I-131 Therapies

["Michael P. Grissom" <MIKEG%SLACVM.bitnet@vmd.cso.uiuc.edu>]

1.  Quick and easy for radioiodine therapy in-patient setups is a
relative term.  I would suggest in Rob's case contacting Ken
Miller's people at Heshey Medical Center in sunny PA!  Ken's folks
have given poster sessions at HPS meetings on methods to
systematize patient set-ups for I-131 therapies.

2.  At my old hospital, we used pre-cut pieces of herculite for all
floor surfaces that the patient's "bare" feet or other body parts
could reach.  Plastic covers were installed on paging systems, bath-
room fixtures, and walls up to about half-way to the typical ceiling.
[Since on occasion a patient would re-emit the dose--maybe 100-200
mCi I-131--much faster than it went down with considerable splash/
aerosol effect!]  Plastic covers were also put on personal effects
that the patient expected to be able to take home with him or her at
the end of the in-patient period (24-72 hours).  We used tape on the
nose piece and staves of glasses and were able to remove it without
contaminating the glasses with a high percentage of effectiveness.
A shielded barrel (using portable lead shields) was used for waste
which was collected at least once a day (more often in the first 24
hours when things were warmer) and transported to a DIS storage
facility well removed from hospital occupancy areas.

3.  The bed and mattress were pre-covered with cut to fit plastic.
Linens after the therapy were collected and transported to the DIS
facility.  After 10 half-lives, the DIS barrels were sorted with
linens surveyed below detectable (using a sensitive NaI detector
in a low background) returned to normal laundry and other waste to
the appropriate waste stream:  class A waste, biohazards, sharps,
liquids, etc.

4.  Room disassembly involved a prearranged folding of the precut
materials into sections, which were transported to the DIS area and
maintained in a barrel.  By observing careful removal of tape,
with folding (and instructing the patient to minimize movement
"barefoot"), we would normally only have two or three areas of
detectable contamination which were fairly easily decontaminated with
one or two soap washings.  We did very large numbers of swipes
in the room disassembly process in order to have a "high" level
of comfort that the room was releasable for non-radioiodine
patients' use.  On occassion, the bathroom had to be controlled
for more than 2-3 days due to contamination inside the plumbing
(we did not perform "heroic" plumbing decontamination efforts!).

5.  Of course, in those days we used 2 mR/h as the controlled area
limit for tape barrier setup, posting, and delimiting visitor
restriction areas.  Also of course, the after hours duty sections of
nurses and attendants activities (and internists, etc.) were when
much of the fun began--proving that 10CFR19 training doesn't always
have a long retention time!

6.  There seem to be many approaches at various levels of rigor to
deal with this (I suspect we were at the extreme end even though
two persons could successfully disassemble most rooms setup in 2-3
hours including decon time).
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The opions expressed above are those of the author alone and do not
not represent those of the Stanford University or the US Department
of Energy.
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