GRAD MEDICAL EQUIPMENTS PVT LTD

OPERATING MANUAL

GRAD-300
X –ray Machine

FACTORY: E-93, SECTOR – 7, NOIDA,

Uttar Pradesh-201301.
E-mail: gradmedicalequipments@gmail.com
www.gradmedicalequipments.com
Introduction
Thank you for using a Grad Medical Equipments Pvt Ltd product. It is an honour to be associated with your
esteemed institution. We look forward for this new journey with you and assure you of our best services both in
terms of equipment quality and after sales back up at all times. For your convenience and safety, please read
these simple guidelines carefully and thoroughly. Not following them may be dangerous or illegal. Read the
complete user guide for further information.

NOTE: Your device is not water resistant. Keep it dry and switch it on with DRY hands only.

Please read this chapter thoroughly. Grad Medical Equipments Pvt Ltd devices comply with all related
safety requirements; further more it supplies all information necessary for a correct use and the warnings related
to danger associated with x-rays generating units.

However, Grad Medical Equipments Pvt Ltd will not be held responsible for any eventuality, in case of:
 equipment be used different from the intended one as described in this manual;
 Mechanical and/or electrical modifications performed during and after the installation, different from
those described in the manual.
 damages to the unit, to the operator, to the patient, caused either by wrong installation or maintenance
procedures, different from those described in this manual and in the user manual supplied with the unit,
and by wrong operations;

All technical interventions must only be performed by Grad Medical Equipments Pvt Ltd qualified
technicians.
All Guarantees/Warranties become void the moment the equipment is intervened by unauthorised personnel.

This device has not been designed to be used in environments where vapours, anaesthetic mixes flammable with
air, or oxygen and nitrous oxide can be detected.

 While performing the radiography, no one, apart from the operator and the patient, must remaining the
room.
 Though this unit has been designed with a quite acceptable protection level from electromagnetic
interference, it is advisable to install it at a certain distance from electrical energy transformation rooms,
from static continuity units, from portable receiving-transmitting units for a material use and for cellular
use. Cellular telephones are only admitted at a distance of more than 1, 5 m from any component of the
device. Other medical instruments and devices that must be used in the same installation area of the unit
must comply with the Electromagnetic Compatibility rules in force. Non-complying instruments, of
which the poor immunity from electromagnetic fields is well known, must be installed at least 3 m away
 from the equipment and supplied by a different electrical line. The equipment must be off while using
devices such as electrical scalpels or similar instruments. The equipment automatically performs some
self-test functions and therefore is able to detect some anomalous conditions. However, whenever there
are doubts on the performance of the equipment (e.g. images too clear, too dark or with artifacts), the
activity must be suspended and a Grad Medical Equipments Pvt Ltd qualified and authorized engineer
must be contacted.

During the use of the equipment, the operator must comply with the local work safety regulation, in particular
with the ones referring to the use of x-ray equipments.

Recommendations to reduce Radiation Exposure

The main objective of radiation protection procedures in an X-Ray diagnostic installation is to limit the
radiation exposure arising from the use of the diagnostic equipment as low as possible so that the radiation
doses received by the radiological personnel and general public never exceeds the maximum permissible dose
limits recommended by ICRP (International Commission on Radiological Protection).

