Can we be 'Nuked' by our patient?

[loricatus]

Had a patient that was going for a bleeding scan who may or may not have come back to me after the procedure. This got me thinking about how much we can be exposed to nuclear testing after effects.

I found that in a bleeding scan they use gamma radiation, which has a long half life & is extremely penetrating through body tissue. So what, that it will come out in the feces and urine-we are the one's that are exposed to that, also. I don't know about your hospital; but, ours will just send the patient back to where they came from after injecting some form of radioisotope into the patient-potentially exposing not only nurses, but future patients, visitors, etc to small amounts of radiation which are known to have a cumulative effect. BTW, the person's insensible water loss (sweat, vapor, tears, saliva) has the potential to carry the radionucleotide also.

These patients are 'hot' when they come back to us and we have no way to protect ourselves because we can't refuse to care for the patient and cannot wear protective clothing, either. Most don't even get to go into an isolation room where I work. They are just separated with a curtain from the other patients, if they are not placed out in the hallway.

Now, I know that we are exposed to ionizing radiation and that our bones already have absorbed minor amounts of radiation that occur in our environment. My concern comes from the potential for the cumulative effect of all the patients that we are exposed to and what each leaves behind-sorry, you can't take radiation off equipment, supplies, bathrooms, beds, etc that easily. A lot of little bits can certainly add up.

So, what's your thoughts on this. Am I overreacting?

[jmgrn65, RN]

yea you might be overreacting just a tad. they have such a small amt that it isn't a problem. It isn't like every patient you take care of has had a bleeding scan. There really isn't that many that have bleeding scans, because they are only good if the patient is actively bleeding.

[CRIMSON]

In nuclear cardiology testing even the short half life tenichium(myoview) is so hot that patients are picked up by geiger counter through the walls. I worked in a nuclear stress lab for a year and we had to wear multiple radiation badges. They tell you that you only get a small amt and that there is "little risk". However, it did make my migraines much worse and I was dx with osteopenia. So who knows.

[purple1953reading]

I was just going to suggest you might ask the nurse manager, and get some badges to wear, for a set period of time, and then each person exposure should be measured and give a general idea of the exposure rate.

[leslymill]

Good standard precautions against their secretions is probably the best you can do. Don't stay in rooms where they are doing bedside xrays. Limit your exposure as best you can.

Other than that you would have to go to a radiology board. Those guys have to deal with it all day long.

[EmmaG, RN]

Contact your hospital's Radiation Safety Officer (by law, they must have one). My understanding is that the amount used in nuclear med diagnostics is so minute that the body itself shields the radiation exposure to others, and that standard precautions would protect from any secretions.

With therapeutic radiation, there is a risk for exposure. In working with cancer patients, we'd take care of those who'd received I-131 or cesium implants, for example. The rooms were set up and monitored by the department under the direction of the RSO. We were required to have additional training in the care of these patients and we were issued film badges to track our exposure.

Every facility is also required by law to post contact information for the NRC if you have concerns or questions regarding any of this. Our hospital once decided to forgo the film badges and simply keep an estimate of our exposure based upon our 'usual' time in the room with these patients. Which is legal... except they didn't receive NRC authorization to do so. They were reported and received a pretty harsh warning. Oops. Our badges were returned.

Here's something you might find of interest:

http://hps.org/documents/meddiagimaging.pdf