Administrative procedures to restrict doses

The hierarchy of control states that when it comes to restricting exposure, engineering controls should be the first choice in preference to administrative controls or personal protective equipment. This is because they protect everyone involved and rely less on us humans doing the right thing. However, it’s often necessary for these engineering controls to be supplemented with some administrative controls to further restrict exposures. To tell us more about administrative controls, I’d like to introduce James, who is a dentist and the radiation protection supervisor at the dental practice. Hi, James. Could you give me some examples of the administrative controls that you have in place at your practice? Hi, Andrew.

Firstly, we make sure all of our X-ray equipment is either switched off or the exposure controls are disabled when not being used. This helps prevent unauthorised use of the equipment and minimises the risk of accidental exposures. OK. What about when the equipment is in use? What admin controls do you have then? This depends on what type of equipment we’re working with. For the intraoral equipment, we require all our operators to stand at a safe distance from the equipment and away from the main X-ray beams. This might be inside the surgery or in the doorway depending on the layout of the surgery.

We also have to display a controlled area warning sign outside the door when the X-ray set is in use and remember to cover this up again when we’ve finished and switched the X-ray set off. We’ve also got a dental cone beam CT scanner, but for this type of equipment, the operator has to stand outside the room to make use of the shielded door and the shielded walls, which helps keep their exposure down. We have a coverable controlled area sign outside this room, too, but the controlling computer can also be locked with a password so that no one else can operate the scanner when it’s not in use.

It’s a lot easier than having to switch it off and then on again every time a patient needs a scan. That all sounds sensible. Are there any other admin controls you’d like to tell us about? Well, an important one is that the operator must always check that the X-ray exposure is terminated correctly before approaching the patient and the X-ray tube. They do this by either checking the audible warning has finished, normally at the end of the exposure, or by checking that the X-ray warning light has gone out, if it’s visible from their usual position.

If it hasn’t or they can still hear the audible warning sound, they have to switch off the power as quickly as they can to stop the patient being exposed any further. They must then come and tell me straight away that something has gone wrong so that I can take over and deal with the situation. Another practice that I worked at before also had a handheld X-ray set and we had to keep the X-ray beam horizontal so the operator was always protected by the backscatter shield at the end of the cone. This device also had to be locked away safely when it wasn’t being used so that it didn’t get lost or stolen.

And how do you make sure all the staff follow these procedures? Is there somewhere they can look if they need reminding? So all of our administrative controls are in our local rules document, which staff have to read and sign to say that they agree to follow them. We keep copies in each surgery as well as a master copy in our file. Well, the local rules seem to be an important document, and we’ll discuss them in more detail later on in the course. So thanks for sharing that, James. You’re welcome.