Staff employees of a Doctor of Chiropractic may be directed to take x-rays of a patient if they are in possession of a permit issued by the State Board of Radiologic Technology, but this permit is limited only to the taking of x-rays.
Scope of Radiography in the Chiropractic Practice
(1) The radiographic diagnostic aspect of Chiropractic practice shall include all standard radiographic procedures that do not conflict with ORS 684.025.
(2) All radiographs shall be of diagnostic quality. Radiographic films are subject to review by the Board to determine quality. Poor quality radiographs may result in disciplinary action.
(3) X-ray is not to be used for therapeutic purposes.
(4) Fluoroscopy shall not be used as a substitute for an initial radiographic study and shall be used only with documented clinical justification.
(5) Chiropractic physicians may order or refer patients for any diagnostic imaging study, including contrast studies using radio-opaque substances. Use of radio-opaque substances for diagnostic X-ray, other than by mouth or rectum, is not permitted.
(6) Pregnant females shall not be radiographed unless the patient's symptoms are of such significance that the proper treatment of the patient might be jeopardized without the use of such radiographs.
(7) All critical parts, i.e. fetus, eyes, thyroid gland and gonads, beyond the area of primary examination shall be shielded.
Stat. Auth.: ORS 684
Stats. Implemented: ORS 684
Hist.: 2CE 9, f. 10-16-70; 2CE 11, f. 6-20-72, ef. 7-1-72; 2CE 1-1978, f. 6-16-78, ef. 7-1-78; 2CE 2-1984, f. 8-14-84, ef. 9-1-84; 2CE 3-1985, f. 11-13-85, ef. 12-1-85; CE 7-1993, f. 12-9-93, cert. ef. 12-10-93; CE 2-1996(Temp), f. & cert. ef. 5-31-96; CE 3-1996, f. & cert. ef. 9-26-96; BCE 1-2008, f. & cert. ef. 5-29-08
X-Ray Departments, Equipment and Procedures
(1) All X-ray departments, equipment and procedures including fluoroscopy shall be in compliance with the current rules and regulations of the Oregon State Health Division Radiation Control Section, including but not limited to, the physical design of the department, occupational exposure, collimation, shielding, exposure charts.
(2) In addition:
(a) The patient shall be an adequate candidate for the radiographic or fluoroscopic procedure employed;
(b) The radiographic field shall be restricted to the area of clinical interest;
(c) Specialized views shall be used any time the area of clinical interest is not clearly visualized on a standard film;
(d) Every exposure, including post-treatment exposures, and scanograms, shall have clinical justification with adequate documentation consistent with the patient's case history;
(e) The operator shall maintain a record on each exposure of each patient containing the patient's name, the date, the operator's name or initials, the type of exposure and the radiation factors of time, mA, kVp and target film distance, including those exposures resulting in the necessity of repeat exposure for better diagnostic information such as patient motion or poor technical factors. For computerized and automated systems the recording of technique factors is not necessary as long as the equipment is calibrated and maintained. OAR 333-106-045 requires the facility to determine the typical patient exposure for their most common radiographic examinations, i.e. technique chart.
(f) Each film shall be properly identified by date of exposure, location of X-ray department, patient's name or number, patient's age, right or left marker and postural position marker and indication of the position of the patient;
(g) The patient with tremors must be immobilized;
(h) The radiographs of a patient with an antalgic posture may be taken in an upright position only if the patient is adequately supported and immobilized to insure diagnostic quality. Otherwise, the recumbent position shall be used;
(i) Upright or postural views shall not be used for any patient whose size exceeds the capacity of the X-ray equipment. Penetration must be adequate on all films;
(j) Sectional views shall be taken in preference to a single 14 x 36 inch film if the patient's size or height prevents diagnostic quality on a single 14 x 36 inch film;
(k) If two exposures are made on a single film, the area of exposure shall be critically collimated to avoid double exposure of the overlapping area;
(l) All views shall employ graduated filtration or adequate devices to attenuate the primary beam for the purpose of reducing unnecessary radiation and to improve film quality. Split screens, gradient or graded screens, paper light barriers inside the cassette, or any other attenuating device in the beam between the patient and the film shall not be permitted, other than the grid controlling scattered radiation.
(m) A record of radiographic findings on every set of radiographs reviewed shall be included in the patient's permanent file;
(n) Radiographs shall be kept and available for review for a minimum of seven years or until a minor becomes 18 years of age, whichever is longer.
Stat. Auth.: ORS 441 & 684
Stats. Implemented: ORS 684.025, 684.150, 684.155 & 441.059
Hist.: 2CE 9, f. 10-16-70; 2CE 1-1978, f. 6-16-78, ef. 7-1-78; 2CE 1-1980, f. 1-16-80, ef. 2-1-80; CE 7-1993, f. 12-9-93, cert. ef. 12-10-93; BCE 3-2004, f. & cert. ef. 12-10-04
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