a) The radiation exposure to the patient should be the minimum exposure required to produce images of good
diagnostic quality. Use radiation with care, caution and at a rate which is ALARA - ‘As Low As Reasonably
Achievable’
b) The speed of the film, or screen and film combinations should be of fastest speed Consistent with the
diagnostic objective of the radiographic examination.
c) During the radiographic examination, X-ray field should be collimated to dimensions not greater than the X-
ray film dimensions.
d) When a patient or film must be provided with auxiliary support during radiation exposure:
(i) Mechanical holding devices shall be used when the technique permits.
(ii) Individuals may be permitted to hold the patient when absolutely necessary and no individual shall be used
routinely for this purpose to the exclusion of others who might share the task.
iii) If a human holder is required, the holder shall be positioned such that no part of body shall be struck by
primary X-ray beam unless protected by at least 0.5 mm lead equivalent and shall be protected from direct
scatter radiation by protective lead apron of not less than 0.25 mm lead equivalent.
e) Gonald shielding of not less than 0.25 mm lead equivalent shall be used for patients who have not passed
their reproductive age during radiographic procedures in which gonads are under primary beam, except, in cases
where shielding would interfere with diagnostic procedures.
f) Doors of an X-ray room should be closed before making exposures.
g) The X-ray beam should not be directed towards doors or windows of the room, or towards control panel or
darkroom walls unless no other geometry is possible.
h) No patient should wait or change in X-ray room while another patient is being radiographed.
i) Except for patients who cannot be moved out of the room, only the staff and necessary personnel required for
medical procedure shall be inside the room during radiographic exposure. Other then patient being examined:
(i) All individuals shall be positioned such that no part of body is struck by useful beam unless protected by not
less than 0.5 mm lead equivalent.
(ii) The staff or ancillary persons shall be protected from direct scatter radiations by protective aprons or full
body protective barriers of not less than 0.25 mm lead equivalent. The aprons shall be wrapped around if an X-
Ray exposure to the back is possible.
(iii)Patients who cannot be moved out from the room shall be protected from direct scatter radiation by
protective barriers not less than 0.25 mm lead equivalent or shall be positioned in such a way that nearest
portion of the body is at least 2 meters away from both the tube head and nearest edge of image receptor.
j) Obey radiation protection rules pertinent to time, distance and shielding.
k) Prefer low exposure settings to high.
l) Use collimator to set minimal useful field size; keep image intensifier in close proximity to the patient.
Environmental risks and displacement
The equipment contains in some of its parts, materials that at the end of the unit’s life, must be recycled at an
approved location. Particularly the device contains the following materials and/or components:
 Central unit and control console: iron, copper, aluminium, non-biodegradable plastic
Material, glass-resin for printed circuit boards (PCB).
 Tube head Assembly: Tube head assembly of this x-ray equipment contains High voltage tank, x-ray
tube and oil filled alongside, printed circuit board (PCB) and lead used for controlling stray radiations.
Grad Medical Equipments Pvt Ltd is not responsible for the disposal of the device performed by the user and
for the costs
related to this intervention. It is assumed by the manufacturer and distributors of this equipment that all persons
responsible for the operation of this equipment are aware of danger and excessive exposure to X-radiation and
this equipment is sold with the understanding that Grad Medical Equipments Pvt Ltd, their agents and
representatives have no responsibility for injury or damage which may result from exposure to X-radiations.

Know your Equipment better

GRAD-300 X ray Machine is a Floor to Ceiling Line Frequency X-Ray unit. It provides ease of operation with
simple controls. In all procedures, a proper sequence of operation is required.
This equipment is to be used only by Radiologist, Radiology Technician or Doctor. Its unauthorized use can
cause injury or damage.
A Varity of tube stands & tables can be chosen depending upon the customer’s requirements. This machine is
best suited for Chest, Extremities, Skulls, and Abdomen & Pelvic for all routine & special Radiographic &
Fluoroscopy examines.

This unit incorporates State - of – the- Art technology with Line Frequency Invertors that supplies almost
constant voltage to X-Ray tube thus giving a ripple free output of X-Rays and reducing the scattered radiation
that produces good image quality and low dosage to patient and operator.

CAUTION
1. All X-Ray machines generate very high voltage internally. The components carrying high voltage are
well insulated and enclosed in housings which are connected to the ground. When properly grounded its
completely safe to handle.

