Nuclear medicine patients are administered with small quantities of radiopharmaceuticals for diagnosis, or larger quantities for therapy. This means that patients will be radioactive for some time following the procedure.
In general no additional precautions, other than standard hygiene precautions, need to be taken by those caring for patients who have undergone diagnostic procedures. These patients may be cared for on the ward and can be nursed by members of staff who are or may be pregnant.
Excretions from patients who have been administered with radiopharmaceuticals may be radioactive. Therefore, it is especially important to take care when handling or disposing of pads or catheter bags from incontinent patients. Standard, universal precautions will suffice to prevent contamination of staff or other persons. Store any linen or waste that becomes contaminated with bodily fluids from the patient in an unoccupied room for 24 hours before processing normally.
More precautions may need to be taken when caring for patients who have undergone nuclear medicine therapy procedures. When these patients are treated as inpatients (usually Ward 31, CHH), ward staff are aware of the precautions required. Outpatients are provided with written instructions to carry with them and told to show these to healthcare professionals in the event that they are admitted to hospital. If the patient is admitted for surgery, contact the Nuclear Medicine department or the Radiation Protection Advisor for advice prior to surgery. If the surgery is urgent and advice cannot be obtained prior to commencement of the surgery it is safe to proceed with some additional precautions but please contact the nuclear medicine department as soon as possible.
For patients treated with Ra223 Dichloride (Xofigo) see the specific instructions available:
For other nuclear medicine therapies, standard hygiene precautions will be sufficient to protect staff. Anything contaminated with any bodily fluids (including clinical waste, excised tissue and any linen/clothing that becomes contaminated) may be radioactive and might need to be stored before disposal or releasing from theatre. Bag these materials separately, label as “Radioactive – not for disposal” and store securely until further advice is given by the Nuclear Medicine department.
In all cases, providing the advice given above is followed, there is no need to be concerned about caring for a patient who has undergone a Nuclear Medicine procedure. Patient care must always over-ride any instructions regarding radiation protection.