Radiation Safety 2008

Nuclear Medicine & Brachytherapy Safety

OBJECTIVES: 

1. Identify location for use and storage of radioactive material

2. State what to do if radioactive material is

discovered outside the “HOT LAB”

3. Identify methods of prevention and protection from exposure to radiation.

4. Discuss Brachytherapy safety. 

MMH is licensed and regulated by the Bureau of Radiation Protection Ohio State Health Department (OSHD), permitting the use of radioactive materials. Copies of all licenses and regulations are kept in the Nuclear Medicine Department. 

Radioactive materials are used for medical purposes and are used & stored in the Nuclear Medicine Department & in the Radiation Therapy Department. The portions of the departments used to store radioactive materials are RESTRICTED AREAS. 

While working in an area of radioactive materials storage, you may be exposed to some levels of radioactivity. These areas are marked with the “Radioactive Area” symbol.

The materials are kept behind lead shields. The OSHD has set very specific levels on how much radiation may be emitted from these areas. The agencies require the areas to be monitored daily to insure the acceptable limits are not exceeded. 

The Nuclear Medicine HOT LAB is a radiation area & is restricted. Employees who are not Nuclear Medicine Techs may not enter the HOT LAB unless they are accompanied by a NM tech or designated personnel. 

Housekeeping & Maintenance personnel have access to the NMD, except for the HOT LAB. The HOT LAB is a locked area where the radioactive materials are stored and prepared. The HOT LAB has a sign on the door that reads,

 “CAUTION RADIOACTIVE MATERIAL”

Designated personnel are permitted to escort couriers & delivery personnel with radioactive parcels to the HOT LAB only for the purpose of depositing the parcels & MUST immediately leave the area after the parcel has been deposited. Hospital employees designated to escort couriers include: 

• Nuclear Medicine Personnel

• Radiology Technologists 

The Nuclear Medicine Technologist “on-call” or Bill Colwell (Director of Radiology) must be notified to open the HOT LAB after hours. 

All personnel going into the HOT LAB must conduct their work efficiently & leave the area as soon as their work is done. No food, drink or cosmetics are allowed in the HOT LAB. The refrigerator is not to be used for food or drinks.  

Radioactive packages delivered to the hospital should be wheeled in a wheelchair or on a cart to provide distance between the carrier and the radiation. 

The Inverse Square Law basically says that the further away from a radioactive substance you are, the less radiation you receive. Anyway, packages need to be delivered promptly to the HOT LAB. If you find a box outside the NMD with a “Radioactive Materials” label on it, DO NOT TOUCH THE BOX! 

Contact the Radiation Safety Officer (RSO) or a Nuclear Medicine Technologist. The Radiation Safety Officer is currently Dr. Steve Boker. Someone may be notified by calling the Radiology Department at ext. 1434.

 If the package being delivered is wet or is damaged, the driver must be detained until the RSO arrives & releases them. Never attempt to clean up what you suspect to be a radioactive spill. Try to barricade the area or close and lock the door to the area if possible. Call the RSO or the Nuclear Medicine Technologist immediately at ext. 1440 or call the Radiology Department at ext. 1434 to request NM personnel to be paged.

Do not leave as you will be checked for contamination so that the appropriate decontamination procedures may be followed if needed. 

To help decrease exposure levels, increase your distance from the radioactive source, decrease the amount of time in the presence of the radioactive source & use shielding devices (leaded glass, walls, etc.).

 If you are pregnant or think you might be pregnant, notify the RSO or Nuclear Medicine Technologist BEFORE entering a radioactive materials area. There are specific guidelines set to protect pregnant women & their unborn babies.

If you feel something is unsafe, report it to one of the following:

1. Radiation Safety Officer (Dr. Steven Boker),

2. Senior Nuclear Medicine Technologist (Judy Cunningham),

3. Nuclear Medicine Technologists (Cassi M^cCoy and Kelly Paskar),

4. Administrator or representative (must be upper level management). 

#1-3 may be contacted after regular working hours through the Radiology receptionist or technologist. The OSHD requires that you sign an acknowledgment record of radiation exposure to verify you have received this information. Please contact your department manager to do so. Employees working in radiation areas will be monitored on a monthly or quarterly basis for radiation exposure. Your manager must notify you of your results. 

If you have any questions or concerns about radiation safety, please ask the Radiation Safety Office (RSO) or the Senior Nuclear Medicine Technologist (Judy Cunningham). You have the right to have your questions answered or concerns addressed.

Brachytherapy

Brachytherapy is internal radiation therapy in which the radioactive source is placed into a body cavity or a part of the body. It is a method for delivering high, concentrated doses of radiation to a specific area.It also helps minimize the radiation dose to normal tissue.

Cure or control is the goal of care. The implanted devices are seeds or threads and may be temporary or permanent. Brachytherapy can be used in the treatment of many cancers—inoperable lung cancer, gynecological cancer, cancers involving the bone, prostate & brain cancer. 

Brachytherapy uses materials the size of grains of rice and small ribbons, which are radioactive. These materials will be transported throughout the hospital, but there are safeguards in place to protect the staff, patients, visitors & the environment. However, there is a possibility that a seed or ribbon could become dislodged, dropped or misplaced. In the unlikely event that this would happen, there are specific guidelines to follow: 

1. DO NOT TOUCH OR HANDLE the radiation material except for those individuals who have been trained.

2. DO NOT SEARCH FOR the radioactive material, however, if you see it, place a trashcan over it to make locating it easier.

3. Clear the area of all people where the radioactive material has been dropped or misplaced.

4. Dial 1440 (after hours call 1434) so that the following people may be notified immediately: 

a. Radiation Safety Officer, Dr. Steven Boker

b. Medical Physicist, Prabakar Modur

c. Radiation Oncologist, Srini Vasan

d. Radiation Therapist, Dea Osborne

e. Radiation Therapist, Teressa Valentine

5. Call Security to keep the area sealed off and secure. 

PATIENT CARE

There is NO restriction of the time spent with the patient at a distance of greater than 6 feet. Time spent in close proximity (<6 ft.) to the patient’s pelvic area, should be limited to less than one hour per day.

• The patient should not be cared for by a pregnant woman.

• All urine MUST be strained.

• Should a seed become dislodged, it may be picked up with forceps or a cotton-tipped swab & placed in the provided plastic container and lead pouch. Contact the Strecker Cancer Center immediately at extension 5000. 

• There should be no visitors who are pregnant or under the age of 18. The patient must remain in the hospital until discharged by Dr. Vasan or his designee. 

“RADIOACTIVE PRECAUTIONS” tag may be removed after the patient has been discharged and the room surveyed.