Radiation Safety Reminders During Nuc. Med. Procedures

ALARA Practices

By Aggie Barlow, CHP, MBA, MS

ALARA

Attention to small details is necessary to keepdoses to you and others As Low As Reasonably Achievable, or ALARA.

Each and every time you handle unsealedradioisotope, you must think about and planyour actions.

Ordering Studies

Nuclear Medicine studies may only beperformed when ordered by a TuftsVeterinarian or Resident.

Studies requested by outside Vets, mustbe approved by a Tufts Vet or Resident.

Radioisotope Handling Suggestions

Assay doses immediately before use. Thisallows the dosage to be at its lowest activitywhen handled.

Use forceps or tongs to move doses to/fromthe dose calibrator and the transport container.

Labeling

Ensure that there is a label on any radioactivematerial syringe or container that is taken fromthe Nuclear Medicine Hot Lab. The label information should include isotope, activityand date.

Transport Containers

Ensure that transport containers are securelyclosed for transport to the animal stallor administration area.

Carry the transport container away fromyour body. Go directly to the administrationarea – do not make any unnecessary stops.

Things to do before you administer doses of radioisotopes

To keep your exposure low, BEFORE you remove a dose from the transport container, do every task you can -

Put on a lab coat and double gloves,Verify patient identity,Discuss plans with others in area, Flush IV line to verify it is patent.

Dose Storage in Animal Stalls and Areas

Use care when determining where to place thedose/transport container. Ensure it can notfall, or be knocked off a stall ledge or otherresting place. Ensure it can not be damagedor crushed by a moving animal. Keep thedose in the transport container until needed.

Dose Administration

Do not use a dosage if it does not fall within theprescribed dosage range or it is varies morethan +/- 20% from the prescribed dosageexcept as approved by an authorized user.

When measuring a dose, you need notconsider the activity that adheres to thesyringe wall or remains in the needle.

Animal Handler Position

Only persons needed for the study should be in the stall/room. Plan each person’s position tokeep everyone’s exposure low. Ex. Whenfeasible, animal handlers should stand nearthe head of a horse, rather than along side of the injected animal.

Handle syringe shields to minimize your extremity exposure dose

The volume viewing area has the leastshielding. Do not place your hand on top of this area. Grasp the shield fromunderneath to keep your hand exposure low.

Syringe Shield Handling continued

The ends of the syringe shield are other areasof higher dose rate. Do not point either end ofthe syringe shield at yourself or others.

Needle Sticks

Administering radioisotopes to moving animalspresents a needle stick injury risk. Ensure thepatient is calm and as still as feasible beforeattempting to put the needle into the IV line port.

Use “one hand” technique if feasible. That is,keep your other hand away from the needle.

Consider the use of canulas instead of needles.Consider the use of “safe sharp” needles if possible.

Put used needles into the transport carrier ASAP.

Post Administration

IV lines decrease the likelihood of extravasation of the dose. Flush the IV linewith saline to minimize residual radioisotopein the IV line.

Work in a way to minimize contamination

Give the animal time to calm down if needed priorto attempting to administer radioisotope.Place used syringe and other items intotransport or other container immediately after use.Perform post injection surveys to detect contamination immediately and prevent tracking radioactive materialthrough the area. Survey your gloves, lab coat, shoes.Survey all areas where licensed material was used including hot lab and administration areas.

Good Lab Practices

Do not eat, drink, smoke, or apply cosmeticsin any area where licensed material is usedor stored. Avoid touching your face, hair orglasses.

Optional Good Practice

If empty stalls are available, keep adjacentstalls empty so others do not have to workclose to an injected animal, especially for thefirst day post radioisotope administration.

When feasible, use of a stall away from hightraffic areas reduces staff exposures.

Washing Animal Urine Down Drain

When hosing down stalls or other areas wherean injected animal may have urinated, be sureto use a rate of water flow and angle of usesuch that splashes are not generated. Spraysof water used to clean floors could result in splashes of contaminated urine onto workersif extra care is not taken. Use a low water flow rate. Be sure to wear a lab coat and gloves.

Spills or splashes

Restrict the area,Post signs if needed, Clean the spill, getting assistance if needed,Survey to verify dose rate is at release limits,Report the spill to your supervisor and to

Radiation Safety/EH&S

Security of Radioactive Material

Secure all licensed material when not underthe constant surveillance and immediatecontrol of an authorized individual.

Dosimetry

Wear any badge and ring provided wheneverhandling licensed radioactive material orassisting others who are using licensedmaterial. Wear badge and ring whenattending animals immediately postadministration. Exchange badges in a timelymanner.

Transfers of Radioisotope

Nuclear Medicine is NOT authorizedto share or transfer radioisotope to otherfacilities or other off site veterinarians. TheRadioisotope ordered is only to be used onanimal patients at Tufts School of Veterinary Medicine in Grafton.

Physical Safety

The Nuclear Medicine and other staff’s mainconcern with large animals must be theirown physical safety. The likely radiationrisk to staff from performing NM exams onlarge animals is low compared to injury froma large animal.

Additional Information

For additional information, contact your supervisor, FX Masse Associates or Tufts EH&S at 617 636-3450.