Radiation management in the emergency department of patients with internal radiation treatment and raising awareness of health workers

Introduction and Aim: Patients who undergo internal radiation therapy come to the emergency department due to various health problems. The uncertainty of the amount of radioactivity in patients who received internal radiation during admission to the emergency department; It may pose a risk to the health of emergency service personnel and other patients. Our aims in this study; To reveal the incidence of admission to the Emergency department of patients who have undergone tests and treatments in the nuclear medicine department, to measure the daily radioactivity amount of patients who receive radioactive iodine treatment in the nuclear medicine department, to determine the level of measures to be taken during the admission of patients to the emergency department, and to reveal the awareness of the emergency department staff in terms of radiation and radiation protection. Material - Method: 453 patients (289K, 164E, mean age 46.7 ± 19.3) who applied for examination and treatment at Gaziosmanpaşa University Faculty of Medicine Department of Nuclear Medicine between January 2016 and December 2016 were included in the study. Thirteen patients (2.8%) from this patient group applied to the Emergency Service within one week after the completion of their procedures in the Nuclear Medicine Department. 38 patients (29K, 9M, mean age 50.2 ± 15.6) who were treated with high dose radioactive iodine in the same date range were included in the study. Radiation Safety Awareness Questionnaire was applied to 109 people from Gaziosmanpaşa University Adult Emergency Service and Child Emergency Service employees between 2018-2020. Results: 13 patients who applied to the Emergency Department after examination and treatment in the Nuclear Medicine Department were examined, and after which treatments they were admitted were investigated. The daily radioactivity values of the patients who received iodine therapy were evaluated. Descriptive analyzes were conducted to give information about the general characteristics of the study groups. The data of continuous variables are as mean ± standard deviation; Data on categorical variables are given as n (%). The total score of the respondents was 35.53. Total score; It creates a statistically significant difference between married and single occupational groups and between status groups. Conclusion: When 13 patients who applied to the Emergency Service after examination and treatment in the Nuclear Medicine Department were examined, 6 patients (46.1%) had myocardial perfusion scintigraphy (Tc-99m MIBI), 5 patients (38.4%) had oncological PET / CT (F-18 FDG). ) and 2 patients (15.5%) received 100 mCi high dose I-131 treatment. Radioactivity measurements were made on the 1st, 2nd and 3rd days after I-131 treatment. It was observed that there was a significant decrease in the amount of radioactivity (r = 96%) on the first day, and a slower decrease on the other days (r = 39%). Regardless of the amount of radioactivity given to the patients, it was found that the amount of radioactivity in the patients' bodies on the 3rd day was close to each other. The results of the healthcare professionals participating in the survey were evaluated statistically. Keywords: Emergency, Internal Radiation, Radiation Management