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I-131 Clearance Revisited
>Date: Wed, 11 Feb 1998 16:23:33 -0500
>Reply-To: Medical Physics Mailing List <MEDPHYS@LISTS.WAYNE.EDU>
>Sender: Medical Physics Listserver <medphys@lists.wayne.edu>
>From: Mike Bohan <mike.bohan@YALE.EDU>
>Subject: I-131 Clearance Revisited
>To: Multiple recipients of list MEDPHYS <MEDPHYS@LISTS.WAYNE.EDU>
>
>
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>To Tony and Medphys:
>
>Well, life has imitated art... I really didn't want to get this far into
this but sometimes life just has a habit of smacking you upside the head!
>
>Last night at 8:00 PM, my Nuc. Med. Physician informed me that a patient
who was administered 29.9 mCi of I-131 for Hyperthyroidism at 6:00 PM,
vomited on the floor of her daughter's car on the way home!
>
>The daughter was driving on the highway at the time and could not pull over
to get her infirm mother out of the car in time. She attempted to clean up
the spill on her own after she got her mother home with hot water and no
gloves! She said that she did not see the capsule during the clean up. Her
mother was apparently nervous before the administration and refused to eat
anything before administration. Therefore, she apparently had an empty
stomach at administration and threw up about 45-60 minutes later.
>
>The daughter contacted the Nuc. Med. Physician after cleaning up the spill.
We instructed her to wash her hands thouroughly and to put any contaminated
clothing and wastes from the clean up of her car in a plastic bag and return
to the hospital in the morning.
>
>Upon arrival at the hospital, we surveyed the daughter's hands, about
1.5Kcpm @ contact with pancake GM on her right hand, which was used to clean
up the spill. No increased activity detectable at the thyroid with a GM survey.
>
>The following Dose Rates @ 1 meter were measured with a Kiethley 36150 ion
chamber:
>
>1.25 mR/hr - Floor of Car
>0.40 mR/hr - Patient's Clothing
>0.45 mR/hr - Clean-up Wastes
>
>2.1 mR/hr @ 1 meter, Total from all Sources
>
>Consequently, I calculate, using the Gamma Constant for I-131
>(2.2 R-cm^2/mCi-hr) that the patient lost approximately 9.5 mCi of the
29.9 mCi administered.
>
>We placed the waste in our decay storage. We decided that we needed to
attempt a decon of the car floor and purchased a Wet/Dry Vac. We soaked and
vacuumed the rug repeatedly with our special Radioiodine Emergency/Leak
Test Mix (NaOH, Sodium Thiosulphate, and detergent). We were able to reduce
the dose rate from the floor to 0.75 mR/hr @ 1 meter. We instructed the
daughter to buy some rubber floor mats and keep the windows open for the
next month while in the car.
>
>Lesson Learned: Don't treat radiophobic patients until you convince them
that radiation in small doses is HORMETIC! (Tongue in cheek)
>
>
>Isn't this fun??? %^)
>
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>Michael J. Bohan, RSO | e-mail: mike.bohan@yale.edu
>Yale-New Haven Hospital | Tele: (203) 688-2950
>Radiological Physics | FAX: (203) 737-4252
>20 York St. - WWW 204 | As usual, everything I say may be plausibly
>New Haven, CT 06504 | denied at my employer's convenience ...
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