Standards for designing x-ray rooms. X-ray diagnostics in private dental clinics: safety requirements. equipment requirements

The first private dental offices and clinics appeared in Russia in the early 1990s, and today most Russians turn to them. Patients are attracted by the quality of medical services and the use of the latest methods treatment and diagnosis. Even in a small dental office located indoors housing stock, you can come across a dental apparatus, which, by the way, is a source of X-ray radiation, which means that during its operation it is necessary to comply with radiation safety standards. Read the article about what requirements dental offices and clinics that conduct X-ray examinations must meet.

In accordance with clause 3.30 of SanPiN 2.6.1.1192-03 “Hygienic requirements for the design and operation of X-ray rooms, devices and the conduct of X-ray examinations” To install and operate X-ray dental equipment, the institution must collect the following documents:

Sanitary and epidemiological conclusion on the type of activity: operation, storage, testing, etc. of an X-ray machine (devices) in an X-ray room (rooms);

Sanitary and epidemiological certificate for the X-ray machine as a product that poses a potential danger to humans;

Sanitary and epidemiological conclusion for the project x-ray room;

Technical certificate to the X-ray room;

Instructions for labor protection, including requirements for radiation safety, for the prevention and elimination of radiation accidents;

Sanitary rules, other regulatory and instructional documents regulating radiation safety requirements.

X-ray machines are permitted for use in medical practice provided they are registered by the Russian Ministry of Health and have a sanitary-epidemiological report on their compliance with sanitary rules in the field of radiation safety. The data bank on registered X-ray devices is located in the Center for Standardization and Certification of the Russian Ministry of Health. Often, private clinics use exclusive copies of X-ray diagnostic equipment that are not included in the data bank of the Center for Standardization and Certification. Such equipment must undergo radiation-hygienic tests with the involvement of specialists from an organization accredited in in the prescribed manner.

Today, X-ray machines with image recording on film are being replaced by more modern systems, in which data is recorded digitally. For example, when using a radiophysiograph - one of the types of digital dental radiographic systems - studies are carried out by introducing solid-state X-ray sensitive detectors into the oral cavity, which makes it possible to reduce the patient’s radiation dose by 2-4 times.

Requirements for the arrangement of the office and placement of the X-ray diagnostic apparatus

A dental apparatus that works with ordinary film without an intensifying screen is installed in a room of at least 8 m2 only in the X-ray department (room) of a general medical or dental treatment institution. To accommodate a device operating with a highly sensitive film and (or) digital image receiver, including a radiovisiograph, the area of ​​the room must be at least 6 m2. The radiovisiograph can also be installed in the premises of a dental institution located in a residential building, including in areas adjacent to residential premises. At the same time, radiation safety standards for the population within the premises in which X-ray dental examinations are carried out must be observed. The area of ​​the dental office equipped with a radiovisiograph must be at least 14 m2. According to clause 7.3.1 of SanPiN 2.1.3.2630-10, panoramic devices (orthopantomographs) cannot be placed in the dental office, as well as in the premises of the dental clinic adjacent to residential premises.

If the X-ray dental diagnostic room is located on the first or basement floors, then the windows of the treatment room are screened with protective shutters to a height of at least 2 m from the level of the building blind area. If the X-ray room is located above the first floor at a distance from the treatment room to residential and office premises neighboring building is less than 30 m, the windows of the treatment room are screened with protective shutters to a height of at least 2 m from the finished floor level.

The X-ray machine is placed in such a way that the radiation beam falls in the direction of the wall behind which there is a less visited room. If a dental clinic has several rooms, and an X-ray machine is installed in only one of them, then it must be stationary in order to exclude the possibility of its transfer to other rooms that do not have appropriate stationary or mobile radiation protection equipment.

Assortment of modern building materials and the capabilities of private dental clinics make it possible to choose for the manufacture of stationary radiation protection equipment those materials that provide reliable protection. Lead equivalents of building materials used for protection against X-ray radiation are listed in Table. 3-6 appendices 9 SanPiN 2.6.1.1192-03. When using materials not listed in the tables, it is necessary to have information on their protective properties or determine protective characteristics in accredited organizations using control samples.