PLEASE ENSURE THAT A GOOD EARTHING POINT HAS BEEN MADE AND ALL PARTS
OF THE X-RAY UNIT HAVE BEEN FIRMLY CONNECTED TO THE GROUND POINT.
 2. All X-Ray machines generated radiation which is injurious to human body. The X-Ray tube is so
protected that direct radiation does not leave the head except through the ray port. The leakage radiation
is within prescribed limits as per rules or radiation protection.

USE THIS MACHINE OBSERVING ALL RULES FOR RADIATION PROTECTION. DO

NOT EXPOSE YOUR SELF OR OTHERS TO UNNECESSARY RADIATION.

GENERAL INFORMATION

1. The X-Ray machine broadly consists of three parts:

(i) The X-Ray Generator

Consisting of X-Ray Tube head and a control 50, 100, 200 & 300mA.units.

(ii) Patient Positioning Device

A Horizontal table or a Tilting Table with Potter Bucky Grid and a place for the cassette
having X-Ray film. The cassette could be positioned suitably according to the body part
under examination.

(iii) Tube Positioning Device

A separate movable stand such as a Mobile Stand or a Floor to Ceiling type Stand. The Tube
head is maneuverable so that the radiation may be directed towards the body part.

2. The X-Ray Machine is designed to operate from standard electric power supply i.e. either single phase
230 V AC or three phase 440 V AC, 50 c/s. However in actual practice two problems are faced, viz.

(i) The line voltage seldom remains steady at the desired voltage. Depending on load conditions
of electricity and the distance of your clinic from the sub-station, the incoming supply
voltage will be higher or lower. Therefore, a line voltage regulator has been built in the
control by which the difference is adjusted internally.

The range of adjustable difference in voltage will be adjusted by our engineer to suit the
voltage variation obtained in the clinic.

The incoming supply line of the electric supply authorities may be fully loaded and / or the
wiring inside your clinic may not have the proper current carrying capacity.

Due to any of the above-stated two reasons there may be a voltage drop in the line due to X-
Ray load.

You may adjust the difference in incoming voltage by the voltage regulator. But as soon as
the X-Ray Exposure is switched on, a high current is drawn through the electricity supply
line and the voltage may drop substantially. This voltage drop occurs before the plug where
the X-Ray machine is connected.
 A voltage droop during Exposure means lower mA and lower KV than what has been
selected OR the control.

During installation, our engineer will re-calibrate the control to overcome this voltage drop in
your clinic. These re-calibrations are possible only if the voltage drop during exposure does
not exceed 5 % of the incoming voltage.

However, this re-collaboration is done with respect to the line conditions in your clinic only.
If the voltage drop is more than 5% then the machine will not deliver the rated output. It will
have to be calibrated at lower mA to obtain proper KV.

3. GUARANTEE

Our equipment is guaranteed against workmanship and material for a period of 12 months. However,
Vaccumatic parts and parts subject to normal wear and tear are not covered by guarantee. The decision
to replace or repair the parts rests solely with the company.

NO UNAUTHORIZED PERSON MUST TRY TO REPAIR THE MACHINE OR TAMPER

WITH IT IN ANY MANNER, OTHERWISE THE MACHINE MAY BE BADLY DAMAGED,
FURTHER THE WARRANTY TERMS WILL BE BECOME INVALID.

4. X-Ray Machines are built on the basis of sophisticated technology exclusive to each type. It is,
therefore, advisable that, even after the warranty period is over, the machine should be repaired only by
our authorized engineers and no other person. This will be economical to you in the long run.
5. The Manufacturers have specified rating of X-Ray tube used in this machine. But please bear in mind
that an X-Ray Tube has much longer life if it is used at about 80% of its rating. Since the mA is fixed, it
will be to your advantage to use it at lower KVP than 100 and for shorter time duration than the
maximum as far as practicable.

6. This machine is sturdily built and will render a long period of service yet it is only a machine and its life
depends on maintenance. So, please have the machine inspected and serviced at least once in six
months even if there is no noticeable defect in it.

