Operational Protection in Nuclear Medicine

Question 1

List some of the essential contents of a risk assessment.

Answer 1

• Description of work.
• Location of work.
• Exposed individuals and some constraints.
• Nature of the hazards.
• Estimated doses and dose rates.
• Contamination (likelihood and causes).
• Accidents.
• Control measures (e.g. procedures, training, controlled/supervised areas, contamination monitoring, local rules etc.).

Question 2

When are local rules required?

Answer 2

• Must have for controlled areas.
• May have for supervised areas.

Question 3

List some essential contents of local rules.

Answer 3

• Identification of designated areas.
• Name of RPS.
• Arrangements for restricting access (e.g. locks, systems of work etc.).
• Dose investigation levels (agreed between RPA and ADS).
• Summary of work instructions.
• Contingency arrangements.

Question 4

What contingencies might be involved in the event of a radioactive spill?

Answer 4

Decontamination kit including:
- PPE.
- Wipes and radioactive waste bags.
- Contamination monitor.
Wipe, re-monitor, dispose (labelled) and record.

Question 5

What contingencies might be involved in the case of an emergency?

Answer 5

• Fire/injuries take precedent.
• Emergency contacts.
• Notify RPS/RPA/management.
• Evacuate is appropriate.
• Make equipment safe.
• Reduce spread of contamination.
• Prohibit entry.

Question 6

What contingencies might be in place when contamination is expected on individual?

Answer 6

• Monitor.
• Remove clothes and place in labelled radioactive waste bag.
• Wash.
• Re-monitor.
• Limit spread.

Question 7

What contingencies may be in place for a lost radioactive source?

Answer 7

• Report to RPS/RPA.
• Stop cleaning/waste removal.
• Monitor to search for source.
• Emergency contacts if required.

Question 8

How is staff protection applied in nuclear medicine?

Answer 8

• Exposures must be justified (benefit vs risk), optimised (ALARP) and dose limited.
• Time, distance, shielding and contamination principles applied.
• Contamination and ingestion can be minimised with PPE (gloves, apron etc.).

Question 9

What are some special attention areas to consider in protection of patients?

Answer 9

• Pregnant or breastfeeding patients (enquiries must be made). Test deferral may be considered. May suggest breast feeding be stopped temporarily. Justification (risks vs benefits) will again be re-considered.
• Paediatrics. Other investigations may be considered. Reduced activity, preparation and sedation may be appropriate.
• Carers and comforters (e.g. family/friend/carer in room during diagnostic administration or imaging or in room if patient can not comply with routine therapeutic radiation safety precautions). Risks/benefits and doses must be explained.
• Research. Ethics approval, ARSAC approval (on employer and practitioner license) and consent must be acquired.

Question 10

What is required in the case of a significant accidental or unintended exposure?

Answer 10

• CQC notification.
• An investigation.
• A dose estimation.