X-RAY DEPARTMENT

From Big Medical Encyclopedia

X-RAY DEPARTMENT (synonym X-ray diagnostic office) — set of specially equipped rooms for use of x-ray emission with the diagnostic purpose. Use of x-ray emission with the medical purpose (see. Roentgenotherapy ) it is made in specially equipped room radiological department (see). As a rule, R. to. are stationary. An exception make (autox-rays) and field R. mounted in railway cars, buses or on the chassis of high passability mobile to. (see. Fluorography ).

In large to lay down. - the prof. several R.'s institutions to. combine in radiological department. At an arrangement of establishment in one building organizationally the centralized several R.' accommodation is also economically justified to. In hospitals of stage type P. to. place it is dispersed, in separate cases, trying to obtain the minimum extent of a way for the main contingent of patients. R.'s accommodation is not allowed to. in residential buildings, basement and semibasement rooms (see. Hospital construction ).

River to. divide into offices of general purpose, profilizirovanny, specialized, offices for mass preventive inspections and X-ray operating rooms.

X-ray department of general purpose is intended for use of hl. obr. general methods X-ray inspection (see) — a X-ray analysis and roentgenoscopy. Such R. to. equip with the X-ray diagnostic devices RUM-10M, RUM-20, RUM-20M or similar foreign devices (see. X-ray apparatus ). To increase in capacity of R. to. completion of the device the amplifier of the x-ray image helps.

Profilizirovannye R. to. are intended for use of private methods rentgenol. researches are also respectively equipped with devices for longitudinal and cross tomographies (see), a computer tomography (see. Tomography computer ), for rentgenokimografiya (see), devices for X-ray pneumopolygraphies (see), electrox-ray analysis (see), etc.; they can also differ on bodies of interest and bodies and according to it to be equipped with X-ray apparatus for a research of bodies of uric system, dental devices, supports for a X-ray analysis and a tomography of a skull, devices for inspection of children.

In specialized R. to. conduct a complex research of certain bodies and systems by radiological and not radiological methods. E.g., the combined X-ray endoscopic researches went. - kish. a path, lungs and a mediastinum carry out using the endoscopic equipment, and during the use of an anesthesia — in addition narcotic and respiratory and resuscitation equipment.

In R. to. make fluorography for mass preventive inspections (see) bodies of a thorax, stomach, adnexal bosoms of a nose. Such R. to. are equipped with large picture frame X-ray fluorographic devices. For mass inspections of dentoalveolar system the pan-tomograph is perspective (see. Pantomografiya ), a mammary gland — devices for mammographies (see). Increase in overall performance of offices of this type is provided with their inclusion in ACM IT — the automated systems of medical examination of the population (see. Medical examination ).

The X-ray operating room (see. Surgery block ) represents specialized R. to. for rentgenol. the researches connected with an operative measure (e.g., sounding of cardial cavities, an angiography).

Design and equipment of X-ray department of general purpose: And — procedural for a X-ray analysis: B — the room of management; In — a photolaboratory; — procedural for roentgenoscopy; D — a toilet; E, Sh — cabins for patients; 1 — a rentge-nokimograf; 2 — a table of pictures; 3 — a support of pictures; 4 — a rack of pictures; 5 — the operating console; 6 — a low-voltage case; 7 — a desk; 8 — a chair; 9 — the high-voltage generator; 10 — a light-protective curtain on a door; 11 — a light-protective curtain at a window; 12 — the video monitor; 13 — a rotary table support with the amplifier of the x-ray image; 14 — a wash basin; 15 — a couch; 16 — a small protective screen; 17 — the negatoscope; 18 — a drying oven; 19 — a washing tank; 20 — fotochasa; 21 — a pro-attendance tank; 22 — a lamp with the light filter; 23 — a table for dry works; 24 — a suspension bracket for a framework; 25 — a light signal with a text «You do not enter».