AFTER SALES SERVICE: In the event of any break down the customer is requested to contact our
Regional Service Centre whose addresses are given in the attached list of enclosure” Company’s Sales
& Service Centre”.

7. The exposure chart given in this booklet should be used only as a preliminary guide. Your experience
will give you a proper technique chart, suited to conditions in your clinic. mAs required varies with the
type/speed of intensifying screen used to take radiograph/CR/DR Systems Used.

8. BETTER DARK ROOM TECHNIQUE PRODUCES BETTER RADIOGRAPHS.

9. PLEASE OBSERVE RECOMMENDED REST PERIOD BETWEEN EXPOSURES. ONE SECOND

EXPOSURE requires Three Minute of cooling.

OPERATING THE MACHINE

A. Line Voltage Regulation:
 1. The control panel has controls and indicators as in the diagram.

2. On MCB control is on.

3. Voltmeter will indicate line voltage.

4. If the needle is behind the red line, rotate the LINE VOLTAGE REGULATOR clockwise till the needle
reaches the red line, rotate the line voltage regulator anticlockwise till the needle is on the red line or
slightly behind it.

A. Fluoroscopy / Screening

1. Position X-Ray Tube

2. Bring the Technique selector switch in fluoro position.

3. Adjust desired KV by rotating the KV Regulator knob. Anti-clockwise rotations will decrease the KV
where as Clockwise rotation will increase it.

4. Rotate Fluoroscopy mA-Regulator knob to mid-position.

5. Press Foot Switch, X-Ray ON (Green) Lamp will light. MA-meter will indicate tube current. Rotate mA
Regulator knob to adjust it to 3mA. Release foot switch.

6. Switch off all light. Adopt your eyes to darkness for about 15 minutes.

7. Position yourself in front of the fluoroscopic screen/Lead glass assembly. Press foot switch. The image
will be visible on the fluoroscopic screen.

8. DO NOT ROTATE KV REGULATOR OR LINE VOLTAGE REGULATOR WHILE X-RAY IS ON. IT

MAY DESTROY THE X-RAY TUBE.

9. Carry on fluoroscopy intermittently by pressing and releasing foot switch at intervals, but not more than 5
secs.

10. Allow cooling time to x-ray tube after every examination. After one minute of fluoroscopy allow six
minutes rest.

11. Use lead Coat Apron and Lead Rubber Gloves.

12. Avoid fluoroscopic examination whenever possible.

A. Radiography

1. Bring the Technique selector switch in Radiographic Position.

2. Select Radiographic mA bringing the mA Selector Switch at the desired mA station.

3. KV is adjusted by rotating the KV Regulator Knob.

4. Select appropriate exposure time by bringing the time Switch at the desired time.

5. Position the body part, the cassette containing the film and X-Ray Tube Head.

6. Press the stand-by button of the Hand Exposure Switch first. After a few moment press the X-Ray
button and keep these pressed till the exposure is over (X-Ray on lamp will go off) if any one of the button is
released earlier, the exposure will immediately terminate.

7. mA-meter will indicate the tube current.

8. Switch off the machine by pressing the off (Red) button of the Line On-Off switch.

9. If using a Bucky, switch on the bucky switch. Bucky circuit is automatically included. As soon as stand
by of the hand switch is pressed, the Bucky Grid will start moving and further pressing the exposure
switch, there will be exposure.

10. If your X-Ray Machine has no Bucky , and yet Bucky switch is in ON Position, there will be no
exposure.

NOTE:

1. DO NOT ROTATE KV REGULATOR OR LINE VOLTAGE REGULATOR KNOB WHILE X-RAY

IS ON.

2. After each exposure, allow 3 to 5 minutes cooling time before making next exposure.

DO NOT MAKE TWO CONSECUTIVE EXPOSURES.

