RE: Code of Brachytherapy Patients

[Karin Gordon <KGordon@exchange.hsc.mb.ca>]

I assume you are referring to manually afterloaded vaginal/uterine
applicators.  When we were still doing those, we trained nursing staff
how to quickly remove the source rods and transfer them to the lead pig
kept close to the bed.  We developed a training manual for this
procedure, which I would be happy to forward to you if you wish.  The
special training conisted of a 1-hour seminar featuring a close review
of the instructions in the manual and a hands-on practical
demonstration.  We had a skeleton pelvis into which we had
semi-permanently installed the applicators, so that we could demonstrate
insertion and removal of (dummy) source rods with the special forceps
for the job.  Each participant in the seminar was required to insert and
remove the source rods in our dummy "brachy patient"at least once, to
get a sense of the "feel" of the procedure.  All of these nurses had
also undergone our basic brachytherapy radiation safety training
program.  Nursing staff assigned to these patients were required to wear
TLDs and personal digital alarming dosimeters (PADs)  - the latter
provide an extremely valuable feedback tool which really helped the
staff keep their doses ALARA - we noticed a considerable drop in doses
recorded by TLDs after we instituted the PADs.

We are now doing high dose rate brachytherapy in our radiotherapy
department using a selectron unit, so have discontinued the LDR manual
afterloading program on the ward.
 
Let me know if you want more information.

Karin
************************************************************************
************************
Karin Gordon
Radiation Safety Office
Health Sciences Centre
GC-214, 820 SherbrookSt.
Winnipeg, Manitoba
CANADA  R3A 1R9

KGordon@hsc.mb.ca           or        KGordon@cc.UManitoba.ca

phone (204) 787-2903
fax      (204) 787-1313



>----------
>From: 	SMarlette@aol.com[SMTP:SMarlette@aol.com]
>Sent: 	January 6, 1999 7:55 AM
>To: 	Multiple recipients of list
>Subject: 	Code of Brachytherapy Patients
>
>Dear Radsafers;
>I apologize if this subject has been kicked around before.  I am looking for
>suggestions of how to handle the potential event of a brachytherapy needing
>emergency surgery or coding.  The probability is small, but if a code should
>happen they really can't wait for the doc or physicist to arrive in the
>middle
>of the night.  Do you just perform the code then evaluate the exposures to
>the
>code team or try to maintain trained individuals to remove the implant during
>the early stages of the code?  There are so many people involved in a code
>and
>the probability of loss of control of the sources seems to outweigh the risk
>of the radiation to the team.  Does AAPM or anyone have guidelines?
>Thanks.
>************************************************************************
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information can be accessed at http://www.ehs.uiuc.edu/~rad/radsafe.html