[ RadSafe ] RE: Traveling After Nuclear Medicine Procedure

alstonchris at netscape.net alstonchris at netscape.net
Wed Jul 27 15:14:33 CDT 2005


For sure, the pt should have some kind of explanatory document, from Nuc Med (preferably), or the referring doc, on his/her person, for as long as deemed necessary.  It's a standard recommendation of the Society of Nuc Med.  Myself, I don't see that there's a HIPAA issue, since it's the pt's choice to carry, and display, the document.  But, each hospital's department of risk management/HIPAA compliance, whatever, should be able to vet this, no?


Susan Gawarecki <loc at icx.net> wrote:

>Traveling After Nuclear Medicine Procedure May Not Fly
>By Michael Smith , MedPage Today Staff Writer
>Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of 
>Pennsylvania School of Medicine.
>LONDON, July 21-The threat of terrorism has made it tougher for patients 
>who have undergone radioisotope procedures to slip quietly past 
>radiation detectors deployed in airports and many other public places.
>A 55-year-old commercial pilot learned that the hard way, when he was 
>detained for questioning at Moscow's airport two days after having a 
>thallium-201 myocardial perfusion scintigram.
>After "extensive interrogation," the pilot was released, only to trip 
>radiation detectors again four days later while leaving Moscow, 
>according to a case report in the July 23 issue of The Lancet.
>The case and others like it suggest "it is important to warn patients 
>having had a thallium scan that they may trigger radiation detectors for 
>up to 30 days," wrote Richard Underwood, M.D., and colleagues of 
>London's Royal Brompton Hospital.
>In fact, the authors suggested, it should be standard practice to give 
>patients an information card after they've had diagnostic or therapeutic 
>procedures involving radioisotopes.
>The card would give:
>    * The date and place of the procedure.
>    * The radioisotope used and its half-life.
>    * The potential duration of radioactive emissions.
>    * Who to call for verification.
>More than 18 million such procedures are carried out every year and more 
>and more radiation detectors are in place in what the U.S. Nuclear 
>Regulatory Commission calls "critical infrastructure," including 
>airports, banks, railway stations, and highway tunnels.
>In 2003, the commission urged that nuclear medicine specialists make a 
>point of emphasizing that patients should follow the written 
>instructions they get after a procedure, which usually suggest not using 
>public transport within two days.
>The recommendation came after a New York State police pulled over a bus 
>traveling from New York to Atlantic City after it tripped a radiation 
>detector in a highway tunnel leading out of the city.
>It turned out that one of the passengers had received a dose of 
>iodine-131 earlier the same day, but had ignored her doctor's written 
>suggestion to avoid public transit for at least two days.
>To "avoid unnecessary concern by law enforcement authorities," the 
>commission suggested nuclear medicine specialists should "consider" 
>giving patients their business card and written information about the 
>A spokesman for the commission said there's no legal requirement to 
>report such events, so the commission doesn't know how common they are.
>But reports date back to at least 1986, when a letter to the New England 
>Journal of Medicine noted two incidents in which Secret Service agents 
>seized patients who set off radiation detectors at the White House after 
>thallium stress tests.
>The half-life of thallium-201 is 73 hours; the usual intravenous dose is 
>80 mega Becquerel. That means, wrote Dr. Underwood, that patients may 
>trigger radiation detectors for at least two weeks.
>In fact, highly sensitive modern detectors -- like those issued to 
>police and other security personnel -- may detect the traces of 
>thallium-210 for as much as a month, according to a report at the 2004 
>meeting of the Radiological Society of North America.
>The least durable radioisotope was fluorine-18, which lasted about a 
>day; the most durable was iodine-131, which in some cases could still 
>trigger detectors 95 days after it was administered.
>The pilot -- who had never complained of chest pain or shortness of 
>breath -- was shown to have a dilated and hypertrophied left ventricle 
>with no evidence of inducible ischemia, the authors noted.
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