3. As per Tube rating, KV Regulation & exposure time is interlocked.

This equipment does not have any serviceable parts. Company shall not be responsible in case the equipment is
mishandled by any unauthorized person.
 EXPOSURE CHART
Sl. Part of Body Approx. Focus Film Bucky & KV mAS
No. distance (cm) Bucky Grid

1 Skull p.a. 19 100 With 75 80

2 Skull Axial 22 100 With 85 125
3 Sinuses p.a. 22 100 With 75 100
4 Sternum a.p. 21 100 - 70 125
5 Scapula a.p. 17 100 - 65 40
6 Lungs a.p. 21 150 Without 65 16
7 Heart p.a. 21 200 - 85 10
8 Oesophagus obI 27 70 With 75 30
9 Kidney-Gall 18 100 - 65 100
Bladder
10 Stomach a.p. 22 70 - 80 50
11 Duodenum a.p. 22 100 - 85 40
12 Obstetric pelvis p.a. 32 100 - 80 100
13 Obstetric pelvis 28 100 - 90 120
14 Lumber Spin a.p. 22 100 - 80 100
15 Lumber spin lat 33 100 - 85 200
16 Pelvis a.p. 20 100 - 75 80
17 Sacrum, Cocoxy 19 100 - 80 80
a.p.
18 Sacrum, Cocoxy lat 33 100 - 80 250
19 Shoulder a.p. 11 100 Without 65 15
20 Elbow 6 100 Without 60 10
21 Wrist d.v. 4 100 - 50 10
22 Wrist 1at 6 100 - 55 10
23 Hand d.v. 3 100 - 50 10
24 Hand lat/ob1 6 100 - 55 12
 25 Finger 2 100 - 45 8

26 Neck of femur lat 22 100 -- 55 10

27 Femur 13 100 - 70 50

28 Knee a.p. 12 100 Without 60 12

29 Knee 10 100 - 60 15

30 Pattela 11 100 - 60 15

31 Leg a.p. 9 70 - 60 15

32 Ankle a.p. 7 100 - 60 12

33 Ankle lat. 7 100 - 60 10

34 Heel Bone Lat. 7 100 - 60 8

35 Heel Bone axial 10 100 - 60 15

36 Foot lat. 7 100 - 60 15

37 Chest p.a. 35 150 - 55-75 12-18

38 K.U.B. 30 80 with 70-85 75

Dark Room Procedures

To obtain the best results from the X- ray machine, following should be observed generally in the Dark Room:
1. Dark room should be totally dark and no light should enter the room.

2. Loading and unloading of the cassette should be done only in Dark Room under standard safe light.

3. A qualified and trained Radiographer should only be allowed to operate the X ray Equipment.

4. Films should be stored in Dry and Dark place.

5. The Intensifying screens should be handled with care and wet finger marks of any chemicals should not
touch the screen.

6. The Developer and the Fixer solutions should always be covered and preferably new solutions to be
prepared after one month or 250 films, whichever is earlier / Capacity of Chemical Tanks.
 7. The temperature of the Developer and Fixer to be maintained between 25-30 degrees C.

8. Solutions should be stirred with wooden stick each time films are dipped. Separate wooden stick for
developer and fixer respectively be used.

X RAY FILM PROCESSING

1. Open the exposed cassette in the dark room.
2. Take out the exposed film and fix it in the hanger of suitable size.
3. Dip the film in the Developer. After about 15 seconds take the film out from the developer to visually
observe the developing status. Dip it again and take out to monitor the developing status as frequently as
possible.
4. Take out the film from the Developer tank after it is fully developed.
5. Dip the film in water to rinse all traces of developer in the film.
6. After proper rinsing, dip the film in fixer. Let it be dipped in fixer for about 5 min
7. Place the film under running water to rinse and remove all all fixer traces from the film.
8. Dry film either in open or in film drier.

Maintenance
Regular maintenance of the system is necessary for safe and trouble free use . Periodic maintenance helps in
reducing downtime, service cost and operational hazards.

