Official Course Description: MCCCD Approval: 02/28/06
DMI268 20064-20082	LEC	2 Credit(s)	2 Period(s)
Nuclear Medicine Theory II
Radiation protection including basics of radiation characteristics and units used. Regulations for radiation exposure and use of radioactive materials, dose and exposure limit recommendations and regulations, radiation detectors and monitors, and personnel monitoring. Practical methods of radiation protection, possession of radioactive materials, institutional oversight according to Nuclear Regulatory Commission (NRC) regulations. Radiation safety procedures and regulations, contamination, protection with radionuclide therapy and related NRC rules and regulations. Prerequisites: (DMI260AA and DMI260AB), or permission of the Nuclear Medicine Technology Program Director.

Go to Competencies    Go to Outline
 

MCCCD Official Course Competencies:
DMI268   20064-20082	Nuclear Medicine Theory II

1.	Describe the characteristics of gamma, x-ray, beta, and alpha radiation, including half-lives and energies of principal emissions. (I)
2.	Define the various units of exposure, absorbed dose, relative biologic effectiveness, quality factors, and dose equivalent. (I)
3.	Perform calculations using radiation units, and convert standard units to their System International equivalents. (I)
4.	Discuss the role of regulatory agencies in the field of nuclear medicine including federal, state and institutional licenses and the various federal and state regulatory documents. (II)
5.	Define the terms associated with dose and exposure limit recommendations and regulations including EDE, TEDE, DDE, CEDE, SDE, LDE, DAC, ALI, occupational and public dose, unrestricted and restricted areas. (III)
6.	Discuss the occupational limits in relation to whole body total effective dose equivalent, individual organs, lens of the eye, skin and extremities, summation of internal and external exposures, minors, and emergency exposures. (III)
7.	Describe surveys and monitoring, including requirements, equipment, and conditions requiring monitoring of external and internal occupational doses. (III, XV)
8.	Discuss the control of exposure form external sources in a restricted area. (III, XV)
9.	Discuss the regulations pertinent to the possession of detection and monitoring equipment an regulations concerning personnel monitoring. (IV, V)
10.	Discuss the principles and applications associated with time, distance, and shielding. (VI)
11.	Discuss the regulations associated with sealed sources, including inventory and leak tests. (VII)
12.	Explain the quality management program to include radionuclides covered by the program, written directives, patient identification, following directives, recordable and reportable events, program review, and records. (VIII)
13.	Discuss the general safety rules and regulations for both technolgists and patients, associated with working with specific radioactive materials. (IX, X)
14.	Explain the protocols and regulations associated with receipt and shipping of radioactive material packages, waste disposal, decay in storage, and release into sanitary sewerage. (XI, XII, XV)
15.	Describe the procedures and regulations involved with the decontamination of minor and major spills. (XIII, XV)
16.	Explain the procedures associated with therapeutic dose administration including patient identification, written directives, and informed consent. (XIV)
17.	Describe release and isolation criteria and limited restrictions. (XIV)
18.	Describe the measurement of exposure rates including surveys of restricted and unrestricted areas, safe distance markers, and calculated nursing time. (XIV)
19.	Discuss procedures in case of death, autopsy, or emergency surgery. (XIV)
20.	Explain respiratory protection and the controls used to restrict internal exposure in restricted areas. (XV)
21.	Discuss the purpose and implementation of a radiation protection program. (XV)
22.	List the regulations found in Title 10 CFR Parts 19, 20 and 35. (XV)
23.	Describe the various reports and records required by the NRC in 10CFR20. (XV)
24.	Discuss the as low as reasonably achievable (ALARA) concept as it related to a model program. (XV)
25.	Describe the regulations associated with the possession, use, calibration, and quality control requirements for dose calibrators. (XV)
26.	Discuss the regulations pertinent to the management of a mobile nuclear medicine service. (XV)
27.	Discuss the regulations associated with the use of radiopharmaceuticals for therapy. (XV)

