Effective dose equivalent determination during medical fluoroscopy

When a protective apron is worn while working with medical fluoroscopic equipment and monitoring is conducted as specified in subdivision d, the effective dose equivalent for external radiation shall be determined as follows: 1. When only one individual monitoring device is used and it is located at the neck (collar) outside the protective apron, the reported deep dose equivalent shall be the effective dose equivalent for external radiation. 2. When only one individual monitoring device is used and it is located at the neck (collar) outside the protective apron, and the reported dose exceeds twenty-five percent of the limit specified in 10 CFR 20.1201, the reported deep dose equivalent value multiplied by three-tenths shall be the effective dose equivalent for external radiation. 3. When two individual monitoring devices are worn, one under the protective apron at the waist and the other outside the protective apron at the neck (collar), the effective dose equivalent for external radiation shall be assigned the value of the sum of the deep dose equivalent reported for the individual monitoring device located at the waist under the protective apron multiplied by one and five-tenths and the deep dose equivalent reported for the individual monitoring device located at the neck (collar) outside the protective apron multiplied by four-hundredths. 4. Subdivisions b and c only apply when all of the following conditions are met: a. The individual monitoring devices have not been exposed to radiation from radioactive material. b. Leaded glasses, a thyroid shield, and a wraparound protective apron have been worn whenever using the medical fluoroscopic equipment. c. The area around the medical fluoroscopic equipment has been equipped with lead shielding or transparent protective barriers for control of scattered radiation. d. The medical fluoroscopic procedures have been performed in a way that minimizes beam on time, such as utilizing last image hold. e. Users of the medical fluoroscopic equipment must have had formal training in radiation safety and operation of medical fluoroscopic equipment. f. Performance of the medical fluoroscopic equipment must be monitored and maintained via a quality assurance program. g. Patient and staff radiation exposures from medical fluoroscopic equipment must be monitored and actions taken to correct problems.