Radiation Emergencies : Nuclear Medicine (Part I) || Spill Management || Radiation Safety Training

This video is guide for Radiation safety officers in handling radiation emergencies of Nuclear Medicine. This video will tell actions in various radiation emergencies as first responder, actions as subject expert, incident reporting and their timelines etc.

Type of Radiation Emergencies in Nuclear Medicine
1. Misadministration
2. Spills of Radioactive Material
3. Incidental Release of Radioactive Dusts, Mists, Fumes, and Gases
4. Vomiting of radiopharmaceutical by the patient
5. Death of a patient with administered radiopharmaceuticals in the body
6. Fire
7. Loss or theft of radioactive Material
8. Security Threat
9. Bomb Threat
10. Natural Disaster

Articles required for handling radiation emergencies is called Emergency Response Articles and this contains the following:

Personal protective equipments such as lab coats, disposable gloves, safety glasses, shoe covers, and surgical caps

Decontamination kit containing following items:

• Area demarcation tape
• Absorbent paper
• Sponge, Mop, Scrubber, Pail, Rope, Tong/ forceps
• Signage of radioactivity
• Small & medium size plastic bags
• Alkalizing solution for decontamination
• Liquid soap
Survey meter/ contamination monitors
Emergency preparedness plan

Methods for prevention of accidents
 Prepare safe code of practice & Educate radiation safety.
 Identify emergency situations and plan to avoid such situation.
 Any accidents, happening in the department should be attended to immediately and reported.
 Adequate number of trained staff to carry out the emergency plan.
 All instruments to be routinely checked and kept in working condition.
 Maintain proper inventory of radioisotopes received, used, in stock and disposed.

Principals of Handling an Emergency Situation
 Proper labelling are areas with restricted access.
 Emergency Contact information to be pasted in area of use.
 Readily available decontamination kit and Personal Protective Equipment (PPE) for handling spills.
 Regular Radiation Safety Training.
 The Emergency Response Plan and an Evacuation diagram to be available in the area.

Handling of Radiation Emergencies
1. Misadministration
Following types of mis-administrations are possible:
 Administration of radio-pharmaceutical to a wrong patient.
 Administration through wrong route e.g. oral, intravenous injection or muscular injection
 Administration of wrong radiopharmaceuticals.
 Administration of wrong dose
 A diagnostic dose, more than 50 percent of prescribed.
 A therapeutic dose more than 10 percent of prescribed
 Administration of radio-pharmaceutical in pregnant female patient without confirming the pregnancy or lactation.

Prevention of mis-administration
The chances of mis-administration can be reduced by adopting standard operating procedures of following minimum points as mentioned below:
 Tagging and segregating the vials and syringes with proper labeling.  Writing the amount of activity, name of the source and patient on the vial or syringe containing dose.
 Checking the labels of vial or syringes before administration.
 Measuring the activity and identifying the source before administration.
 Proper identification of name, number and case of the patients with case file, and
 Ensuring that the female patient is not pregnant.

Primary actions to be taken in case of a misadministration
 Immediate actions to minimize any adverse effects.
 Inform responsible nuclear medicine physician.
 Inform patient and referring physician.
 Calculate dose.

Spills of Radioactive material
All efforts are to made to avoid spills of radioactive material. However, in the event of accidental spillage, keep calm, use common sense, protect people and do not spread the contamination.
Spills are classified in two categories:
If the level of contamination is less than 100 times of Acceptable Surface Contamination Levels and a restriction for access does not exceed 24 hours, it is MINOR SPILL else it is MAJOR.
Alternatively
Table 2 can be used to distinguish minor vs major spill for different radioisotopes. If less than this, it is minor else it is Major Spill.
 Indicate corrective measures.
 Implement measures.

Actions by first responder
 Confine the spill immediately, by dropping paper towels or other absorbent material onto it.
 Evacuate the area immediately so that persons will not walk over the spill and spread the contamination.
 If the spilled material has splashed onto a person or clothing, remove the clothes and collect in a polythene bag and keep in radioactive waste storage room.
 Report the incident to the RSO promptly.
 Allow no one to return to work in the area unless approved by the RSO.
 Cooperate and follow the instruction of RSO.

Видео Radiation Emergencies : Nuclear Medicine (Part I) || Spill Management || Radiation Safety Training канала Nuclear Medicine Solutions