Contact the local service representative for spares or preventive maintenance inspections. It is recommended
that preventive maintenance be performed every three months.

10.1 Inspecting the System

Daily Check List

 After each use, remove the power cord from Power outlet and cover the machine properly.
 Clean the Tube head and external surface of the unit by dry cloth.

Weekly Check List

 Check system connecting wires for any cracks or damage.
 Check all connections outside the machine for their firmness.
 Clean the Hand Switch with a soft dry cloth.

Monthly Check List

 Visually inspect the unit every month for any physical damage to different parts.
 In case of tube head oil leakage, immediately suspend operations and contact our authorised service
representative.
 Check that generator covers are firmly screwed from all sides.
 Check the connecting cable for any cracks, cuts etc.
 Check the system for any loose connection or loose hardware.
 Check the tube head for any leakage.
 Check for any abnormal noise or sparking in the system.
 Check condition of Dark Room chemicals (Chemical must be replaced every month or depending upon
their usage).
 10.2 General Maintenance

1. Since only trained and qualified personnel should be permitted access to the internal portion of the X ray
unit , it is recommended that service and maintenance be performed by our local Service Engineer.

2. User should confine only to preserve the external appearance of the unit by
cleaning the unit with dry cloth. It is recommended to take suitable
precautions against accumulation of dust etc. on the control panel, tube head
etc. Dust covers may be used.

3. Grad Medical Equipments maintains a nation wide network of Service Centres through which
assistance of skilled service personnel may be availed. You are requested to contact any of the centre
near you for all your service related problems.

Trouble Shooting Chart

Sr FAULT OBSERVED POSSIBLE REASON FOR THE FAULT
No.
1 Machine not switch Check Power Supply in wall socket. It should be 230VAC.
in “ON” Check the polarity of Line & Neutral in wall socket, Live must be
at right pin of the socket
Check for the main line fuse. Replace if damaged.
2 Electrical Shock can Check earthing at wall socket (Take Local electrician’s help)
be felt while touching
the operating Console
or the Generator
3 The Light Beam Check for the collimator bulb. Replace with a new 12V bulb in
Diaphragm doesn’t case it is damaged.
go ON.
4 The Machine Exposes Collimator lead shutter may be closed
but no X ray on film Developer and Fixer may be too week/old. Replace chemicals.
(transparent X ray Light beam and X ray beam not congruent ( call for authorised
film) Grad Medical Equipments Service Engineer)
Machine needs re-calibration.
5 X ray film comes out X ray film may be exposed to light accidentally.
black with no image Too long developing time
Machine needs recalibration from authorised Grad Medical
Equipments Service Engineer

The users are requested not to open the machine and access inside the Operating Console, Tube head and other
devices , as it may be dangerous and risky for them.
The servicing of X ray equipment should be entrusted to only Authorised Service Personnel. All Guarantees /
Warranties become null and void in the event of the machine being serviced/ calibrated by an unauthorised
personnel.

Dismantling & Decommissioning.

The procedure for decommissioning-ray machine depends on the type of the generating device and its
construction. Several manufacturers, upon purchase, provide users with the option to return the equipment for
disposal at a cost. The cost varies among manufacturers. If the return option is not available, the machine could
be disassembled according to the manufacturer’s specific procedures and its individual components disposed of
accordingly.

X-ray machines do not present a radiation hazard when they are not in operation.
Additionally, activation of structural components is not likely due to the nature of the produced radiation and its
interaction with the structural materials. However, many structural components are built with materials that may
be considered hazardous (e.g. lead, tungsten) for disposal purposes. These materials may be segregated and
disposed of according to the regulatory agency AERB.

X-ray generating machines are usually registered with the regulatory agency AERB. It is recommended that
users contact the regulatory agency and seek permission regarding specific requirements prior to dismantling
and disposing of any x-ray generating device. Additionally, if a license is required for the use of x-ray machines
the user should seek removal of the machine from its license upon decommissioning and disposal.