Chapter 24: Radionuclide therapy
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Post‐procedural considerations
Ongoing care
Contamination control
When using unsealed sources, it is important to guard against contamination of both personnel and the hospital environment by the correct use of protective gloves, plastic aprons or gowns, and overshoes (DH [15]). The patient's body fluids are highly radioactive, especially in the days immediately after a radioactive substance has been administered. Any action that is likely to cause contamination of personnel, for example the application of cosmetics, eating, drinking or smoking when the healthcare worker's hands are contaminated with radioactivity, is prohibited.
In an emergency, the safety and medical care of the patient must take precedence over any potential radiation hazards to staff. Written radiation safety instructions must be available in all radiation areas where an emergency may arise. These instructions must contain a detailed description of how to manage a patient in the event of a medical emergency and the action required in other emergency situations, such as fire. The course of action in an emergency procedure depends on local circumstances and the nature of the emergency.
An incident occurring within the first 24 hours of a radioactive substance being administered is obviously a greater hazard than a similar incident on the day of discharge. Movement of the patient to other wards or areas, for example X‐ray or the critical care unit (CCU), must only be undertaken following the medical physics department's advice.
Incident procedure
If an accident or incident has occurred or if one is suspected, the immediate priority is to ensure the safety of patients, staff and visitors and to take whatever action is practicable to prevent further damage or injury (see Procedure guideline 24.1).
As soon as immediate care has been provided, all accidents, untoward incidents and near misses, irrespective of severity, must be reported on an incident report form. Proactive and reactive risk management processes are important. These processes should identify areas of potentially higher risk or allow lessons to be learnt from past incidents and accidents. This will allow the implementation of appropriate action plans to reduce the probability and/or severity of an incident occurring or recurring.