Stationary radiation protection facilities The x-ray room (walls, floor, ceiling, protective doors, observation windows, shutters, etc.) must ensure attenuation of x-ray radiation to a level at which the main dose limit (PD) for the relevant categories of exposed persons will not be exceeded. The calculation of radiation protection is based on determining the attenuation factor (K) of the absorbed dose rate ( D 0) X-ray radiation in the air at a given point in the absence of protection up to the value of the permissible absorbed dose rate (ADR) in the air:

K = D 0 / DMD = 10 3 × KR × W × N/ (30 × r 2 × DMD),

where 10 3 is the conversion factor from mGy to μGy;

KR- radiation output - the ratio of the power of the air kerma in the primary X-ray beam at a distance of 1 m from the focus of the tube, multiplied by the square of this distance, to the strength of the anode current, mGy × m 2 / (mA × min.);

W— workload of the X-ray machine (mA × min.)/week;

N— radiation directivity coefficient, relative unit;

30 is the value of the normal operating time of the X-ray machine per week during single-shift work of group A personnel (30-hour work week), h/week;

r— distance from the focus of the X-ray tube to the calculation point, m.

When equipping an X-ray diagnostic room in a room adjacent to residential, it is necessary to adhere to the requirements of radiation safety standards for the population within the X-ray dental office. Therefore, when calculating radiation protection in this case, the points located:

Close to internal surfaces the walls of the X-ray room located horizontally adjacent to the living quarters;

At the floor level of the X-ray room - when the living space is located under the room;

At the ceiling level of the X-ray room - when the living space is located above the room.

It should be noted that the materials used today for the manufacture of protective fences and interfloor ceilings, in most cases, provide the necessary attenuation factor for X-ray radiation, so residents of apartments located adjacent to the X-ray room are not exposed to doses exceeding the dose limit for the population. Moreover, the calculation of radiation protection is carried out in such a way that the requirements of radiation safety standards for the population living in rooms adjacent to the rooms in which X-ray examinations are carried out are met with a significant margin. Often, part of the residential premises adjacent to the X-ray room of a private dental clinic is occupied by its owners, which for the population serves as a strong argument in favor of the reliability of radiation safety.

When planning to equip an X-ray room in a dental clinic located in a residential building, you need to make sure that it interfloor ceilings are not made of wood, which is not a barrier to x-rays. Wooden floors preserved in many old houses. In this case, it becomes necessary to create a special protective ceiling in the X-ray room.

Radiation protection of personnel and patients

The office where X-ray dental examinations are carried out must have a set mobile And individual funds protection of staff and patients. If the control panel and the treatment room are located in the same room, it is necessary to install large protective screen with viewing window. It is possible to move the X-ray machine control panel (anode voltage switch button) to a separate room (control room). In any case, it must be possible to monitor the patient through the viewing window. The office can also be equipped with a television camera. If the power button is located outside the office, it is necessary to exclude the possibility of access to it by random persons.

To protect personnel, the X-ray room must be equipped with an apron protective one-sided lung and collar protective. The patient is provided with a protective dental apron or cape (cape) protective and apron to protect gonads.

According to NRB-99/2009, persons working with man-made radiation sources are defined as Group A personnel. In our case, these are employees who work directly with dental devices. Persons working at a radiation facility or on the territory of its sanitary protection zone and located in the sphere of influence of man-made sources are defined as Group B personnel. This includes employees who do not work with an x-ray diagnostic apparatus, but are exposed to x-ray radiation. The main dose limits and permissible exposure levels for group B personnel are equal to 1/4 of the values ​​for group A personnel.

The effective dose for personnel should not exceed 1000 mSv over a period of working activity (50 years), and for the population over a lifetime - 70 mSv. Planned increased exposure (above established dose limits) is allowed only for men over 30 years of age with their voluntary written consent after being informed of the possible radiation doses and health risks. The main radiation dose limits for personnel of groups A, B and the population, established by NRB-99/2009, are given in the table.

The International System of Units (SI) measures absorbed dose in grays (Gy). 1 Gy is equal to the absorbed energy of 1 J per 1 kg of mass of the substance. To take into account the biological effect of the absorbed dose, an equivalent absorbed dose of ionizing radiation was introduced, equal to the product of the absorbed dose and the biological effectiveness coefficient. In the SI system, the effective and equivalent absorbed dose is measured in sieverts (Sv).

In order to prevent unnecessary re-exposure of patients at all stages of medical care, the results of previously conducted x-ray studies and the doses received during the year are taken into account. When referring a patient for an x-ray examination, consultation or hospital treatment, when he is transferred from one hospital to another, the results of X-ray studies (description, pictures) are transferred along with an individual card. The established standard for annual preventive radiation exposure during preventive medical X-ray examinations and scientific research for practically healthy individuals is 1 mSv. Radiation dose limits for patients for diagnostic purposes are not established.

