[ RadSafe ] RE: Traveling After Nuclear Medicine Procedure
alstonchris at netscape.net
alstonchris at netscape.net
Wed Jul 27 15:14:33 CDT 2005
Folks
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?
cheers
cja
Susan Gawarecki <loc at icx.net> wrote:
>Traveling After Nuclear Medicine Procedure May Not Fly
>http://www.medpagetoday.com/Radiology/GeneralRadiology/tb1/1403
>
>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
>procedure.
>
>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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