The Design of Diagnostic Medical Facilities where ... - ResearchGate

e assessed by the RPA as part of the room design. If a fixed fluoroscopic system is provided, the room must
contain a shielded operator console.
3.6.3 Operating theatres and recovery areas
Some surgical procedures, particularly in orthopaedic and vascular surgery, require mobile C-arm and/or
mobile X‐ray exposures. The theatre must be large enough to allow staff to stand well back from the X‐ray
tube and the patient; theatre areas of 40 m 2 (BIR, 2000) and 55 m 2 (NHS, 2001) have been recommended.
The boundaries will require shielding to a level advised by the RPA, and this would normally be Code 3 lead
equivalent, but may be greater for interventional procedures or less for low workloads or for applications
such as intra-operative dental work. It may be feasible to install X‐ray warning lights outside the theatre door.
When building a suite of theatres, it may be pragmatic to shield them all to the same level of shielding as
their usage may change over time.
Dedicated theatres used for interventional X‐ray procedures will require significant protection as these
generally involve fixed equipment with higher power output. The boundaries will generally need to be
shielded as for an X‐ray room. A shielded operating console should be included, and X‐ray warning lights
must be installed outside the door.
The use of mobile X‐ray units is often required in the recovery area. Examinations will often involve chest
X‐rays, and thus the considerations listed below for ICU/CCU/HDU apply, and special consideration must be
given to the need for shielding the floor and the boundary behind the head of the trolley.
Lateral X‐rays are often required after orthopaedic surgery, and thus a shielded trolley bay may be required.
This situation is similar to that discussed previously for multi-bay resuscitation room in A&E. The Theatre area
also needs to include a secure storage place for mobile X‐ray units and mobile C-arms.
3.6.4 ICU/CCU, high dependency units/neonatal units and general wards
In situations where it is not possible or advisable to move patients to the X‐ray department, mobile X‐ray
equipment is required. This occurs in neonatal units, intensive or coronary care units, and high dependency
units. Shielding will often be required to contain the primary beam. Since the majority of exposures involve
chest X‐rays with the patient lying supine, semi-supine or sitting upright, shielding is often required for the
floor and at the back of the bed.
The RPA must assess the shielding requirements. Consideration should be given to the location of the bed.
In new developments, beds are often positioned in front of windows, where shielding may be required.
Generally, Code 3 lead equivalence is sufficient in these situations. Figures 3.9(a) and 3.9(b) illustrate the
issues involved. If the bed backs onto a solid concrete wall, additional lead shielding is not normally required.
However the need for shielding of the floor area must be assessed.
Occasionally mobile X‐rays will be required in general wards, and the above considerations will also apply. A
risk assessment must be carried out to determine if structural shielding is required, but more often than not,
the assessment shows that, because of the low workload, no additional shielding is required.
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The Design of Diagnostic Medical Facilities where Ionising Radiation is used