The structure of X-ray department is defined by its appointment and the methods of a research (fig.) used in it. The main room of R. to. is procedural, in a cut the X-ray apparatus is established. In R. to., equipped with devices for mammography, for production of tooth pictures (working with a nominal voltage to 60 kV) or devices for fluorography (having a protective cabin), the operating console is admissible to be located in procedural. For other devices the arrangement of the operating console in the certain room (the room of management) is obligatory. In R.'s structure to., in Krom different types are carried out X-ray analysis (see), the photolaboratory with devices for photochemical processing of film materials, enters into R.'s structure to. for an electrox-ray analysis — electroradiographic laboratory with devices for charging of selenic plates and manifestation of the electrostatic image. Increase in labor productivity is promoted by the organization of the centralized photolaboratories. The centralized photolaboratory consists from light (for cutting, marking and the layout of ready pictures) and dark (for charging and a discharge of cartridges, photochemical processing of a film) the rooms supplied with a light labyrinth (lock), transfer windows and conveyors for cartridges and equipped with the automated pro-attendance cars for photo processing of a sheet or rolled film. Adjacently with the centralized photolaboratory have viewing — the room for studying of pictures and execution of the conclusions supplied with devices for viewing of full-size roentgenograms — negatoscopes and flyuorogramm — fluoroscopes (see. Roentgenogram , Fluorography ). River to. for mass inspections of bodies of a thorax contains in addition the room for an undressing combined with registry. River to. general purpose, and also specialized R. to. for a research of uric system have a toilet, cabins for patients; River to. for a research went. - kish. a path — also the room for preparation of a baric suspension; the X-ray operating room has in addition preoperative, sterilizing and other technologically necessary rooms. In rentgenol. department there are also an office of the manager, a staffroom, rooms for medical and technical personnel, the room for storage of ward X-ray apparatus, spare parts and tools, wheelchairs, linen.

The floor area of R. to. is chosen taking into account requirements radiation safety (see). The distance from a X-ray emitter to walls of procedural shall make ye less than 1,5 m at a X-ray analysis and not less than 2 m at roentgenoscopy that determines the minimum area procedural. E.g., the minimum area procedural for fluorography (with one X-ray apparatus) — 20 m 2 , the minimum area of the procedural X-ray operating room — 54 m 2 .

Rooms of the X-ray operating room, rooms of management, electro-radiographic laboratory and offices of personnel shall have natural lighting. Procedural for roentgenoscopy and a photolaboratory supply with light-protective curtains on windows and doors. Height of rooms of R. to. not less than 3 m. Walls of the X-ray operating room, a photolaboratory and electroradiographic laboratory completely revet with a ceramic tile, walls in other rooms revet usually only at a wash basin. Floors of the X-ray operating room, a photolaboratory and electroradiographic laboratory cover with a ceramic tile, other rooms — a parquet or linoleum on insulating coating, it is preferable on a wooden flooring. In procedural, photolaboratories, electroradiographic laboratory and rooms of personnel establish wash basins with a supply of cold and hot water.

Ensuring antiactinic protection adjacent with procedural rooms is carried out by selection of building constructions with a necessary lead equivalent (see. Antiactinic protection , Radiological protective processing equipment ). Calculation of protection of procedural R. to. for tooth pictures and mammography it is carried out on the mode of raying 50 kV, 0,25 ma, other procedural — on 100 kV, 2 ma. Horsepower rating of an air dose of radiation makes for rooms of X-ray department 1,7 mr / hour, for adjacent premises of institution 0,12 mr / hour.

During R.'s work to. in its atmosphere harmful substances — ozone, nitric oxides (due to interaction of ionizing radiation with air), lead (owing to use of the leaded protection devices), acetone, toluene, styrene (can collect during the work with an electroroentgenograph). For their removal procedural, the room of management, a photolaboratory, electroradiographic laboratory are supplied forced-air and exhaust ventilation (see) with frequency rate of air exchange on inflow 4 and on an extract 3. The electroradiographic laboratory uses in addition exhaust umbrella over electroroentgenographs or place them in chemical hood (see). Besides, all products from not varnished leaded rubber place in covers (a self-adhesive film, polyethylene or an oilcloth), and put on protective gloves cotton.

Prevention of impact of electric current on R.'s personnel to. and patients it is provided with connection with the earth of the zero feeding network wire and the obligatory device from the metal tire with a section of 25 X 4 mm of a repeated contour of grounding, to-ry becomes stronger in the bottom of a wall procedural, rooms of management and a photolaboratory at the height of 15 — 20 cm from a floor. With a resistance of spreading no more than 10 ohms connect to a contour in the conditions of direct vision metal parts of all elements of equipment. In addition in the presence in R. to. several X-ray emitters provide the blocking interfering their simultaneous uncontrollable inclusion. 1 U entrances to procedural R. to. establish a light signal with a text «Do not enter!», blocked with inclusion of the operating console at a X-ray analysis or high tension at roentgenoscopy. For fire safety quantity of the x-ray film which is stored in R. to., limit up to 2 kg, in special premises of x-ray department — to 100 kg. The film is stored in metal cases. Noise level in workplaces of personnel shall not exceed 60 dB, in rooms of periodic stay — 70 dB. Decrease in noise level is provided with the device of sound insulation and use low-noise elekt-, rodvigatel and reducers.