Requirements for personnel working with X-ray dental equipment

Persons at least 18 years of age who have a document confirming appropriate training, who have been instructed and tested their knowledge of safety rules, documents and instructions in force in the institution are allowed to operate an X-ray machine. Training of specialists involved in X-ray examinations is carried out according to programs that include the section “Radiation Safety” in institutions licensed to educational activities. X-ray examinations are carried out radiologist And x-ray technician. For dental clinic best option when X-ray diagnostics are carried out by a radiologist with a higher education professional education in the specialty "Dentistry" and postgraduate professional education (internship and (or) residency) in the specialty "Radiology", as well as a radiographer who has received secondary vocational education in the specialty "Dentistry", "Preventive Dentistry", "Orthopedic Dentistry" and a specialist certificate in specialty "Radiology".

Before starting an X-ray dental examination, personnel must check the serviceability of equipment and reagents with mandatory recording of the results in a control and technical journal. If malfunctions are detected, it is necessary to suspend work and call a representative of the organization carrying out Maintenance and equipment repair. After the end of the working day, the X-ray machine, electrical appliances, table lamps, electric lighting, ventilation are turned off, the walls are wet cleaned, the floors are washed, and the elements and accessories of the X-ray machine are thoroughly disinfected. Wet cleaning is carried out monthly using a 1-2% solution acetic acid. It is not allowed to carry out wet cleaning procedure room and control room of the X-ray dental room immediately before and during the examination.

The administration of the dental clinic is responsible for organizing preliminary (upon employment) and annual periodic medical examinations of group A personnel. Persons who do not have medical contraindications for working with sources of ionizing radiation are allowed to work. If deviations in the state of health are identified that prevent the continuation of work in the X-ray room, the question of temporary or permanent translation these persons to work outside of contact with radiation in the prescribed manner is decided by the administration of the institution in each individual case individually.

NOTE!

Women are exempt from direct work with X-ray equipment for the entire period of pregnancy and breastfeeding child.

Radiation control

The person responsible for conducting radiation monitoring is appointed by the administration of the dental institution. The implementation of radiation monitoring is part of production control, the program of which is determined taking into account the characteristics and conditions of work performed in the X-ray and dental room, and is agreed upon with the state sanitary and epidemiological inspection body.

In accordance with clause 8.5 of SanPiN 2.6.1.1192-03 radiation monitoring includes:

Monitoring the radiation dose rate at personnel workplaces, in rooms and areas adjacent to the X-ray room. It is carried out during technical certification of the X-ray room, obtaining a sanitary and epidemiological report;

Monitoring the technical condition and protective effectiveness of mobile and personal radiation protection equipment. Conducted at least once every two years;

Individual radiation monitoring of group A personnel. It is carried out continuously with registration of measurement results once a quarter (in agreement with the state sanitary and epidemiological inspection body - once every six months);

Individual radiation monitoring of persons periodically participating in special X-ray examinations (surgeons, anesthesiologists, etc.) is carried out in the same way as for group A personnel; the assessment of radiation doses of a given contingent may be carried out using a calculation method;

Control of patient dose loads. It is carried out with every x-ray examination.

As part of the implementation of the production control program The administration of the institution determines:

List of employees for whom individual or group dosimetry monitoring is required;

The procedure for conducting group dosimetric monitoring, indicating the workplaces where dose rate measurements are required;

The procedure for conducting individual dosimetric monitoring, indicating the number of individual dosimeters and where they are worn on the employee’s body;

The procedure for monitoring the correct wearing of personal dosimeters and the use of personal protective equipment;

List of actions when exceeding control levels is detected.

According to the established practice of radiation monitoring in medical organizations, measurements and recording of results are usually carried out by third-party organizations - testing laboratory centers, radiation control laboratories, etc., accredited in accordance with the established procedure.

