Re: Volatility of I-131 NaI

[carol marcus <csmarcus@ucla.edu>]

At 06:57 AM 9/16/99 -0500, you wrote:
>This seems to be "pushing the envelope," legally.  Two issues:
>
>(1)  Can a physician write a prescription "to whom it may concern"?
>
>(2)  Can SSKI prescribed for one individual be given to someone else?
>
>The opinions expressed are strictly mine.
>It's not about dose it's about staying out of jail.
>
>Bill Lipton
>liptonw@dteenergy.com
>
>
>carol marcus wrote:
>
>...
>
>
>>   I also send over a fresh bottle of SSKI from time to time
>> to my RSO, in case I am not around during an accident.  NaI-131 used for
>> radiolabeling is NOT stabilized, and so it could be more of an issue in
>> research laboratories than on Nuclear Medicine services.  If there are
>> laboratories around that use significant quantities of NaI-131 or NaI-125,
>> it would probably be enough to keep some SSKI around those labs.  As it is
>> available only by prescription, get one of your docs to write as many
>> prescriptions as are necessary, and instruct that anyone using it after an
>> accident should report to Nuclear Medicine for a thyroid uptake.  As thyroid
>> uptake probes are not calibrated for I-131 or I-125 for any clinical
>> purpose, you might invest in some standards to do so in case of a worker
>> contamination situation.  At Harbor-UCLA, the RSO and Nuclear Medicine have
>> uptake probes, and whenever the RSO calibrates his probe, he sends the
>> sources over to Nuclear Medicine for a calibration as well.
>>
>> Ciao, Carol
>>
>> <csmarcus@ucla.edu>
>>
>> ************************************************************************
>> The RADSAFE Frequently Asked Questions list, archives and subscription
>> information can be accessed at http://www.ehs.uiuc.edu/~rad/radsafe.html
>
>************************************************************************
>The RADSAFE Frequently Asked Questions list, archives and subscription
>information can be accessed at http://www.ehs.uiuc.edu/~rad/radsafe.html
>



Dear Bill and Radsafers:

Medicine operates as a performance standard, with board-certified experts
deciding medical issues if they are in doubt.  We do not have the
preposterous prescriptive regulations characteristic of NRC, which doesn't
even understand what "performance standard" means.  Yes, I can write any
kind of prescription that makes medical sense.  I wrote a prescription for
the head of Los Angeles Rad Health and for the Fire Chief to get SSKI and
dispense it as needed, with the dose for adults and for children on the
bottle.  That way, when a truck carrying large quantities of I-131 crashes
and burns on the freeway, those who respond to the accident can protect
themselves and any other bystanders they think might be exposed.  I also
recommended that in such a situation, all exposed folks come in for a
radioactive iodine thyroid uptake measurement, just to document what's there
and treat as appropriate.  I don't see any problem with this--those at the
scene give the first dose of SSKI, and the persons treated are then seen by
a nuclear medicine physician, who decides if anything more is needed.

The object of regulatory groups is to protect people, not to prevent them
from being protected. 

Ciao, Carol

<csmarcus@ucla.edu>    

************************************************************************
The RADSAFE Frequently Asked Questions list, archives and subscription
information can be accessed at http://www.ehs.uiuc.edu/~rad/radsafe.html