NUCLEAR MEDICINE DEPARTMENT: BLUE BAND STAFF LEAFLET

1.      Introduction

The purpose of this document is to assist and support staff in contact with a patient wearing a blue wrist band, either by direct face-to-face contact or indirect contact (e.g. handling of waste). It also provides radiation protection instructions and advice following a Nuclear Medicine diagnostic investigation.

2.      Purpose

The purpose of the blue wristband is to act as a visual, easily recognised indicator that a patient has attended for a Nuclear Medicine diagnostic investigation.

This document applies to any areas (wards or departments) where the patient wearing a blue wrist band might attend.

3.      What does a blue band mean?

Patients wearing a blue band will have received intravenous or oral administration of a radioactive substance. The radioactive substance is introduced into the patient to acquire information about the patient's illness or symptoms. The patient will emit a small amount of radiation for some time after the radioactive substance has been given. The amount of radioactivity within the patient decreases in two ways. The first is by the natural physical decay of the radioisotope used, which we cannot change. The second is by excretion of the radioactive substance from the patient's body, usually via the urine and occasionally the faeces. If a patient returns to the ward or department wearing a blue wrist band, there are easy to follow guidelines to ensure that the patient is managed in a way that maintains their comfort and the safety of staff, comforters and carers who encounter them.

4.      Duties

Radiation Protection Instructions for Patients

Patients wearing a blue wristband after a diagnostic procedure should:

·         Pay extra attention to their own personal hygiene, washing their hands thoroughly after each visit to the lavatory.

·         Drink plenty of fluids and empty their bladder frequently, as this will hasten the removal of the radioactive tracer from the body.

 

Patient Breastfeeding Instructions:

Specific advice for breastfeeding patients:

·         If possible express at least one feed in advance of the radioactive administration.

·         Feed an infant as normal prior to radioactive administration

·         3 to 4 hours after administration express as much milk as possible and discard.

·         Breastfeeding can only resume after the times stated in the instruction sheet provided to the patient, post administration of the radiopharmaceutical.

 

Radioactive Contamination Instructions for Staff:

Pregnant Staff

Although the risk to the unborn child is minimal from patients who have been administered Tc-99m, to avoid undue concern, pregnant staff should avoid attending these patients.

Pregnant staff should not have physical contact with patients or patient fluids who have been administered I-123. This will be indicated on the patient's wrist band.

In the event of a patient's incontinence or a spill from a bedpan or catheter bag please do the following:

·         The soiled linen should be placed in a yellow clinical waste bag and clearly labelled Radioactive - DO NOT DISPOSE.

·         Any waste should be placed in a yellow clinical waste bag and clearly labelled RADIOACTIVE.

·         Contact the Nuclear Medicine Department (ext. 3368) to arrange for collection or further advice.

·         For out of hours collections, the bag should be stored in a locked room/cupboard until the Nuclear Medicine Department is open.

 

Blood samples and further tests on all patients with blue bands:

·         Where possible all blood tests should be performed prior to administration of radioactive substance.

·         Only clinically urgent blood tests may be performed on patients with blue wrist bands.

·         Examinations such as X-ray, Computerised Tomography (CT) should be performed prior to administration of the radiopharmaceutical.

 

Contaminated sharps/dressings from patients wearing blue bands:

·         When removing inserted devices from patients wearing blue bands, the waste items should be placed in a bag/bin and taken to the Nuclear Medicine department.

·         These items can then be handed to the nuclear medicine team for disposal.

Comforters and Carers IR(ME)R 2017 defines “comforters and carers” as individuals knowingly and willingly incurring an exposure to ionising radiation by helping, other than as part of their occupation, in the support and comfort of individuals undergoing or having undergone an exposure.

·         Ensure that the number of comforters/carers in the room with the patient is kept to a minimum.

·         Ensure that the comforter/carer is not pregnant or under the age of 18.

·         Verbally inform the comforter/carer that should they wish to remain with the patient during the uptake period they will receive a small radiation dose from the patient.

·         To minimise the dose exposure, advice comforter/carer to increasing their distance as much as possible from the patient.

 

Contact details: Nuclear Medicine Department 01895 279368