For medical personnel who are not in close proximity to the radiation source or X-ray beam (control room, darkroom, adjacent rooms) who are subject to uniform irradiation, one individual dosimeter located on the surface of the body (for example, in the breast pocket of a robe) is enough to indications, using the appropriate transition coefficient, estimate the value of the effective dose. Medical staff, conducting special X-ray examinations under the control of X-ray radiation, by the nature of his activity must be close to the patient, that is, in close proximity to the radiation source or X-ray beam. The exposure of this category of personnel is uneven. According to data from phantom and full-scale measurements on the front surface of the body, such workers have a more than 10-fold excess dose, and the dose gradient in the body is much greater. The distribution of surface and deep doses also depends on additional shielding of the body protective apron. In this case, to correctly assess the standardized values, it is necessary to use two individual dosimeters on the surface of the worker’s body.

In accordance with clause 3.13.7 OSPORB-99/2010 medical organization, using sources of ionizing radiation, a card is issued for each employee classified as group A personnel accounting of individual doses. It reflects the following information:

Information about the employee: last name, first name and patronymic, date of birth, gender, home address, telephone number;

Information about professional activity employee: position, nature of work, work experience in radiation hazardous conditions;

Information about radiation doses:

• quarterly radiation doses;
• total annual radiation doses;
• total radiation dose at the time of filling out the card;

• radiation dose received during the period of secondment to other organizations;
• radiation dose received as a result of radiation accidents and planned increased exposure.

If an employee moves to another institution where work with radiation sources is carried out, a copy of the individual dose record card is transferred to the new place of work. The original is stored on same place work for 50 years.

SanPin provisions define specific requirements for the condition of x-ray and dental rooms, based on concern for the health of patients. They are based on relevant federal laws. In addition to general cleaning and cleaning equipment after use, the rules establish safety parameters for patients and staff.

The rules developed in SanPin 2.6.1.1192-03 apply to all organizations using X-ray installations. Amended new rules were released in 2006. All medical centers must obey them, regardless of who owns them. The rules come into force at the stage of designing a house and are valid during the construction of a medical building, modernization of its parts and operation of offices.

One-time amount of radiation and motivation for radiography

Radiation doses for doctors and patients are subject to restrictions according to SanPin:

1. A radiologist has no right to receive a radiation dose of more than 20 m3 per 12 months. A dose of 50 m3 is acceptable, but the annual dosage must be maintained.
2. Women under 45 years of age should not take more than 1 m 3 x-ray per month.
3. A single dose for the patient being examined should be kept in the amount of no more than 1 m 3 in.

SanPin 2003 says that the patient receiving a dose of X-ray radiation must be justified. Motivation includes:

• if possible, use other diagnostic methods that do not involve irradiation of the patient;
• prescribing radiography only for serious indications;
• least choice dangerous species radiography;
• an unfavorable outcome of the disease should exceed the risk of an x-ray examination.

The same conditions apply when prescribing x-ray therapy. The benefit from it must be greater than the harm from radiation.

Concern for the safety of the subject

Minimizing harm to patients in SanPin contains the following provisions:

• examination of the patient in x-ray rooms is carried out on the direction of the doctor;
• the subject receives all the information about a single dose of X-ray irradiation and its possible negative consequences;
• X-ray equipment complies with established standards;
• the optimal dosage for the study is used;
• X-rays are carried out by specially trained personnel;
• the office is kept in proper condition;
• the rules for using the equipment are observed;
• The operation of the X-ray room is monitored.

Responsibility for the consequences of the examination lies with the radiologist. He decides whether x-rays can be taken. If, in his opinion, the referral for an x-ray is not justified, he has the right to refuse the examination.

Rules for placing x-ray units and establishing their functioning

For installation X-ray machines New centers in SanPin have strict requirements:

• the devices cannot be placed in residential buildings;
• It is recommended to organize special x-ray departments;
• X-ray rooms are installed at the end of the houses of medical centers or hospitals;
• at the top (on the next floor) there should be no rooms with the possibility of water leakage;
• X-rays should not be adjacent to the children's department and rooms for expectant mothers;
• cabinets should be used only for their intended purpose, there should be no other equipment there;
• The gaps between the radiologist's table, the protective screen, the X-ray machine, walls and windows are strictly regulated.

The floor covering in the radiography room must be antistatic and prevent sparks. It is suitable for frequent washing with detergents. The walls are being finished matte materials so that there is no glare. The window is equipped with light protection. The X-ray installation is installed so that the beam of rays falls on the main wall.

X-ray machine

The wall partitions of the darkroom are finished with a tiled apron. When using static x-ray installations, it is recommended to organize work in two rooms - the control room and the examination room. A window is provided from the control room to the examination room for visual communication with the patient. The installation is located in the examination room, and in the control room there is a remote control and a screen.

