Section II: Radiation
Safety Guidelines for the
Human Use of
Radionuclides.
1: Radiation Safety
Program
Responsibilities
Authorization
Nursing Procedures
Use of Radiation
Sources
2: Procedures and Nursing Instructions
General Procedures
Brachythrapy
Radiopharmaceutical
Therapy
Appendix A
Emergency Procedures
Radiation Safety Call
List
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Biological
Safety |
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Chemical
Safety |
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EHOS |
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Fire
Safety |
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Radiation
Safety |
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BRACHYTHERAPY
A list of individuals permitted to handle brachytherapy sources at the Georgia Radiation Therapy Center shall be posted in the cesium room. The following instructions shall be posted for Radiation Safety Personnel:
1. After sources are checked in at the warehouse, radiation safety personnel shall take them to the cesium room at the radiation therapy center, perform an inventory and set up a log sheet for the source container.
2. After the physician has counted the sources and completed the log entry for sources removed from or returned to the cesium room, radiation safety personnel shall verify the source count(s) and initial the log.
3. At the time of implant, radiation safety personnel must measure dose rates at one meter from the patient and in all accessible adjacent areas to the room.
4. The brachytherapy form must be completed in duplicate. One form is labeled with tape bearing the radiation symbol and put into the patient's chart as a permanent record. The outside of the patient's chart must also be labeled with tape bearing the radiation symbol.
5. The second form shall be posted on the door to the patient's room with tape which bears the radiation symbol. After removal of the sources, the second form will be removed from the door and returned to the radiation safety office as a permanent record.
6. After the physician removes the sources from the patient's room, a survey will be performed and recorded. An operational check of the instrument used will be documented.
The following instructions will be posted for the Therapy Physician:
1. No sources will be removed from the cesium room unless radiation safety personnel are present.
2. The sources must be signed out/in each time they are removed from/returned to a storage container in the cesium room. The following information shall be included in the log:
Date and time of check-out
Number and activity of sources removed from storage
Number and activity of sources in storage container after the removal
Patient's name
Destination (hospital and room number)
Initials of the individual who removed the sources from storage
Date and time of return
Number and activity of sources returned to storage
Number and activity of sources in storage container after return
Initials of the individual who returned the sources to storage
3. Only those sources intended for use in a treatment will be taken to a treatment location.
4. A tag containing the following information will be attached to the transport container:
Isotope
Number and activity of sources
Patient's name
Hospital
Initials of person inspecting and transporting the package
Institution name (GRTC) and phone number
Emergency instruction
Initials of person inspecting and transporting the package
This tag should be removed when the sources are returned to the cesium room and kept as a permanent record. If the number of sources and/or activity differs for the return trip a new tag will be completed and attached to the transport container.
5. Prior to the implant, the authorized user shall prepare an order, signed and dated, specifying the patient, treatment site, radioisotope, number of sources, total source strength and treatment time. Verify the patient's identity, using more than one method, as the individual named in the above order.
6. If the treatment plan is changed prior to explant, an amended order shall be completed and signed by the authorized user.
7. If any sources are not implanted they must not be left in the patient room but will be returned to the cesium room.
8. It is the responsibility of the physician to ensure that sources in the transport container are never left unattended.
9. A shielded container must be left in the patient's room during the treatment. If it is likely that the transport container will not be left in the room, a second container should be taken to the patient's room at the time of implant.
10. Sources must be returned to the storage container in the cesium room after removal from the patient. A count of sources removed from the patient must be reported to the radiation safety personnel.
11. In the event of temporary unloading of the sources from a patient, where the patient will be left alone in the hospital room, unattended by the GRTC physician, the sources are to be returned to the Georgia Radiation Therapy Center cesium room in the approved transport container, and may be retained in the container with appropriate radiation labels placed and the wheels of the transport container secured. The sources must be counted and the counts recorded 1) when the sources are explanted, 2) when the sources are placed in the cesium room, 3) when they are taken from the cesium room, and 4) when they are reimplanted.
12. When sources are returned to a storage container in the cesium room an inventory of the container will be documented and the results reconciled with the sources logged out. Any discrepancy must be reported to the Radiation Safety Office immediately.