Dose Transmittals and Pregnancy Documentation Flashcards
Purpose and Requirement for completion of a Dose Transmittal Letter
Shall be forwarded within 30 days of receipt of final exposure.
- An individual exposed at an installation other than where their health records are maintained.
- visitors health record custodian must receive up-to-date exposure information at least quarterly.
- crew members who transfer from your command without their final exposure
Dose transmittal letters must include
Name of command forwarding
command assigned
Individual’s name SSN rate and DOB
Period of exposure
LTEDE
type of TLD worn
If exposure was reported to NDC
(no retention requirements)
Purpose of requirements for completion of a termination letter
Method of summarizing a radiation worker’s total occupational radiation exposure received during period of employment or service with USN or USMC. via naval letter
Completed on request of worker
Record that demonstrates an individual did not request a termination letter is not required
Submitted within 30 days of receipt of the individuals final exposure information.
Format for a termination letter
Current year exposures will be listed quarterly
Prior years shall be listed as command, period, and cumulative exposure during that time. Day month year
2 Statements: report is provided per P-5055.
Signed by CO
Copies to NDC and NRC (if radiographer)
Retain termination letters for 5 years
Purpose of the embryo/fetus statement
Ensure proper calculation and documentation to a declare pregnant woman and her embryo or fetus during pregnancy, and to prevent exceeding of Chapt 4 exposure limits in P-5055
Declaration
Shall be made on a SF-600, and placed in her health record.
Recording Initial Embryo/fetus
allowed exposure to the embryo the embryo/fetus from the estimated date of conception will be calculated and recorded on the SF 600 in the mother medical record
Entry will be made, signed and dated by a MDR on the SF600 from one of the statements below documenting that she was or was not monitored for occupational exposure from the estimated date of conception to the date of declaration.
Entries on /10 for documenting exposure to the fetus
Remarks:
Worker was not monitored for occupational exposure to ionizing radiation from estimated date of conception to DD MMM YYYY. The worker is transferring and will receive no further exposure at her present place of employment Assignment of a total dose equivalent for the fetus is not applicable.
Total effective dose equivalent to the fetus from the estimated date of conception to DD MMM YYYY is estimated to be XX.XXX rem. Worker is transferring and will receive no further exposure at her present place of employment.
Conclusion of pregnancy
TEDE to the embryo/fetus shall be calculated for the entire pregnancy
A statement in Remarks: /10
Worker was not occupationally exposed to ionizing radiation from the estimated date of conception to the date of conclusion of her pregnancy. The total effective dose equivalent to the fetus is not applicable
The TEDE to the fetus from the date of conception to the date of conclusion of her pregnancy is estimated to be XX.XXX rem.
