Quick question for everyone. When a patient has been injected for a nuclear study prior to receiving their picc line, is there any contraindication to placing the picc line while they are still radioactive or would it be best to wait the usual 24 hour period if the line request is not urgent? May sound like a silly question, just wanted to get some opinions. Thanks for your input.
I did not know the answer to your question but was curious, so I spend a little time today searching the Internet for "radioisotopes in nuclear medicine". I found lots of information about how safe and short-lived these doses actually are, but not information about avoiding catheter insertion for any period. There was also information about radiation treatments as well as diagnostic nuclear medicine. Still nothing. My father had neck radiation for 7 weeks last spring and we were not giving any warnings about avoiding anything like catheter insertion. He was told that he should not be in contact with small children following a PET scan for several hours, but that was about it. Maybe others will have more information.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
thank you for spending time researching this. I know that our nuclear medicine techs have told us that these are short lived and usually are gone within 24 hours but I have not been able to find out anything either by researching and am hoping others can provide some insight on this. I am not sure anything could or would happen to the catheter, just wanting to provide best practice. Thanks again.
Great question.
I would think that the best way to assess it, is by finding out what is the "Half Life" of the injected radioactive substence. The radiologist who ordered it should know.
I would assume if there was a contraindiction of any kind it should be on the lable, and passed on to other health personnell, or at least be told to the client "don't let anyone start an IV on you or draw your blood until......"
our nuclear medicine department actually puts an orange sticker on the chart stating that the patient is radioactive until.... (usually 24 hours after injection). We do try to avoid lab draws and handle excretions appropriately, it's just that no one knows if this could potentially affect the catheter or not and actually I didn't either so i came to this great forum seeking help. thanks so much for everyone's input.
I agree with short half lives, low doses as stated already. Have you talked to your physics folks? There has to be someone to oversee your radiological equipment, even if you don't have therapeutic radiation, only diagnostic. My suggestion would be to get from physics a "real time" personnel dosimeter to put in your pocket. If you stand as close to the patient (maybe consenting, doing your pt ed) as you usually do during insertion for about 15 min, you'll see how much radiation you'd be getting in that amount of time. Multiply it by however long it wil take you to insert.
The other aspect would be radioactive contamination of any spilled blood. I might suggest that physics or nuc med use a geiger counter on the items (gloves, drapes) to assess radioactivity after insertion. Physics ought to be able to guide you in radioactive disposal, if needed.
Wendy Erickson RN
Eau Claire WI
We had the same situation come up last week. We got a call to place a picc because vascular would not place a port. When we asked why they would not place a port, they told us that the pt had been injected with a radio isotope (sp?) and they were told by the nuc med people that the pt was not to have ANY invasive procedure until after 10 pm that night, so needless to say, we declined to do the picc.
With further investigation, this particular isotope required 105 minutes x 5 to be considered safe for handling of the patients blood. The nuc med doc said that the times are different for different isotops, so we would just have to call and ask when we are not sure. Kinda scarey. We never knew this till now. PICC insertions usually do not bleed much, but there are those few that do. It would be just my luck that it would have been that one.