Temperature and air exchange requirements

The temperature in the X-ray room according to SanPin is allowed to range from 18 to 22 degrees. Air extraction occurs once every 60 minutes. The influx of fresh air into the examination room occurs once every 20 minutes, in the control room - once every half hour. The intensity of lighting in the department is also regulated.

Concern for the safety of medical workers

Employees of the radiographic department are provided with radiation protection items. Employees over 17 years of age can conduct radiation examinations. Radiographers and technicians must undergo an annual physical examination. Expectant mothers at all stages and women breastfeeding a baby are not allowed to work with emitting equipment.

Operating conditions for dental offices with an X-ray machine

The room intended for x-rays in a dental clinic according to SanPin must have a minimum size of 8 m 2. In 60 minutes, old air is extracted three times and oxygen is supplied twice. The room temperature is allowed within 18 - 20 degrees. The equipment is registered with the Ministry of Health. The question of whether radiography can be performed is resolved simply - the clinic must have a licensing permit. Radiation protection items must be present in the office. Radiography is performed by a certified specialist.

After the end of the appointment time, all devices in the radiography room are turned off. A technician performs wet cleaning - wipes wall coverings, washes the floors. Trained personnel conduct disinfection measures with an X-ray machine and component materials.

Once a month it is necessary to carry out general cleaning with a 2% acetic acid solution. General cleaning and the usual one cannot be carried out in the morning before the start of patients’ appointments - only in the evening.

The developed operating conditions for the radiography room ensure the safety of patients and staff. They cannot be neglected.

03.02.2018

Basic requirements for the premises of the X-ray room and for placement in it x-ray equipment

The placement of the X-ray room and equipment in it is carried out on the basis of a project completed by an organization that has a license to operate in the placement of ionizing radiation sources (generating) and the design of radiation protection equipment.

An X-ray room, unlike other rooms in medical institutions, is not one room, but several rooms (rooms isolated from each other), each of which has its own purpose and corresponds in area to the established regulatory requirements, and also meets all other sanitary and hygienic requirements. We will dwell on the latter in detail.

Composition and area of ​​the X-ray room/rooms of the X-ray room

The X-ray room includes at least 3 isolated rooms, one of which serves as a treatment room (the room in which work is directly carried out using sources of ionizing radiation), the second is a control room (the room in which the equipment that controls the radiation source is located) and the third is an office doctor Depending on the purpose of the X-ray equipment or the specifics of the activity medical institution The X-ray room may include a darkroom, a waiting room, a dressing room, a staff room, etc. ( detailed information the types of X-ray rooms are described in the article “Project of an X-ray room”).

Appendix 5 to SanPiN 2.6.1.1192-03 establishes the composition and area of ​​X-ray rooms. Thus, based on the information in Appendix 5 to SanPiN 2.6.1.1192-03, we present below in Table 1 the area of ​​the treatment room with different X-ray machines, in Table 2 the composition and area of ​​the rooms of the X-ray diagnostic room, in Table 3 - the composition and area of ​​the rooms of the X-ray therapy room.

Table 1

Treatment room area with different x-ray machines

table 2

Composition and area of ​​the premises of the X-ray diagnostic room

* Not necessary.
** Not needed when using devices for digital radiography and fluorography.

Table 3

Composition and area of ​​premises of the X-ray therapy room

The use of premises of a smaller area or a reduced set of premises is possible in cases where the equipment used, the organization of work, the number of personnel, etc. ensure compliance with general hygienic requirements (microclimate, bacterial contamination, sanitary and epidemiological regime, etc.).

X-ray room in the building: basic requirements

According to the hygienic requirements of SanPiN 2.6.1.1192-03, it is advisable to place x-ray rooms centrally, as part of the x-ray department, at the junction of the hospital and the clinic. X-ray rooms of infectious diseases, tuberculosis and obstetric departments of hospitals and, if necessary, fluorography rooms of emergency departments and outpatient departments can be located separately.

By general rule The X-ray department (office) is not allowed to be located in residential buildings and children's institutions. The exception is X-ray dental rooms (devices), the possibility of placing which in residential buildings is regulated by a special chapter of rules SanPiN 2.6.1.1192-03, as well as the “Basic sanitary rules ensuring radiation safety (OSPORB-99/2010" SP 2.6.1.2612-10 and Amendment 1 to SP 2.6.1.2612-10. It is not allowed to place dental X-ray machines with a film image receiver in residential buildings.

