Radiation Safety Reminders During Nuc. Med. Procedures

1. Radiation Safety Reminders During Nuc. Med. Procedures ALARA Practices By Aggie Barlow, CHP, MBA, MS

2. ALARA Attention to small details is necessary to keep doses to you and others As Low As Reasonably Achievable, or ALARA. Each and every time you handle unsealed radioisotope, you must think about and plan your actions.

3. Ordering Studies Nuclear Medicine studies may only be performed when ordered by a Tufts Veterinarian or Resident. Studies requested by outside Vets, must be approved by a Tufts Vet or Resident.

4. Radioisotope Handling Suggestions Assay doses immediately before use. This allows the dosage to be at its lowest activity when handled. Use forceps or tongs to move doses to/from the dose calibrator and the transport container.

5. Labeling Ensure that there is a label on any radioactive material syringe or container that is taken from the Nuclear Medicine Hot Lab. The label information should include isotope, activity and date.

6. Transport Containers Ensure that transport containers are securely closed for transport to the animal stall or administration area. Carry the transport container away from your body. Go directly to the administration area – do not make any unnecessary stops.

7. 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.

8. Dose Storage in Animal Stalls and Areas Use care when determining where to place the dose/transport container. Ensure it can not fall, or be knocked off a stall ledge or other resting place. Ensure it can not be damaged or crushed by a moving animal. Keep the dose in the transport container until needed.

9. Handle syringe shields to minimize your extremity exposure dose The volume viewing area has the least shielding. Do not place your hand on top of this area. Grasp the shield from underneath to keep your hand exposure low.

10. Syringe Shield Handling continued The ends of the syringe shield are other areas of higher dose rate. Do not point either end of the syringe shield at yourself or others.

11. Animal Handler Position Only persons needed for the study should be in the stall/room. Plan each person’s position to keep everyone’s exposure low. Ex. When feasible, animal handlers should stand near the head of a horse, rather than along side of the injected animal.

12. Needle Sticks Administering radioisotopes to moving animals presents a needle stick injury risk. Ensure the patient is calm and as still as feasible before attempting 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.

13. Post Administration IV lines decrease the likelihood of extravasation of the dose. Flush the IV line with saline to minimize residual radioisotope in the IV line.

14. Work in a way to minimize contamination Give the animal time to calm down if needed prior to attempting to administer radioisotope. Place used syringe and other items into transport or other container immediately after use. Perform post injection surveys to detect contamination immediately and prevent tracking radioactive material through the area. Survey your gloves, lab coat, shoes.

15. Optional Good Practices If empty stalls are available, keep adjacent stalls empty so others do not have to work close to an injected animal, especially for the first day post radioisotope administration. When feasible, use of a stall away from high traffic areas reduces staff exposures.

16. 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

17. Washing Animal Urine Down Drain When hosing down stalls or other areas where an injected animal may have urinated, be sure to use a rate of water flow and angle of use such that splashes are not generated. Sprays of water used to clean floors could result in splashes of contaminated urine onto workers if extra care is not taken. Use a low water flow rate. Be sure to wear a lab coat and gloves.

18. Physical Safety The Nuclear Medicine and other staff’s main concern with large animals must be their own physical safety. The likely radiation risk to staff from performing NM exams on large animals is low compared to injury from a large animal.

19. Transfers of Radioisotope Nuclear Medicine is NOT authorized to share or transfer radioisotope to other facilities or other off site veterinarians. The Radioisotope ordered is only to be used on animal patients at Tufts School of Veterinary Medicine in Grafton.

20. Additional Information For additional information, contact your supervisor or Tufts EH&S at 617-636-3450.