Operational ionising radiation protection Flashcards
What are the three main peices of legislation required in Nuclear Medicine and who do they apply to?
- Ionising Radiations Regulations 2017
- Protects staff and the public
- Ionising Radiation (Medical Exposures) Regulations 2017
- Protects patients
- Environmental Permitting Regulations 2016
- Accounts for storing and disposing of sources
What are the two main peices of guidance that suport the legislation?
- Approved Code of Practice for IRR17
- Medical and Dental Guidance Notes (IPEM guidance for all legislation)
What do we need risk assessments?
- Legal requirement in Regulation 8 IRR17 ‘Prior Risk Assessment’
- It must be suitable and sufficinet assessment of the radiation risk
- The risk assessment must be created based on the advice of an RPA
- It must be documented and reviewed periodically
What MUST be included in a risk assessment?
There are 9 items that should be included
- Description of work
- Location
- Exposed persons & dose constraints
- Nature of hazard
- Doses and dose rates
- Contamination
- Accidents
- Control measures
Outline the principle of hierarchy of controls in radiation protection
- Engineering controls e.g. dead man’s handle, switch, automatic dispensers in NM
- Procedural Controls e.g. Local Rules containing schemes of work, restricted entry, contingency plans, switching equip off etc
- PPE e.g. aprons etc worn by anyone required to remain in controlled area, shielded pots/syringes in NM/tongs etc
What are the Local Rules?
- They are instructions that employers must create to ensure the safety of employees and others working with ionising radiation.
- They Must have them for Controlled Areas
- They May have them for Supervised Areas
- They must be understood and signed by all in area
What MUST go into the Local Rules?
- Identify designated areas
- Name of RPS (resposible for ensuring compliance)
- Arrangements for restricting access
- Dose investigation level
- Summary of work instructions
- Contingency arrangements
What should there be contingency plans for?
There should be 5 different plans.
- Radioactive spills
- Fire/flood
- Loss/theft of source
- X-ray emergency stops
- Delivery driver accident contingency
What are the three key points about an exposure stated in IRMER?
Exposure must be:
* Justified (benefit vs risk)
* Optimised (ALARP)
* Dose limited
What are the three key radiation protection principles for external radiation?
- Time
- Distance (Inverse square law)
- Sheilding
What regulation in IRMER applies to patients of childbearing capacity?
Childbearing capacity is defined as all females aged between 12 and 55.
Regulation 11(1) A person must not carry out an exposure unless –
(f) in the case of an individual of childbearing potential, the person has enquired whether that individual is pregnant or breastfeeding, if relevant.
For which groups of patienst is there a need for special attention?
- Pregnancy
- Breastfeeding
- Paediatrics
- Research
What should you do if a patient is pregnant?
- Consider deferring test
- Alternative techniques not invovling ionising radiation should always be considered
- Re-consider risks and benefits by the practitioner
- The exposure to both the patient and foetus must be
optimised
What should you do if a patient is breastfeeding?
- Delay investigation
- Bank feeds
- Express as much milk prior to the scan and appropriately stored
- Inject the patient
- Stop breast feeding and feed the infant with stored milk/formula
- Express and discard any milk within 24 hours (This is dependant on the radiopharmaceutical)
- Re-start after ~24 hours
- External exposure from close contact with the patient for
prolonged periods of time during feeding should also be considered
When is a pregancy test REQUIRED for a Nuclear Medicine Procedure?
For a therapeutic procedure.