In dental and X-ray rooms adjacent to residential apartments, it is allowed to place X-ray diagnostic devices with digital image processing, the total rated workload of which does not exceed 40 mA-min/week. (detailed information on this issue is described in the article “Placement of X-ray equipment in a dental clinic”).

It is allowed to operate X-ray rooms in clinics built into residential buildings if the vertically and horizontally adjacent rooms are not residential. It is also allowed to place X-ray rooms in an extension to a residential building, as well as in the basement, if the entrance to the X-ray department (room) is separate from the entrance to the residential building.

As stated in clause 3.3 of SanPiN 2.6.1.1192-03, an X-ray department serving only a hospital or only a clinic should be located in the end parts of the building. In this case, the department should not be a walk-through. Entrances to the X-ray department for inpatient and outpatient department patients are separate.

Important: by virtue of clause 3.4 of SanPiN 2.6.1.1192-03, it is not allowed:

• Place X-ray rooms under rooms where water can leak through the ceiling (swimming pools, showers, restrooms, etc.);
• Place the X-ray treatment room adjacent to the wards for pregnant women and children.

Room for x-ray equipment

According to clause 2 of Appendix 7 to SanPiN 2.6.1.1192-03, the selection of premises included in the X-ray room (department) is carried out by the administration of the medical institution together with the X-ray and radiological department (RRO) (or another organization similar in function to the RRO) of the region and is consistent with institution of sanitary and epidemiological surveillance. At the same time, in relation to individual rooms of the X-ray room, the medical organization must comply with special requirements, established by SanPiN 2.6.1.1192-03. However, in practice, such coordination of the selected premises with Rospotrebnadzor no longer exists and applications for approval of the placement of the X-ray room are no longer submitted.

X-ray room

A treatment room is a specially equipped room in an x-ray room in which an x-ray emitter is located and x-ray examinations or x-ray therapy are carried out.

According to clause 3.11 of SanPiN 2.6.1.1192-03, the height of the X-ray treatment room must ensure the functioning of technical equipment, for example, ceiling mounting of an X-ray emitter, tripod, television monitor, shadowless lamp, etc. X-ray equipment with ceiling suspension emitter, screen-imaging device or X-ray image intensifier requires a room height of at least 3 m (2.6 meters according to the newer SanPiN 2.1.3.2630-10). The height of the X-ray treatment room in the case of rotational irradiation must be at least 3 m. The width of the doorway in the X-ray diagnostic room, RCT room and cath lab must be at least 1.2 m with a height of 2.0 m, the size of the rest doorways- 0.9 x 1.8 m.

Requirements for the treatment room area, including depending on the X-ray machine, are given in Tables 1, 2 and 3 above. At the same time, as stated in clause 3.9, the area of ​​the procedural room can be adjusted in agreement with the body exercising federal sanitary and epidemiological supervision, taking into account the following requirements:

• The distance from the personnel workplace behind a small protective screen to the walls of the room is at least 1.5 m;
• The distance from the personnel workplace behind a large protective screen to the walls of the room is at least 0.6 m;
• The distance from the rotating tripod table or from the imaging table to the walls of the room is at least 1.0 m;
• The distance from the photo stand to the nearest wall is at least 0.1 m;
• The distance from the X-ray tube to the viewing window is at least 2 m (for mammography and dental devices - at least 1 m);
• The technological passage for personnel between elements of stationary equipment is at least 0.8 m;
• The area where the gurney is placed for the patient is at least 1.5 x 2 m;
• Additional area if there is a technological need to bring a gurney into the treatment room - 6 m2.

In accordance with clause 3.30 of SanPiN 2.6.1.1192-03, in the treatment room, in addition to the procedure room for fluorography and the X-ray operating room, it is provided for the installation of a sink with a supply of cold and hot water. In a procedural room designed for urological studies, a viduar should be installed.

In the treatment room for the study of children, the presence of toys (washed in a soap and soda solution and disinfected) and distracting design is allowed.

Important: Placement in procedural equipment, which is not included in the project, as well as carrying out work not related to x-ray examinations.

