Pre‐procedure

ActionRationale

1. 1.Show
   Explain and discuss the procedure with the patient and/or parents if the patient is a child.
   To ensure that the patient and/or parents understand the procedure and give their consent (O'Dwyer et al. [54], R1b).
2. 2.Show
   Apply a vital signs monitor with a variable time setting mode to the patient that will be visible to staff from outside the room.
   Following the administration of mIBG, a transient rise in blood pressure and pulse rate may occur (Brophy et al. [9], E).
3. 3.Show
   Check that the patient has a patent vascular access device in situ, usually a cannula or, for children, a central venous access device.
   To ensure administration of mIBG. E

Procedure

1. 4.Show
   The nurse or doctor will set up the iodine‐131 mIBG infusion and administer as prescribed.
   To ensure safe administration of iodine‐131 mIBG (DH [15], C).
2. 5.Show
   During the procedure, monitor blood pressure and pulse rate at 5‐minute intervals during the infusion.

   1. Monitor whole‐body retention measurements at regular intervals as directed by the medical physics department.
   2. After the procedure monitoring can be reduced to 4 hourly if the patient is clinically stable.
   To detect and monitor any change to blood pressure and pulse rate. Alter rate according to changes as prescribed by clinician. E

   This may vary according to department policies. E