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In-office procedure room/fluoro room

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radic

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I'm curious about those of you who perform fluoro procedures in your office. Are there an regulations (I'm sure they vary state be state) that you have to adhere to in terms of being lead lined or any special air filtration system? Does your state require you to have a crash cart or resuscitation equipment? How about if you perform sedation with your procedures? Thanks.

Radic
 

brori

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can't speak to the air filtration and lead lining. However, crash kit and resuscitation kit should be absolutely mandatory (critical allergic reaction possible even without sedation)
 

PMR 4 MSK

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I had my own office with fluoro a few years ago. No special lead walls or air system was needed - the newer fluoro units keep scatter down. The rule I was told was to have it 4 feet from a wall.

Crash cart - should have one anyways. Even TPI's and joint injections can drop a patient here and there. We get at least 1/month going to the ER, but we have 18 docs.

Check with your state board for requirements. In-office anesthesia may require additional certification. I believe California requires additional certification for in-office fluoro, not sure of others. Mine doesn't.
 

pars

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In my state we had to call department of health to register the C-arm and pay radiology site fees. Then we had to arrange for a physicist to inspect and calibrate the C-arm, measure scatter and set up radiation badges around the office to measure potential exposure. (Lead lining depends on the number of procedures, exposure time, C-arm settings, and distance to people. I was concerned about the proximity of a waiting room but it turns out that the distance to office workers is considered the main concern because they are there day after day...) Then we got the go ahead to start. Then a few weeks later a state inspector from department of health randomly showed up with more minor requirements that needed to be instantly addressed. It really did not feel like an organized process.

I would start by contacting your department of health...
 

Aether2000

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Same for Indiana. You can call and give the health dept the room size diminisions and the specific model of C-arm anticipated, and they will tell you if you need lead (usually not). They do not permit waiting rooms to be on the other side of the wall for a fluoro suite but otherwise, no restrictions. We have no air flow requirements for office procedures, but the state has adopted a new cumbersome office anesthesia rule that will require certification by the same outfits that certify ASCs with similar rules...
 

lobelsteve

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Same for Indiana. You can call and give the health dept the room size diminisions and the specific model of C-arm anticipated, and they will tell you if you need lead (usually not). They do not permit waiting rooms to be on the other side of the wall for a fluoro suite but otherwise, no restrictions. We have no air flow requirements for office procedures, but the state has adopted a new cumbersome office anesthesia rule that will require certification by the same outfits that certify ASCs with similar rules...

Georgia: If the C is mobile and not set for use in a specific room- then no regs. If used in a specific room, you need lead, a physicist eval, and a certificate.

As far as ASC/office sedation: It is a great idea to have equal measures using equal drugs. A real PITA for us office guys as it will add to paperwork, but a real benefit to patients having no office left behind (without a crash cart, without monitoring for sedation, etc)
 
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