X-ray machine placement

The X-ray machine is placed in the treatment room in such a way that the primary beam of radiation is directed towards main wall, behind which there is a less visited room. The direct beam of radiation should not be directed towards the viewing window (control room of the protective screen). When the office is located on the first or ground floor, the windows of the treatment room are screened with protective shutters to a height of at least 2 m from the level of the building's blind area. When the X-ray room is located above the first floor at a distance of less than 30 m from the treatment room to the residential and office premises of the neighboring building, the windows of the treatment room are screened with protective shutters to a height of at least 2 m from the finished floor level.

Information about controlling the X-ray machine is presented in the article “X-ray room project”.

Photo lab

In accordance with clause 3.23 of SanPiN 2.6.1.1192-03, a photo laboratory can consist of one room - a “dark room”. When equipping a laboratory with a developing machine, an additional “light” room should be provided for sorting, marking and trimming dry photographs.

The minimum area of ​​a darkroom (“dark room”) for small-format photographs is 6 m2, for large-format photographs - 8 m2. The minimum width of the passage for personnel between elements of equipment in a dark room is 1.0 m. The width of the doorway is 0.9 - 1.0 m.

The walls of the darkroom are finished with light-colored tiles, primarily at the sink and photo processing device (tiled apron). It is allowed to finish with tiles to a height of 2 m with the overlying finishing materials allowing for repeated wet sanitization.

The door from the darkroom, as well as the treatment room and control room to the corridor, should, for reasons fire safety open “to the exit” (during the evacuation), and from the control room to the treatment room - towards the treatment room.

Window, transfer hatch and front door darkrooms are protected with light-proof curtains to prevent exposure of photographic materials.

However, it is worth noting that a darkroom is necessary when using film X-ray machines, which have actually already been replaced by modern digital technology.

Other requirements for X-ray room premises

SanPiN 2.6.1.1192-03 contains a number special rules in relation to the X-ray room premises. Thus, the floor of the treatment room, control room, except for the X-ray operating room and darkroom, is made of natural or artificial electrical insulating materials. Application artificial surfaces and floor structures is possible if they have a conclusion on their electrical safety. In the X-ray operating room, preoperative room, and darkroom, the floors are covered with waterproof materials that are easy to clean and allow frequent washing and disinfection. The floor of the cath lab must be antistatic and spark-free. When making a floor from antistatic linoleum, it is necessary to ground the base of the linoleum.

The surfaces of the walls and ceilings in the treatment room and control room should be smooth, easy to clean and allow wet cleaning. Finishing materials must have a sanitary and epidemiological certificate allowing their use in residential and public buildings.

The walls in the X-ray operating room are finished with materials that do not produce light reflections, for example, matte tiles.

The orientation of the windows of the X-ray room for fluoroscopy and the control room is preferable to the north-west directions.

The treatment room window for fluoroscopy, if necessary, is equipped with light-protective devices to darken it from natural light(direct sunlight).

An important requirement to comply with is the requirement to place a light sign (signal) “Do not enter!” white-red color, automatically lights up when the anode voltage is turned on, at the entrance to treatment room X-ray diagnostics, fluorography and into the control room of the radiotherapy room at a height of 1.6 - 1.8 m from the floor or above the door. In this case, it is allowed to apply a radiation hazard sign to the light signal.

The regulated air exchange rate, calculated values ​​of illumination and temperature in the premises of the X-ray department (room) are given in Appendix 6 to SanPiN 2.6.1.1192-03. The inflow should be carried out into the upper zone, the exhaust - from the lower and upper zones in a ratio of 50 +/- 10%.

Ventilation of X-ray rooms in newly constructed buildings general purpose must be autonomous. In existing departments, the presence of non-autonomous general supply and exhaust ventilation is allowed, with the exception of computed tomography departments and X-ray departments of infectious diseases hospitals. It is allowed to equip X-ray rooms (departments) with air conditioners.

Start and end of work in the X-ray room

In accordance with clause 3.32 of SanPiN 2.6.1.1192-03, before starting work, personnel check the serviceability of equipment and reagents with mandatory registration of the results in a technical control log. If malfunctions are detected, it is necessary to stop work and call a representative of the organization performing maintenance and repair of equipment.

After the end of the working day, the X-ray machine, electrical appliances, table lamps, electric lighting, ventilation are turned off, the walls are wet cleaned, the floors are washed, and the elements and accessories of the X-ray machine are thoroughly disinfected. Wet cleaning is carried out monthly using a 1 - 2% acetic acid solution. Wet cleaning of the treatment room and control room of the X-ray room is not allowed immediately before and during X-ray examinations.