R.'s equipment to. place taking into account ensuring radiation safety and technology of a X-ray analysis. The working bunch of x-ray emission is directed towards the main wall not adjacent to the room of management or a photolaboratory. Jobs of the doctor, X-ray laboratory assistant and other employees of R. to. are equipped with a two-way communication. Placement in R. is not allowed to. not used equipment.

The organization of work of X-ray department is in direct dependence on type, a profile and power to lay down. institutions, corresponding regular standards. These factors determine the volume and structure of X-ray inspection (see) taking into account the contingent of the population serviced by medical establishment. Operational load of the radiologist and X-ray laboratory assistant (see) calculate on the basis of accepted standards of time spent for carrying out various methods rentgenol. researches. E.g., on roentgenoscopy of bodies of a thorax 7 min., on a bronchography — are allotted 36 min.

R.'s operation to. it is regulated by «Health regulations of work at carrying out medical X-ray inspections». Daily before the beginning rentgenol. researches check operability of the x-ray equipment. During the carrying out rentgenol. researches in R. to. there have to be only persons participating in it and no more than one patient. The persons accompanying the child or the seriously ill patient shall be provided with individual protection equipment from ionizing radiation. At roentgenoscopies (see) use of protective gloves, use of the maximum diaphragming and remote tools is obligatory. Volume rentgenol. researches are established by the radiologist bearing responsibility for validity of appointment and carrying out a research. Results rentgenol. researches enter in the medical record out-patient or the inpatient where note also approximate dose of his radiation.

After completion of work in R. to. switch off a network knife switch, carry out wet cleaning and disinfection of the elements contacting to a body of the patient and accessories of the x-ray equipment. Monthly perform technical routine maintenance of all equipment of R. to. with simultaneous planovopredupreditelny repair. Also monthly in R. to. make clear-out using 1 — 2% of solution acetic to - you. Annually check resistance of spreading of a grounding conductor and frequency rate of air exchange. Time in 2 years measure a lead equivalent of protection devices and carry out radiation control (see) in workplaces. Individual radiation control of personnel is carried out monthly. The personnel undergo periodic instructing on to the accident prevention (see) and for prevention of occupational diseases — medical examinations (see. Medical examination ). Women are exempted from work in the field of action of ionizing radiation for the entire period of pregnancy. Are not allowed to work in R. to. the persons under 18 and persons having medical contraindications.

X-ray department of field mobile hospital and other military-medical institutions is intended for performance rentgenol. researches in field conditions (see. X-ray inspection ), it is developed in special x-ray frame tents or in the adapted rooms. For equipment of x-ray department the set which is carrying the name of the same name, including a field X-ray apparatus like RUM-4 or RUM-24, a figurative X-ray apparatus is used (see. X-ray apparatus ), photolaboratory objects and chemicals, protective screens, aprons and gloves from the leaded rubber, the electroradiographic device and necessary materials for its work. Power supply of X-ray apparatus is carried out from the electrical unit which is contained in a set or from the power supply network.

X-ray department can be mounted in the car with a special body (autox-ray). In this case at expansion of department the X-ray apparatus is placed in a special frame tent, edges is a part of a set of autox-ray, and in a body of the car place a photolaboratory. In a body the large picture frame X-ray fluorographic device can be installed. Such x-ray department is used for preventive inspection of staff of troops.

Considering that the tents used for expansion of x-ray department have no antiactinic protection, department cannot be placed in close proximity to other divisions.



Bibliography: Pancakes H. N, etc. Technical means of radiodiagnosis, M., 1981, bibliogr.; Lagunova I. G., etc. Technical means of x-ray diagnosis, M., 1973, bibliogr.; Hidirbeyli X. And. and Pinkhosevich E. G. Work of a rentge-but-diagnostic office in policlinic and in hospital, M., 1969, bibliogr.


L. N. Gorelova, E. G. Chikirdin; V. P. Wingnuts (soldier.).

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