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There is a necessity for the containment of radiation exposure to the personnel administering high doses of radio iodine solution to cancer thyroid patients. A novel methodology has been devised to effectively administer high doses of radio iodine to patients. This technique is less time consuming, exposure to the person administering the dose is far less, and yet the procedure is simple and patient friendly.
Conventionally radio iodine is administered by directly sucking with a paper straw, from an opened radioactive vial.
Materials required: IV sets of plastic tubes, two IV drip needles, one long and one short, and a beaker of water (100 – 200 ml). The plastic tubing is cut into lengths of 12 and 24 inches and fixed to the respective short and long needles [Figure 3].
Procedure: The consignment of the radioactive vial along with the lead pot is placed inside the Fume hood for administration of I-131 solution to the patient [Figure 4].
Step 1. The lead pot cover is removed and without lifting the radioactive vial out of the lead pot, the small central aluminum foil covering the rubber stopper is flipped off with the tip of a long metal screwdriver thus exposing the rubber cap.
Step 2. The needle with the attached short length plastic tubing is inserted through the rubber cap into the vial only till the top of the vial, the other end of the plastic tubing is immersed in the beaker containing plain water.
Step 3. The long needle with the attached longer plastic tubing is inserted into the vial till the tip of the needle touches the bottom of the vial and the free end of the plastic tubing is kept in the mouth of the patient, who is then asked to start sucking slowly and steadily.
As the solution from the sealed vial is sucked, vacuum is created inside the vial, as a result water from the beaker will enter the vial through the short tube flushing the entire radioactive solution as the patient continuously drinks the solution. A quantity of 100 ml of water in the beaker is sufficient to flush the entire solution from the vial leaving no significant activity in the vial. The whole procedure takes only a few minutes.
The procedure is explained to the patient and multiple cold practice runs can be given, which will reduce the patients' apprehension, and will make them drink the solution all by themselves without spillage or regurgitation.
The conventional procedure is more time consuming, and cumbersome, as it requires decapping, and the vial having to be taken out of the lead pot thus exposing the technologist to radiation all the time. Chances of inhalation of the volatile radioactive iodine solution from the opened vial are high. There is a possibility of spillage and contamination if the patient regurgitates or chokes when drinking. The technologist has to be standing next to the patient pouring water into the vial, during the whole process of the patient's drinking it. Radioactive waste is more and in a loose form, consisting of a rubber stopper, opened vial, and the straw.
The newer method has a distinct advantage in terms of ease of administration, reduced radiation exposure to the technologist, generation of less and sealed radioactive waste, and most importantly it is patient friendly. Its implementation in high-dose radio iodine administration will immensely benefit the nuclear medicine personnel.
Source of Support: Nil
Conflict of Interest: None declared.