Necessary formalities

According to the general rule, enshrined in clause 3.31 of SanPiN 2.6.1.1192-03, an institution that has an X-ray room or an X-ray machine must have the following documentation related to the premises of the X-ray room and the placement of X-ray equipment in it:

• Sanitary and epidemiological conclusion on the type of activity (operation, storage, etc.) (see also “Sanitary and epidemiological conclusion on types of activity”);
• technical passport for the X-ray room (more details in the article “Technical passport for the X-ray room”);
• Project documentation for the placement of X-ray equipment;
• The act of putting the X-ray machine into operation, signed by representatives of the organization carrying out commissioning works, and a medical organization (for newly supplied devices) and an act for hidden work.

The arrangement of a modern X-ray room includes several stages, starting with the preparation of the room itself. The planning of the room, calculation of parameters and technological arrangement are carried out by special services, preferably in tandem with an experienced radiologist.

The X-ray diagnostic room equipment includes:

• arrangement of radiation protection,
• treatment room equipment,
• photo laboratory equipment,
• equipment for the doctor's and laboratory assistant's workplace.

It is also advisable to have a separate room for storing film archives.

Arrangement of radiation protection

To provide protection from penetrating X-ray radiation, the treatment room is finished with special X-ray protective materials over the entire area: walls, ceilings and floors, doors and windows. Barite plaster is used for walls or special X-ray protective gypsum panels, leaded materials with a certain lead equivalent - glass and metal sheets to protect doors and windows.

Treatment room equipmentrooms

List of basic equipment for the X-ray room procedure room:

• stationary X-ray machine for 2 or 3 workstations (radiography, fluoroscopy, linear tomography),
• ward mobile device,
• dental x-ray machine for intraoral images or orthopantomograph,
• digital radiovisiograph (on request).

By sanitary standards to install one x-ray diagnostic complex for 2 or 3 workplaces, an area of ​​at least 6 square meters is required. m, including installation of a targeted dental apparatus. For additional installation orthopantomograph requires more than 8 square meters. m area. For installation and operation of the second device, a room of 12 square meters is required. m.

In modern X-ray diagnostics, both film and digital X-ray systems with highly sensitive receivers are used, which improve the quality of research and reduce the radiation load. Remote-controlled complexes are used for remote fluoroscopy, which does not require light adaptation, and also reduces the radiation load on personnel.

A digital radiovisiograph is a wireless flat-panel detector in cassette format that allows you to obtain a digital image using an analog X-ray machine.

Required additional equipment:

• mobile (screens) and individual means lead rubber protection, the set of which includes: aprons, collars, gloves, skirts and aprons, caps, a set of protective plates and safety glasses. All personal protective equipment must have factory markings and a lead equivalent of at least 0.3 mm,
• individual wearable dosimeters-radiometers for individual monitoring of personnel, they are periodically changed and sent to a special laboratory (to determine the possible radiation dose received),
• screw chair,
• fixing chair for examining children (on request).

If there are two X-ray machines, a special blocker must be installed to prevent the simultaneous activation of all equipment.

X-ray complexes are placed in such a way that the main radiation beam is directed at the main wall.

In the absence of a specially designated room, the control panel is located behind a B-40 type protective screen.

The X-ray room must be equipped with an autonomous supply and exhaust ventilation with an air exchange rate of at least 3 per hour.

The entrance door must be latchable from the inside and have a warning light for patients on the outside.

Equipping a photo laboratory and a doctor’s workplace

The X-ray laboratory must be equipped with the following equipment:

• film processing plant manually(tank tanks) or developing machine for automatic processing of X-ray film,
• non-actinic developing lights with red (for green-sensitive film) or green (for blue-sensitive film) light,
• negatoscopes for viewing pictures,
• darkroom clock with timer,
• a set of several cassettes standard sizes for exposing film,
• electrical cabinet for drying developed film,
• cabinet for storing X-ray film supplies,
• Consumables: X-ray film, photo reagents, barium for fluoroscopy.

The photo laboratory must have cold and hot water supply, supply and exhaust ventilation.

The radiologist's workplace is located in a separate room or combined with a control room. Equipped with:

• personal computer with a package of application programs,
• fluoroscope (for viewing fluorograms),
• negatoscope,
• laser printer for printing digital images,
• an intercom for transmitting commands to the patient, a video device for monitoring the patient, or a viewing window with X-ray protective glass.

TO additional equipment includes furniture: chairs and tables, cabinets for storing documentation.