Go to Description    Go to top of Competencies
 

MCCCD Official Course Outline:
DMI268   20064-20082	Nuclear Medicine Theory II

I. Review of the Basics A. Characteristics of radiation 1. Types of radiation a. gamma b. x-ray c. beta negative d. beta positive (positron) e. alpha 2. Half-life 3. Energy B. Units 1. Exposure a. Roentgen b. Coulomb/kilogram (C/kg) 2. Absorbed Dose a. Radiation Absorbed dose (rad) b. Gray (Gy) 3. Relative Biologic Effectiveness (RBE) and Quality Factors (QF) 4. Dose Equivalent a. Roentgen equivalent man (rem) b. Sievert (Sv) c. Calculations and conversions II. Regulation of Radiation Exposure and Use of Radioactive Materials A. Agencies 1. Nuclear Regulatory Commission (NRC) 2. Department of Transportation (DOP) 3. Food and Drug Administration (FDA) 4. Environmental Protection Agency (EPA) B. Licensing 1. Federal and state 2. Institutional licenses C. Introduction to regulatory documents 1. NRC, Title 10CFR20 2. NRC, Title 10CFR35 3. NRC, Title 10CFR71 4. DOT, Title 49CFR170 D. State regulations III. Dose and Exposure Limit Recommendations and Regulations A. Definitions 1. Effective dose equivalent (EDE) 2. Total effective dose equivalent (TEDE) 3. Deep-dose equivalent (DDE) 4. Committed effective dose equivalent (SDE) 5. Shallow-eye equivalent (LDE) 6. Eye dose equivalent (LDE) 7. Derived air concentration (DAC) 8. Annual limit on intake (ALI) 9. Occupational dose 10. Public dose 11. Restricted area 12. Unrestricted area B. Occupational limits 1. Whole body total effective dose equivalent (TEDE) 2. Individual organs, except lens of eye 3. Lens of eye 4. Skin or any extremity 5. Summation of internal and external exposures 6. Planned special exposures 7. Minors 8. Embryo/fetus of occupationally exposed worker 9. Emergency exposures C. Limits for individuals members of the public 1. Principles 2. Recommended levels D. Radiation protection programs – Title 10 CFR Part 20 E. Restricted and unrestricted areas 1. Exposure rates 2. Access 3. Signage IV. Radiation Detectors and Monitors A. Regulations concerning possession of instruments B. Survey instruments 1. Geiger-Mueller counter 2. Ionization chamber 3. Liquid scintillation 4. Well counter 5. Comparison of devices C. Personnel monitors 1. Regulations 2. X-ray film dosimeter 3. Thermo luminescent dosimeter 4. Pocket ionization chamber 5. Care and use of devices 6. Potential sources of erroneous readings 7. Comparison of devices V. Personnel Monitoring A. Regulations B. Bioassay following use of radioiodine C. Personnel exposure records 1. Report interpretation 2. Notification of exposure levels 3. Prior exposures VI. Practical Methods of Radiation Protection A. Time 1. Principles 2. Applications 3. Calculations B. Distance 1. Principles 2. Applications 3. Calculations C. Shielding 1. Principles 2. Applications 3. Calculations VII. Possession of Radioactive Materials A. Licensed materials 1. Radioactive materials for use in humans 2. Controlled reference sources 3. Exempt sources B. Activity inventory limits C. Sealed sources 1. Regulations 2. Inventory 3. Leak tests D. Lost sources VIII. Institutional Oversight - NRC regulations A. Radiation Safety Officer (RSO) 1. Responsibilities 2. Training requirements 3. Delegation of authority B. Radiation safety committee (RSC) 1. Responsibilities 2. Composition 3. Frequency of meetings 4. Records C. Quality management program (QMP) 1. Covered radionuclides 2. Written directives 3. Patient identification 4. Following directives 5. Recordable & reportable events 6. Program review 7. Records IX. Radiation Safety Procedures A. Worker protection 1. Regulations 2. Posting notices 3. Radiation safety education 4. Notification and reports to workers 5. Workers' rights 6. Declaration of pregnancy B. General safety rules when working with unsealed radioactive sources C. Use of shields and labels 1. Regulations 2. Syringes 3. Vials D. Radioactive liquids 1. Regulations 2. Preparation of kits and dose ranges E. Radioactive gases and aerosols 1. Regulations 2. Storage of volatiles and gases 3. Room concentration limits 4. Negative pressure requirements 5. Calculation 6. Postings 7. Handling Iodine-131 liquid X. Protection of the Patient A. Measurement of dose to be administered 1. Regulations 2. Calibration requirements 3. Instrument requirements 4. Instrument quality control B. Labeling of patient doses to be administered 1. Regulations 2. Definitions 3. Procedures XI. Radioactive Material Packages A. Receipt 1. Regulations 2. Procedures B. Shipping 1. Regulations 2. Procedures 3. Labels XII. Waste Disposal Procedures and Regulation A. Waste exempt form disposal regulations B. Decay-in-storage C. Discharge into sewer system D. Discharge into atmosphere E. Transfer to authorized recipient XIII. Contamination A. Ambient dose rate survey 1. Regulations 2. Survey