demonstrate familiarity with these procedures.

DHS 157.74(2)(d) (d) Only the staff, ancillary personnel or other persons required for the medical procedure or training may be in the room during the radiographic exposure. Other than the patient, the following applies to all persons in the room:

DHS 157.74(2)(d)1. 1. All persons shall be positioned such that no part of the body will be struck by the useful beam unless protected by not less than 0.5 millimeter lead equivalent material. If the hands must be in the beam and unprotected, a ring badge on the hand in the beam shall be worn unless contraindicated by the clinical procedure.

DHS 157.74(2)(d)2. 2. All persons, including any patients who cannot be removed from the room, shall be protected from the direct scatter radiation by whole body protective barriers of not less than 0.25 millimeter lead equivalent material or shall be so positioned that all parts of the person’s body are at least 2 meters from all of the following:

DHS 157.74(2)(d)2.a. a. The tube head.

DHS 157.74(2)(d)2.b. b. The direct beam.

DHS 157.74(2)(d)2.c. c. The nearest part of the examined patient’s body being struck by the useful beam.

DHS 157.74(2)(d)3. 3. Operators of c-arm configuration units which do not operate at a tube current in excess of 0.2 mA are exempt from the requirement to wear a leaded apron, provided the operator wears a personal dosimeter as required under s. DHS 157.25 (2).

DHS 157.74(2)(f) (f) Persons may not be exposed to the useful beam except for healing arts purposes and unless such exposure has been authorized by a licensed practitioner of the healing arts or a Wisconsin licensed physical therapist. Deliberate exposure for any of the following purposes is prohibited:

DHS 157.74(2)(f)1. 1. Exposure of a person for training, demonstration or other non-healing arts purpose, except as authorized by the department.

DHS 157.74(2)(f)2. 2. Exposure of a person for healing arts screening, except as authorized by the department.

DHS 157.74 Note Note: The procedure for requesting permission to conduct screening x-ray examination is in ch. DHS 157 Appendix M.

DHS 157.74(2)(fm) (fm) Registrants may conduct medical research that includes exposure to radiation and are exempt from obtaining individual project authorization from the department under all the following conditions:

DHS 157.74(2)(fm)1. 1. The use of radiation-generating equipment to conduct research on human beings has been approved by an institutional review board as required by 45 CFR 46 and 21 CFR 56.

DHS 157.74(2)(fm)2. 2. The institutional review board’s review of the research project includes a radiation safety review by qualified radiation personnel.

DHS 157.74(2)(fm)3. 3. All research projects using radiation need to be identified and documentation shall be made available to the department upon request.

DHS 157.74(2)(fm)4. 4. The number of facilities and exam types used by the registrant are reported to the department annually.

DHS 157.74(2)(fm)5. 5. Nothing in this paragraph relieves registrants from complying with the other requirements of this subchapter.

DHS 157.74(2)(g) (g) When a patient or film must be provided with additional support during a radiation exposure, all of the following applies:

DHS 157.74(2)(g)1. 1. The human holder shall be instructed in personal radiation safety and protected as required by subd. 2. Written safety procedures are required.

DHS 157.74(2)(g)2. 2. In those cases where the patient must hold the film, any portion of the body other than the area of clinical interest struck by the useful beam shall be protected by not less than 0.5 millimeter lead equivalent material.

DHS 157.74(2)(g)3. 3. Each facility shall have leaded shielding garments and devices available in sufficient numbers to provide protection to all personnel who are involved with x-ray operations and who are otherwise not shielded.

DHS 157.74(2)(g)4. 4. Leaded shielding garments and devices shall be fluoroscopically or radiographically inspected at least every 2 years for defects and replaced if defective.

DHS 157.74(2)(g)5. 5. If visual inspection reveals possible defects, radiographic or fluoroscopic inspections shall be performed.

DHS 157.74 Note Note: Leaded shielding garments and devices include aprons, gloves, vests, skirts, thyroid shields and gonadal shields.

DHS 157.74(2)(h) (h) Procedures and auxiliary equipment designed to minimize patient and personnel exposure commensurate with the needed diagnostic information shall be utilized, as follows: