DOTmed Home MRI Oncology Ultrasound Molecular Imaging X-Ray Cardiology Health IT Business Affairs
News Home Parts & Service Operating Room CT Women's Health Proton Therapy Endoscopy HTMs Pediatrics
SEARCH
Current Location:
>
> This Story


Log in or Register to rate this News Story
Forward Printable StoryPrint Comment
advertisement

 

advertisement

 

X-Ray Homepage

MR method could spare patients with skull lesions from CT, says study Could benefit children and pregnant women

FDA greenlights Samsung S-Vue 3.02 dose reduction solution Reduces X-ray dose exposure for pediatric patients

DR now makes up over 80 percent of US general radiography install base Up from only half in 2015

FDA clears GE’s AI-based CT image reconstruction technology Available as upgrade to Revolution Apex scanner

Philips Medical Systems sues ex-employee over alleged secrets theft Suit claims X-ray tube trade secrets were stolen before erasing hard drive

The upper extremity value of mini C-arms in the ER and OR Insights from Dr. Korsh Jafarnia

X-ray sheds new light on ancient mummy The Everhart Museum in PA tapped Geisinger Radiology for help

First ultra high-res CT scan performed on US patient Scanner at UC Davis can image anatomy as small as 150 microns

This UK company is utilizing space technology to develop a portable 3D X-ray system Adaptix has received $1.35 million from space agencies

Industrial hi-res X-ray yields greater insight into child abuse case Identified microscopic injuries that would not have been detected with standard CT

The Joint Commission is requiring
the max. exposure rates of each
fluoroscopy device be specified

Joint Commission fluoro mandate may confuse providers, say experts

by John R. Fischer , Staff Reporter
A new requirement of the Joint Commission for assessing the performance of fluoroscopy equipment may be a source of confusion for providers, due to its mandate that “maximum exposure rates in all imaging modes” be specified for each piece of fluoroscopic X-ray equipment.

Such devices, according to ECRI Institute's Jason Launders, director of operations for its health devices group, can be “worlds apart” in type and use, and come with a wide range of modes.

Story Continues Below Advertisement

RaySafe helps you avoid unnecessary radiation

RaySafe solutions are designed to minimize the need for user interaction, bringing unprecedented simplicity & usability to the X-ray room. We're committed to establishing a radiation safety culture wherever technicians & medical staff encounter radiation.



“Every part of the anatomy has a different mode,” he told HCB News. “Am I looking at the arteries or the ventricles? Am I looking at the brain, or am I looking at a leg? There are different types of imaging you can do in each mode. Are you going to be testing every single one? That could be a very long list.”

Such confusion has led many providers to reach out to manufacturers for advice and information on how to answer this question in full, a task that results in long and cumbersome testing, which may not be able to specify the maximum exposure rate for any piece of technology, according to MITA.

“Control modes (according to U.S. regulation 21CFR1020.32) are the only imaging modes with regulated maximum exposure rates (i.e., maximum air kerma rates),” it said in a statement. “On modern fluoroscopy equipment there may be dozens of fluoroscopy modes available, which may be based on clinical protocols and requirements, and include multiple dose modes and pulse rates that could impact the measured exposure rate. Non-regulated imaging modes could number in the hundreds and have no regulated maximum value.”

In addition, testing a piece of equipment by pushing it to its maximum exposure rate can place prolonged stress on its X-ray tube, causing the part to prematurely degrade or fail. This stress is further enhanced by the resistance exerted by the system, which will try to cut back its output when pushed to its highest rate.

Such damage can often destroy the tube, requiring the hospital to purchase another.

“A broken X-ray tube is not cheap,” said Launders, who says that the most a provider can do in this situation is contact their medical physicist, who, in turn, should consult with the manufacturers of the equipment to figure out the maximum exposure rate of each to help hospitals complete their Joint Commission surveys.

He stresses that while confusing, completing this task is important, as failure to do so could result in a citation.

“It really depends on the surveyor and what they’re looking for. They might not know about imaging to a great extent, and may not understand what this requirement is asking,” he said. “These instructions are directed to the medical physicists. The medical physicist should include this in their report and contact the manufacturer for guidance regarding this. They need to go to the manufacturer and say, ‘I need to specify what the maximum dose rates in each of these are. Can you give me a table?’”

MITA said it had no comment at this time.

X-Ray Homepage


(1)

Thomas Petrone

New Joint Commission Fluoroscopy Standards

April 19, 2019 08:47

John and Jason,
Nice article to raise awareness of the new standard. I checked with our CTO and Diagnostic Imaging physics chief and here is his response:

“We and other physicist have conferred with the JC who basically leaves the application of the standard and interpretation to the medical physicist. In most cases you just have to do what makes sense. Take the thing they use the most and then under that protocol, test max exposure for the low dose “mode”, normal “mode”, high level “mode” and the cine/subtraction “mode”
While we may use some extra tube heat once per year, these units are usually resilient and handle procedures which stress the tube throughout the year.
So if a physicist writes a reasonable protocol and carries it out, JC should be satisfied. Again, we have conferred directly and feel this to be a reasonable approach.

Christopher Smitherman, MS DABR
Thomas J. Petrone, PH.D. DABR

Petrone Associates

Log inor Register

to rate and post a comment

(1)

Larry Sheppard

Joint Commission Fluoroscopy Standards

May 10, 2019 11:11

I agree that as long as a physicist writes a reasonable protocol a maintains it, then all should be compliant.

Log inor Register

to rate and post a comment

You Must Be Logged In To Post A Comment

Advertise
Increase Your
Brand Awareness
Auctions + Private Sales
Get The
Best Price
Buy Equipment/Parts
Find The
Lowest Price
Daily News
Read The
Latest News
Directory
Browse All
DOTmed Users
Ethics on DOTmed
View Our
Ethics Program
Gold Parts Vendor Program
Receive PH
Requests
Gold Service Dealer Program
Receive RFP/PS
Requests
Healthcare Providers
See all
HCP Tools
Jobs/Training
Find/Fill
A Job
Parts Hunter +EasyPay
Get Parts
Quotes
Recently Certified
View Recently
Certified Users
Recently Rated
View Recently
Certified Users
Rental Central
Rent Equipment
For Less
Sell Equipment/Parts
Get The
Most Money
Service Technicians Forum
Find Help
And Advice
Simple RFP
Get Equipment
Quotes
Virtual Trade Show
Find Service
For Equipment
Access and use of this site is subject to the terms and conditions of our LEGAL NOTICE & PRIVACY NOTICE
Property of and Proprietary to DOTmed.com, Inc. Copyright ©2001-2019 DOTmed.com, Inc.
ALL RIGHTS RESERVED