instrument requirements 3. Survey instrument quality 4. Survey instrument control 5. Action and trigger levels B. Removable contamination survey 1. Regulations 2. Procedures 3. Action and trigger levels C. Decontamination of minor spill 1. Definition 2. Procedures D. Decontamination of major spill 1. Definition 2. Procedures XIV. Radionuclide Therapy A. Regulations B. Responsibilities of RSO and authorized user C. Dose administration 1. Patient identification 2. Written directives 3. Informed consent 4. Procedure D. Release and isolation criteria 1. No restrictions 2. Limited restrictions 3. Isolation requirements E. Limited restrictions 1. Restrictions 2. Instructions to patient F. Safety precautions involving patients in radiation-based isolation 1. Nursing instructions 2. Instructions to patient 3. Room preparation and sign postings 4. Contamination control 5. Room decontamination upon discharge 6. Disposal of waste 7. Patient care and control 8. Visitor control 9. Personnel monitoring 10. Nursing precautions and restrictions 11. Bioassay of personnel G. Measurement of exposure rates 1. Surveys of restricted and unrestricted areas 2. Safe distance markers 3. Calculated nursing time H. Procedures in case of death, autopsy, or emergency surgery XV. NRC Rules and Regulations A. Title 10 CFR Part 19 1. Posting of notices to workers a. documents b. location 2. Instructions to workers 3. Notification and reports to individuals 4. Request for inspections a. right b. request c. employee protection B. Title 10 CFR Part 20 1. Radiation protection programs 2. Occupational dose limits 3. Radiation dose limits for individual members of the public 4. Surveys and monitoring a. General requirements for surveys b. Survey equipment c. Monitoring of external and internal occupational doses 5. Control of exposure from external sources in restricted areas 6. Respiratory protection/controls to restrict internal exposure in restricted areas 7. Storage and control of licensed material a. Security of stored material b. Control of materials not in storage 8. Precautionary procedures a. Caution signs b. Posting requirements c. Exceptions to posting requirements 9. Labeling containers 10. Exceptions to labeling containers 11. Procedures for receiving and opening packages 12. Waste disposal a. General requirement. b. Decay in storage 13. Release into sanitary sewerage 14. Transfer for disposal 15. Records a. Surveys b. Prior occupational dose 16. Individual monitoring results 17. Dose to individual members of the public 18. Waste disposal 19. Form of records 20. Reports a. Reports of theft or loss of licensed material b. Notification of incidents c. Reports of excess exposure 21. Reports of individual monitoring C. Title 10 CFR Part 35 1. As Low As Reasonably Achievable (ALARA) program a. Model program b. Management commitment c. Radiation Safety Officer d. Investigational levels I and II e. Methods to meet ALARA goals 2. Radiation Safety Officer (RSO) a. Responsibilities b. Training requirements c. Delegation of authority 3. Radiation safety committee (RSC) a. Responsibilities b. Composition c. Frequency of meetings d. Records 4. Quality management program (QMP) a. Covered radionuclides b. Written directives c. Patient identification d. Following directives e. Recordable & reportable events f. Records 5. Misadministration a. Definitions (1). Recordable event (2). Reportable event b. Verbal and written reports c. Who is informed d. Records 6. Possession, use, calibration, and check of dose calibrators a. Requirement for possession and use b. Constancy check (1). Sources (2). Corrections (3). Records c. Accuracy test (1). Sources (2). Corrections (3). Records d. Linearity test (1). Range (2). Corrections (3). Records e. Test for geometry dependence (1). Range (2). Corrections (3). Records 7. Calibration and check of survey instruments a. Frequency b. Calibration procedure c. Daily operational check d. Records 8. Measurement of radiopharmaceutical doses a. Requirements b. Records 9. Authorization of calibration and reference sources a. Controlled sources b. Exempt sources 10. Syringe shields and labels a. Use of shields b. Labeling of doses to be administered 11. Vials shields and labels a. Use of shields b. Labeling requirements 12. Mobile nuclear medicine service a. Administrative requirements b. Doses c. Waste d. Security of byproduct material e. Survey meters and dose calibrators f. Records 13. Storage of volatiles and gases 14. Decay-in-storage 15. Permissible molybdenum-99 concentration a. Limits b. Measurements c. Records 16. Control of aerosols and gases a. Room concentration limits b. Negative pressure requirements c. Calculation of room ventilation time d. Postings and records 17. Use of radiopharmaceuticals for therapy

Go to Description    Go to top of Competencies    Go to top of Outline